A U-shaped relationship between plasma folate and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Shu Chun Chuang, Rachael Stolzenberg-Solomon, Per Magne Ueland, Stein Emil Vollset, Øivind Midttun, Anja Olsen, Anne Tjønneland, Kim Overvad, Marie Christine Boutron-Ruault, Sophie Morois, Franoise Clavel-Chapelon, Birgit Teucher, Rudolf Kaaks, Cornelia Weikert, Heiner Boeing, Antonia Trichopoulou, Vassiliki Benetou, Androniki Naska, Mazda Jenab, Nadia SlimaniIsabelle Romieu, Dominique S. Michaud, Domenico Palli, Sabina Sieri, Salvatore Panico, Carlotta Sacerdote, Rosario Tumino, Guri Skeie, Eric J. Duell, Laudina Rodriguez, Esther Molina-Montes, José María Huerta, Nerea Larrañaga, Aurelio Barricarte Gurrea, Dorthe Johansen, Jonas Manjer, Weimin Ye, Malin Sund, Petra H M Peeters, Suzanne Jeurnink, Nicholas Wareham, Kay Tee Khaw, Francesca Crowe, Elio Riboli, Bas Bueno-De-Mesquita, Paolo Vineis

Research output: Contribution to journalArticle

Abstract

Folate intake has shown an inverse association with pancreatic cancer; nevertheless, results from plasma measurements were inconsistent. The aim of this study is to examine the association between plasma total homocysteine, methionine, folate, cobalamin, pyridoxal 5′-phosphate, riboflavin, flavin mononucleotide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). We conducted a nested case-control study in the EPIC cohort, which has an average of 9.6 years of follow-up (1992-2006), using 463 incident pancreatic cancer cases. Controls were matched to each case by center, sex, age (±1 year), date (±1 year) and time (±3 h) at blood collection and fasting status. Conditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for education, smoking status, plasma cotinine concentration, alcohol drinking, body mass index and diabetes status. We observed a U-shaped association between plasma folate and pancreatic cancer risk. The ORs for plasma folate ≤5, 5-10, 10-15 (reference), 15-20, and >20 nmol/L were 1.58 (95% CI = 0.72-3.46), 1.39 (0.93-2.08), 1.0 (reference), 0.79 (0.52-1.21), and 1.34 (0.89-2.02), respectively. Methionine was associated with an increased risk in men (per quintile increment: OR = 1.17, 95% CI = 1.00-1.38) but not in women (OR = 0.91, 95% CI = 0.78-1.07; p for heterogeneity

Original languageEnglish
Pages (from-to)1808-1816
Number of pages9
JournalEuropean Journal of Cancer
Volume47
Issue number12
DOIs
Publication statusPublished - Aug 2011

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Keywords

  • EPIC
  • Folate
  • One-carbon metabolism
  • Pancreatic cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Chuang, S. C., Stolzenberg-Solomon, R., Ueland, P. M., Vollset, S. E., Midttun, Ø., Olsen, A., Tjønneland, A., Overvad, K., Boutron-Ruault, M. C., Morois, S., Clavel-Chapelon, F., Teucher, B., Kaaks, R., Weikert, C., Boeing, H., Trichopoulou, A., Benetou, V., Naska, A., Jenab, M., ... Vineis, P. (2011). A U-shaped relationship between plasma folate and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. European Journal of Cancer, 47(12), 1808-1816. https://doi.org/10.1016/j.ejca.2011.02.007