期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 113, 期 6, 页码 1468-1481出版社
ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqaa422
关键词
colorectal cancer; B vitamins; dietary supplement use; health-related quality of life; fatigue; functioning; biomarkers; folates; vitamin B6; pyridoxal 5 '-phosphate
资金
- Wereld Kanker Onderzoek Fonds (WKOF)
- World Cancer Research Fund International (WCRF International)
- World Cancer Research Fund International Regular Grant Programme (WKOF/WCRF, the Netherlands) [2014/1179]
- Alpe d'Huzes/Dutch Cancer Society (KWF Kankerbestrijding, the Netherlands) [UM 2012-5653, UW 2013-5927, UW 2015-7946]
- ERA-NET (European Research Area Network) on Translational Cancer Research (TRANSCAN/Dutch Cancer Society, the Netherlands) [UW 2013-6397, UW 2014-6877]
- Netherlands Organization for Health Research and Development (ZonMw, the Netherlands)
- Stichting Alpe d'HuZes within the research program Leven met kanker of the Dutch Cancer Society [UM-2010-4867, UM-2012-5653]
- Kankeronderzoekfonds Limburg as part of Health Foundation Limburg [00005739]
- WKOF, WCRF International grant program [2016/1620]
- ERA-NET on Translational Cancer Research (TRANSCAN/Dutch Cancer Society, the Netherlands) [UM 2014-6877]
- ERANET on Translational Cancer Research [01KT1503]
- Federal Ministry of Education and Research
- National Cancer Institute [R01 CA189184]
- Matthias Lackas Foundation
- Stiftung Lebensblicke
The study found that higher levels of vitamin B6 in the body were associated with better quality of life, but there was limited evidence of an association between changes in B-vitamin concentrations in the blood and quality of life. Participants who stopped using B-vitamin supplements reported higher levels of fatigue.
Background: B vitamins have been associated with the risk and progression of colorectal cancer (CRC), given their central roles in nucleotide synthesis and methylation, yet their association with quality of life in established CRC is unclear. Objectives: To investigate whether quality of life 6 months postdiagnosis is associated with: 1) circulating concentrations of B vitamins and related biomarkers 6 months postdiagnosis; 2) changes in these concentrations between diagnosis and 6 months postdiagnosis; 3) B-vitamin supplement use 6 months postdiagnosis; and 4) changes in B-vitamin supplement use between diagnosis and 6 months postdiagnosis. Methods: We included 1676 newly diagnosed stage I-III CRC patients from 3 prospective European cohorts. Circulating concentrations of 9 biomarkers related to the B vitamins folate, riboflavin, vitamin B6, and cobalamin were measured at diagnosis and 6 months postdiagnosis. Information on dietary supplement use was collected at both time points. Health-related quality of life (global quality of life, functioning scales, and fatigue) was assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 6 months postdiagnosis. Confounder-adjusted linear regression analyses were performed, adjusted for multiple testing. Results: Higher pyridoxal 5'-phosphate (PLP) was cross-sectionally associated with better physical, role, and social functioning, as well as reduced fatigue, 6 months postdiagnosis. Associations were observed for a doubling in the hydroxykynurenine ratio [3-hydroxykynurenine: (kynurenic acid + xanthurenic acid + 3-hydroxyanthranilic acid + anthranilic acid); an inverse marker of vitamin B6] and both reduced global quality of life (beta = -3.62; 95% CI: -5.88, -1.36) and worse physical functioning (beta = -5.01; 95% CI: -7.09, -2.94). Dose-response relations were observed for PLP and quality of life. No associations were observed for changes in biomarker concentrations between diagnosis and 6 months. Participants who stopped using B-vitamin supplements after diagnosis reported higher fatigue than nonusers. Conclusions: Higher vitamin B6 status was associated with better quality of life, yet limited associations were observed for the use of B-vitamin supplements. Vitamin B6 needs further study to clarify its role in relation to quality of life.
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