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Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake.

https://arctichealth.org/en/permalink/ahliterature61482
Source
Stroke. 2005 Jul;36(7):1426-31
Publication Type
Article
Date
Jul-2005
Author
Bethany Van Guelpen
Johan Hultdin
Ingegerd Johansson
Birgitta Stegmayr
Göran Hallmans
Torbjörn K Nilsson
Lars Weinehall
Cornelia Witthöft
Richard Palmqvist
Anna Winkvist
Author Affiliation
Department of Medical Biosciences, Umeå University Hospital, Umeå, Sweden. Bethany.Van.Guelpen@nutrires.umu.se
Source
Stroke. 2005 Jul;36(7):1426-31
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Brain Ischemia - etiology - pathology
Case-Control Studies
Cerebrovascular Accident - etiology - pathology
Cohort Studies
Diet
Female
Folic Acid - blood - pharmacology
Hemorrhage - blood
Homocysteine - blood
Humans
Male
Methylenetetrahydrofolate Reductase (NADPH2) - genetics
Middle Aged
Multivariate Analysis
Nutritional Status
Odds Ratio
Polymorphism, Genetic
Prospective Studies
Registries
Research Support, Non-U.S. Gov't
Risk
Sweden
Vitamin B 12 - pharmacology
Abstract
BACKGROUND AND PURPOSE: Folate metabolism has been implicated in stroke. However, the possibility of a role for folate and vitamin B12, independent of their effects on homocysteine status, remains to be explored. The aim of this prospective, nested case-referent study was to relate plasma and dietary intake levels of folate and vitamin B12 to risk of stroke, taking into consideration plasma homocysteine concentrations and methylenetetrahydrofolate reductase polymorphisms. METHODS: Subjects were 334 ischemic and 62 hemorrhagic stroke cases and matched double referents from the population-based Northern Sweden Health and Disease Cohort. RESULTS: Plasma folate was statistically significantly associated with risk of hemorrhagic stroke in an inverse linear manner, both in univariate analysis and after adjustment for conventional risk factors including hypertension (odds ratio [OR] for highest versus lowest quartile 0.21 (95% confidence interval [CI], 0.06 to 0.71; P for trend=0.008)). Risk estimates were attenuated by inclusion of homocysteine in the model (OR, 0.34; 95% CI, 0.08 to 1.40; P for trend=0.088). A similar pattern was observed for increasing folate intake (multivariate OR, 0.07; 95% CI, 0.01 to 0.55; P for trend=0.031 without homocysteine, and OR, 0.16, 95% CI, 0.02 to 1.23; P for trend=0.118 with homocysteine in the analysis). We found little evidence of an association between plasma or dietary folate and risk of ischemic stroke. Neither plasma nor dietary vitamin B12 was associated with risk of either stroke subtype. CONCLUSIONS: The results of this study suggest a protective role for folate, possibly in addition to its effects on homocysteine status, in hemorrhagic but not ischemic stroke.
PubMed ID
15933256 View in PubMed
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Low-carbohydrate, high-protein diet score and risk of incident cancer; a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature261486
Source
Nutr J. 2013;12:58
Publication Type
Article
Date
2013
Author
Lena Maria Nilsson
Anna Winkvist
Ingegerd Johansson
Bernt Lindahl
Göran Hallmans
Per Lenner
Bethany Van Guelpen
Source
Nutr J. 2013;12:58
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Diet, Carbohydrate-Restricted
Dietary Fats - administration & dosage
Dietary Proteins - administration & dosage
Energy intake
Fatty Acids - administration & dosage - adverse effects
Female
Follow-Up Studies
Food Habits
Humans
Incidence
Male
Middle Aged
Neoplasms - epidemiology
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Sweden - epidemiology
Abstract
Although carbohydrate reduction of varying degrees is a popular and controversial dietary trend, potential long-term effects for health, and cancer in specific, are largely unknown.
