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Baseline plasma total homocysteine and adenoma recurrence: results from a double blind randomized clinical trial of aspirin and folate supplementation.
- Source :
-
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2010 Oct; Vol. 19 (10), pp. 2541-8. Date of Electronic Publication: 2010 Sep 14. - Publication Year :
- 2010
-
Abstract
- Background: Elevated plasma total homocysteine (tHcy) is an accepted marker of functional folate deficiency but may have independent effects on colorectal neoplasia risk. It is uncertain whether plasma tHcy is associated with risk at the low levels common in a folate-fortified population.<br />Methods: Study subjects, about half of whom were recruited after fortification of grain products with folic acid in the United States and Canada, consisted of 871 individuals with a recent history of one or more colorectal adenomas who were randomized to receive either a 1 mg/day folic acid supplement or a placebo within one of three randomly assigned aspirin treatment groups (placebo, 81, or 325 mg/day). Nonfasting plasma tHcy was determined by a gas chromatograph mass chromatography method. We estimated adjusted risk ratios and 95% confidence intervals (95% CI) for one or more adenoma recurrences for each quartile of baseline plasma tHcy using generalized linear regression with an overdispersed Poisson approximation to the binomial.<br />Results: The Q4/Q1 adjusted risk ratio for any adenoma was 0.98 (95% CI, 0.70-1.38; P trend = 0.17) in the placebo group, and 0.81 (95% CI, 0.58-1.12; P-trend = 0.17) in the folic acid group. Results were similar for adenomas with advanced features. There was no modification by sex, aspirin treatment group or MTHFR 677C>T genotype.<br />Conclusions: Plasma tHcy is not an independent marker for an increase in colorectal adenoma recurrence risk in postfortification populations in which plasma tHcy levels are in the lower range of values.<br />Impact: Controlling plasma tHcy levels is unlikely to favorably modify adenoma recurrence risk in folate-fortified populations.<br /> (©2010 AACR.)
- Subjects :
- Adenoma enzymology
Adenoma prevention & control
Adult
Aged
Aged, 80 and over
Aspirin blood
Colorectal Neoplasms enzymology
Colorectal Neoplasms prevention & control
Double-Blind Method
Folic Acid blood
Humans
Methylenetetrahydrofolate Reductase (NADPH2) genetics
Middle Aged
Neoplasm Recurrence, Local enzymology
Neoplasm Recurrence, Local prevention & control
Surveys and Questionnaires
Young Adult
Adenoma blood
Aspirin therapeutic use
Colorectal Neoplasms blood
Folic Acid therapeutic use
Homocysteine blood
Neoplasm Recurrence, Local blood
Subjects
Details
- Language :
- English
- ISSN :
- 1538-7755
- Volume :
- 19
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20841390
- Full Text :
- https://doi.org/10.1158/1055-9965.EPI-10-0536