Serum Folate and Cancer Mortality Among U.S. Adults: Findings from the Third National Health and Nutritional Examination Survey Linked Mortality File

Abstract

Background: The relation between folate status and cancer is controversial. Several epidemiologic studies have suggested that increased folate intake is associated with reduced risk of various cancers, others have found no such associations, and a few have suggested that high folate intake might increase the risk of certain cancers. Methods: Using data from the Third National Health and Nutrition Examination Survey (NHANES III) Mortality File, a prospective cohort study of a nationally representative sample of 14,611 U.S. adults, we conducted Cox proportional hazards regression modeling to investigate the association of baseline serum folate concentrations and all-cancer mortality determined from linked death certificate data. Results: Relative to the lowest quintile of serum folate (<3.0 ng/mL), the multivariable-adjusted hazard ratios across quintiles 2 to 5 were: 1.61 [95% confidence interval (95% CI), 1.11-2.32], 1.00 (95% CI, 0.65-1.49), 1.39 (95% CI, 0.96-2.03), and 0.85 (95% CI, 0.59-1.22). These findings did not differ substantially by age or sex, but the higher risk for those in the second quintile appeared limited to non-Hispanic whites. Conclusion: These findings suggest that there may be a nonlinear relationship between folate status and the risk of all-cancer mortality such that persons with low, but not grossly deficient, serum blood folate concentrations may be at increased risk. Further study is needed to determine whether these findings are due to chance, and if not, to clarify their biological basis.

Maternal Folate Intake and Risk of Childhood Brain and Spinal Cord Tumors: A Systematic Review and Meta-Analysis

“…Furthermore, folate has garnered much attention because of its purported role in the pathogenesis of neural tube defects and adverse pregnancy outcomes [18,[59][60][61]. Although the appreciation of the role of folate in carcinogenesis is a recent development, folate deficiency has been implicated in the development of several human epithelial cell cancers, such as cervical, colorectal, lung, and esophageal cancer, and many others [22,[62][63][64][65]. Thus, considering the preventive effect of folate on neural tube defects, on other maternal and infant outcomes, and CBSCT, it is important to reinforce WHO recommendation of folic acid consumption before and during pregnancy and to improve the level of adherence to this recommendation.…”

Niveles plasmáticos de la vitamina B12 y ácido fólico en pacientes con hepatopatía crónica

“…También el ácido fólico y la vitamina B 12 intervienen en la síntesis de proteínas que son esenciales en la integridad y función de las membranas celulares, así como en el trasporte de metabolitos y transmisión de señales 28 . Estudios epidemiológicos y de cohortes muestran discrepancias en relación al efecto que puedan tener las concentraciones de ácido fólico y vitamina B 12 en la aparición de tumores 29 o con un aumento de la mortalidad por este motivo 30,31 . Podría ocurrir que, las alteraciones plasmáticas de vitamina B 12 y ácido fólico en los pacientes cirróticos tuvieran relación con un peor pronóstico (hepatocarcinoma, trasplante y mortalidad).…”

Methylation variation atIGF2differentially methylated regions and maternal folic acid use before and during pregnancy

“…[19][20][21] As the population coverage and dose of FA intake increase, monitoring its effects on human health will require an understanding of mechanisms underlying the benefits (hence potential risks) of FA supplement use. Although epigenetic mechanisms are hypothesized, 48 empirical data are lacking.…”