We studied a previously established low-carbohydrate, high-protein (LCHP) score in relation to the incidence of cancer and specific cancer types in a population-based cohort in northern Sweden. Participants were 62,582 men and women with up to 17.8 years of follow-up (median 9.7), including 3,059 prospective cancer cases. Cox regression analyses were performed for a LCHP score based on the sum of energy-adjusted deciles of carbohydrate (descending) and protein (ascending) intake labeled 1 to 10, with higher scores representing a diet lower in carbohydrates and higher in protein. Important potential confounders were accounted for, and the role of metabolic risk profile, macronutrient quality including saturated fat intake, and adequacy of energy intake reporting was explored.
For the lowest to highest LCHP scores, 2 to 20, carbohydrate intakes ranged from median 60.9 to 38.9% of total energy intake. Both protein (primarily animal sources) and particularly fat (both saturated and unsaturated) intakes increased with increasing LCHP scores. LCHP score was not related to cancer risk, except for a non-dose-dependent, positive association for respiratory tract cancer that was statistically significant in men. The multivariate hazard ratio for medium (9-13) versus low (2-8) LCHP scores was 1.84 (95% confidence interval: 1.05-3.23; p-trend?=?0.38). Other analyses were largely consistent with the main results, although LCHP score was associated with colorectal cancer risk inversely in women with high saturated fat intakes, and positively in men with higher LCHP scores based on vegetable protein.
These largely null results provide important information concerning the long-term safety of moderate carbohydrate reduction and consequent increases in protein and, in this cohort, especially fat intakes. In order to determine the effects of stricter carbohydrate restriction, further studies encompassing a wider range of macronutrient intakes are warranted.
Notes
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PubMed ID
23651548 View in PubMed
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One-carbon metabolism and CpG island methylator phenotype status in incident colorectal cancer: a nested case-referent study.

https://arctichealth.org/en/permalink/ahliterature99464
Source
Cancer Causes Control. 2010 Apr;21(4):557-66
Publication Type
Article
Date
Apr-2010
Author
Bethany Van Guelpen
Anna M Dahlin
Johan Hultdin
Vincy Eklöf
Ingegerd Johansson
Maria L Henriksson
Inger Cullman
Göran Hallmans
Richard Palmqvist
Author Affiliation
Department of Medical Biosciences, Pathology, Umeå University, Building 6M, 2nd Floor, 90185 Umeå, Sweden. bethany.van.guelpen@medbio.umu.se
Source
Cancer Causes Control. 2010 Apr;21(4):557-66
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged
Carbon - metabolism
Case-Control Studies
Colorectal Neoplasms - epidemiology - genetics - metabolism
CpG Islands - genetics
DNA Methylation
Female
Folic Acid - blood
Genetic Predisposition to Disease
Homocysteine - blood
Humans
Incidence
Male
Methylenetetrahydrofolate Reductase (NADPH2) - genetics
Middle Aged
Multivariate Analysis
Odds Ratio
Phenotype
Polymorphism, Single Nucleotide
Risk factors
Sweden - epidemiology
Vitamin B 12 - blood
Abstract
OBJECTIVE: We related prediagnostic plasma folate, vitamin B12, and total homocysteine concentrations, and the MTHFR 677C>T and 1298A>C polymorphisms, to the risk of colorectal cancer with and without the CpG island methylator phenotype (CIMP). METHODS: This was a nested case-referent study of 190 cases and double, matched referents from the large, population-based Northern Sweden Health and Disease Study. Using archival tumor tissue, promoter methylation in an eight-gene panel was analyzed by MethyLight. RESULTS: A reduced risk of CIMP-low/CIMP-high CRC (> or =1 gene methylated) was observed in subjects with very low plasma folate concentrations [multivariate odds ratio 2.96 (95% CI 1.24-7.08) for quintiles two to five versus one (lowest)]. With the exception of a reduced risk in MTHFR 677 TT-homozygotes, none of the other one-carbon variables were associated with the risk of CIMP-low/CIMP-high CRC. For CIMP-negative CRC, only the MTHFR polymorphisms were statistically significantly related to risk, inversely for 677C>T and positively for 1298A>C, but a tendency toward a reduced risk was observed in subjects with an adequate methyl availability, combining the plasma variables [multivariate odds ratio 0.61 (95% CI 0.32-1.15)]. CONCLUSION: Though limited by low power, these findings suggest the possibility of different roles for one-carbon metabolism in different pathways of colorectal tumorigenesis.
