背景:维生素B6是与胰腺癌发展相关的途径中重要的酶促辅因子。为了评估维生素B6作为胰腺癌的预防因子,需要一种生物标志物方法来克服自我报告饮食信息固有的局限性.
方法:为了确定血清B6维生素的水平,包括吡哆醛5'-磷酸(PLP),吡哆醛(PL),4-吡啶酮酸(PA),和PA/(PLP+PL)比率(PAr),与胰腺癌的风险有关,在上海的两个前瞻性队列中,对187例胰腺癌事件病例和258例个体匹配对照进行了两项巢式病例对照研究,包括81,501例参与者,中国,和新加坡。PLP,PL,和PA在诊断前血清样品中定量。使用条件逻辑回归计算赔率和95%置信区间(CI),并对潜在的混杂因素进行调整。
结果:上海和新加坡队列对照受试者的血清PLP浓度中位数(第5-95百分位数)分别为25.7(10.0-91.7)nmol/L和58.1(20.8-563.0)nmol/L,分别。在汇总分析中,高血清PLP与胰腺癌风险降低相关(趋势P=0.048);与维生素B6缺乏(<20nmol/L)相比,最高PLP类别(>52.4nmol/L)的校正比值比为0.46(95%CI0.23,0.92).血清PL没有发现关联,PA,或PAr与胰腺癌的风险。
结论:较高浓度的PLP可以预防胰腺癌的发展。在循环维生素B6浓度低的人群中,保护作用可能更为明显。
BACKGROUND: Vitamin B6 is an important enzymatic cofactor in pathways relevant for the development of pancreatic cancer. In order to evaluate vitamin B6 as a preventive factor for pancreatic cancer, a biomarker approach is needed to overcome the limitations inherent in self-reported dietary information.
METHODS: To determine whether levels of serum B6 vitamers, including pyridoxal 5\'-phosphate (PLP), pyridoxal (PL), 4-pyridoxic acid (PA), and the PA/(PLP + PL) ratio (PAr), were associated with risk of pancreatic cancer, two nested
case-control studies of 187 incident pancreatic cancer cases and 258 individually matched controls were conducted within two prospective cohorts of 81,501 participants in Shanghai, China, and Singapore. PLP, PL, and PA were quantified in pre-diagnostic serum samples. Odds ratios and 95% confidence intervals (CIs) were calculated using conditional logistic regression with adjustment for potential confounders.
RESULTS: The median (5th-95th percentiles) concentrations of serum PLP among control subjects of the Shanghai and Singapore cohorts were 25.7 (10.0-91.7) nmol/L and 58.1 (20.8-563.0) nmol/L, respectively. In pooled analyses, high serum PLP was associated with a reduced risk of pancreatic cancer (P for trend = 0.048); the adjusted odds ratio for the highest category of PLP (>52.4 nmol/L) was 0.46 (95% CI 0.23, 0.92) compared to vitamin B6 deficiency (<20 nmol/L). No associations were found for serum PL, PA, or PAr with pancreatic cancer risk.
CONCLUSIONS: Higher concentrations of PLP may protect against the development of pancreatic cancer. The protective effect may be more apparent in populations with low concentrations of circulating vitamin B6.