食管癌和胃癌的发病率与 B 族维生素水平较低有关。我们在 Golestan 队列研究中对食管鳞状细胞癌（ESCC；340 个病例对照对）和胃癌（GC；352 个病例对照对）进行了配对巢式病例对照研究。主要暴露是血浆生物标志物：核黄素和黄素单核苷酸（FMN）（维生素 B2）、磷酸吡哆醛（PLP）（B6）、钴胺素（B12）、对氨基苯甲酰谷氨酸（pABG）（叶酸）和总同型半胱氨酸（tHcy）；缺乏指标：3-羟基犬尿氨酸比率（维生素 B6 的 HK-r）和甲基丙二酸（维生素 B12 的 MMA）。我们使用条件逻辑回归调整匹配因素和潜在混杂因素来估计比值比 (OR) 和 95% 置信区间 (CI)。大部分参与者的 B 族维生素水平较低，而 tHcy 水平较高。测得的维生素 B 水平均与 ESCC 和 GC 的风险无关，但 MMA 水平升高与 ESCC 略有相关（OR = 1.42，95% CI = 0.99-2.04）并与 GC 相关（OR = 1.53，95） %CI = 1.05-2.22）。 HK-r 最高四分位数与最低四分位相比 (OR = 1.95, 95%CI = 1.19-3.21) 以及 HK-r 水平升高与非升高 (OR = 1.59, 95% CI = 1.13-) 的胃癌风险较高2.25）。 tHcy 最高四分位数与最低四分位数相比，ESCC（OR = 2.81，95% CI = 1.54-5.13）和胃癌（OR = 2.09，95%CI = 1.17-3.73）的风险较高。总之，在血浆 B 族维生素水平普遍较低的人群中，维生素 B12 不足与 ESCC 和 GC 的较高风险相关，维生素 B6 水平不足与 GC 的风险较高相关。较高水平的 tHcy（OCM 功能的整体指标）与较高的 ESCC 和 GC 风险相关。© 2024 作者。约翰·威利出版的《国际癌症杂志》

Incidence of esophageal and gastric cancer has been linked to low B-vitamin status. We conducted matched nested case-control studies of incident esophageal squamous cell carcinoma (ESCC; 340 case-control pairs) and gastric cancer (GC; 352 case-control pairs) within the Golestan Cohort Study. The primary exposure was plasma biomarkers: riboflavin and flavin mononucleotide (FMN) (vitamin B2), pyridoxal phosphate (PLP) (B6), cobalamin (B12), para-aminobenzoylglutamate (pABG) (folate), and total homocysteine (tHcy); and indicators for deficiency: 3-hydroxykyurenine-ratio (HK-r for vitamin B6) and methylmalonic acid (MMA for B12). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression adjusting for matching factors and potential confounders. High proportions of participants had low B-vitamin and high tHcy levels. None of the measured vitamin B levels was associated with the risk of ESCC and GC, but elevated level of MMA was marginally associated with ESCC (OR = 1.42, 95% CI = 0.99-2.04) and associated with GC (OR = 1.53, 95% CI = 1.05-2.22). Risk of GC was higher for the highest versus lowest quartile of HK-r (OR = 1.95, 95%CI = 1.19-3.21) and for elevated versus non-elevated HK-r level (OR = 1.59, 95% CI = 1.13-2.25). Risk of ESCC (OR = 2.81, 95% CI = 1.54-5.13) and gastric cancer (OR = 2.09, 95%CI = 1.17-3.73) was higher for the highest versus lowest quartile of tHcy. In conclusion, insufficient vitamin B12 was associated with higher risk of ESCC and GC, and insufficient vitamin B6 status was associated with higher risk of GC in this population with prevalent low plasma B-vitamin status. Higher level of tHcy, a global indicator of OCM function, was associated with higher risk of ESCC and GC.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.