PubMed ID
20012180 View in PubMed
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Plasma folate, vitamin B12, and homocysteine and prostate cancer risk: a prospective study.

https://arctichealth.org/en/permalink/ahliterature17418
Source
Int J Cancer. 2005 Feb 20;113(5):819-24
Publication Type
Article
Date
Feb-20-2005
Author
Johan Hultdin
Bethany Van Guelpen
Anders Bergh
Göran Hallmans
Pär Stattin
Author Affiliation
Department of Medical Biosciences, Clinical Chemistry, Umeå University Hospital, Umeå, Sweden.
Source
Int J Cancer. 2005 Feb 20;113(5):819-24
Date
Feb-20-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bone Neoplasms - blood - etiology - secondary
Case-Control Studies
Comparative Study
Folic Acid - blood
Homocysteine - blood
Humans
Lymphatic Metastasis
Male
Middle Aged
Prospective Studies
Prostatic Neoplasms - blood - epidemiology - etiology
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Vitamin B 12 - blood
Abstract
The role of folate metabolism in cancer development is a topic of much current interest, with maintenance of adequate folate status tending to show a protective effect. Aberrant methylation, primarily hypermethylation of certain genes including tumor suppressors, has been implicated in prostate cancer development. Folate, vitamin B12 and homocysteine are essential for methyl group metabolism and thus also for DNA methylation. We related plasma levels of these factors to prostate cancer risk in a prospective study of 254 case subjects and 514 matched control subjects. Increasing plasma levels of folate and vitamin B12 were statistically significantly associated with increased prostate cancer risk, with an odds ratio of 1.60 (95% CI = 1.03-2.49; p(trend) = 0.02) for folate and 2.63 (95% CI = 1.61-4.29; p(trend)
PubMed ID
15499634 View in PubMed
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Prospective study of first stroke in relation to plasma homocysteine and MTHFR 677C>T and 1298A>C genotypes and haplotypes - evidence for an association with hemorrhagic stroke.

https://arctichealth.org/en/permalink/ahliterature100984
Source
Clin Chem Lab Med. 2011 Jun 2;
Publication Type
Article
Date
Jun-2-2011
Author
Johan Hultdin
Bethany Van Guelpen
Anna Winkvist
Göran Hallmans
Lars Weinehall
Birgitta Stegmayr
Torbjörn K Nilsson
Author Affiliation
Clinical Chemistry, Department of Medical Biosciences, Umeå University, Umeå, Sweden.
Source
Clin Chem Lab Med. 2011 Jun 2;
Date
Jun-2-2011
Language
English
Publication Type
Article
Abstract
Abstract Background: Abnormalities in homocysteine metabolism have been suggested as risk factors for stroke. The aim of this prospective study was to examine whether total plasma homocysteine concentration (tHcy) and its main genetic determinant, methylene tetrahydrofolate reductase (MTHFR) polymorphisms, were associated with first ischemic or hemorrhagic stroke. Methods: This was a nested case-referent study of 321 ischemic and 60 hemorrhagic stroke cases, defined by WHO MONICA criteria and each matched with two event-free referents for sex, age, cohort, recruitment date and geographical area. All subjects were from the population-based Northern Sweden Health and Disease Study cohorts. Odds ratios were determined by conditional logistic regression. Results: The mean follow-up time was 4.2 years. Both tHcy and MTHFR were independent predictors of hemorrhagic stroke in multivariate models including body mass index, hypertension and, for MTHFR, tHcy [OR for the highest vs. lowest tHcy quartile 8.13 (95% CI 1.83-36.1), p(trend)=0.002; OR for MTHFR 677TT vs. 677CC genotype 3.62 (95% CI 0.77-17.0), p(trend)=0.040]. Haplotype analyses confirmed that the MTHFR 677T-1298A haplotype was positively associated with hemorrhagic stroke [OR 1.81 (95% CI 1.09-3.00), p=0.022], whereas the MTHFR 677C-1298C haplotype was not significantly related to either hemorrhagic or ischemic stroke. Neither tHcy nor the MTHFR polymorphisms were significant predictors of ischemic stroke. Conclusion: Both elevated plasma homocysteine levels and the MTHFR 677T allele are indicators of increased risk of hemorrhagic stroke in the northern Swedish population.
PubMed ID
21631392 View in PubMed
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Vitamin B-6 and colorectal cancer risk: a prospective population-based study using 3 distinct plasma markers of vitamin B-6 status.

https://arctichealth.org/en/permalink/ahliterature283480
Source
Am J Clin Nutr. 2017 Apr;105(4):897-904
Publication Type
Article
Date
Apr-2017
Author
Björn Gylling
Robin Myte
Jörn Schneede
Göran Hallmans
Jenny Häggström
Ingegerd Johansson
Arve Ulvik
Per M Ueland
Bethany Van Guelpen
Richard Palmqvist
Source
Am J Clin Nutr. 2017 Apr;105(4):897-904
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biomarkers - blood
Case-Control Studies
Colorectal Neoplasms - blood - etiology - prevention & control
Female
Humans
Inflammation - blood - etiology
Kynurenine - analogs & derivatives - blood
Male
Middle Aged
Nutritional Status
Odds Ratio
Oxidative Stress
Prospective Studies
Pyridoxal - blood
Pyridoxal Phosphate - blood
Pyridoxic Acid - blood
Sweden
Vitamin B 6 - blood
Vitamin B 6 Deficiency - blood - complications
Xanthurenates - blood
Abstract
Background: Higher plasma concentrations of the vitamin B-6 marker pyridoxal 5'-phosphate (PLP) have been associated with reduced colorectal cancer (CRC) risk. Inflammatory processes, including vitamin B-6 catabolism, could explain such findings.Objective: We investigated 3 biomarkers of vitamin B-6 status in relation to CRC risk.Design: This was a prospective case-control study of 613 CRC cases and 1190 matched controls nested within the Northern Sweden Health and Disease Study (n = 114,679). Participants were followed from 1985 to 2009, and the median follow-up from baseline to CRC diagnosis was 8.2 y. PLP, pyridoxal, pyridoxic acid (PA), 3-hydroxykynurenine, and xanthurenic acids (XAs) were measured in plasma with the use of liquid chromatography-tandem mass spectrometry. We calculated relative and absolute risks of CRC for PLP and the ratios 3-hydroxykynurenine:XA (HK:XA), an inverse marker of functional vitamin B-6 status, and PA:(PLP + pyridoxal) (PAr), a marker of inflammation and oxidative stress and an inverse marker of vitamin B-6 status.Results: Plasma PLP concentrations were associated with a reduced CRC risk for the third compared with the first quartile and for PLP sufficiency compared with deficiency [OR: 0.60 (95% CI: 0.44, 0.81) and OR: 0.55 (95% CI: 0.37, 0.81), respectively]. HK:XA and PAr were both associated with increased CRC risk [OR: 1.48 (95% CI: 1.08, 2.02) and OR: 1.50 (95% CI: 1.10, 2.04), respectively] for the fourth compared with the first quartile. For HK:XA and PAr, the findings were mainly observed in study participants with
PubMed ID
28275126 View in PubMed
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6 records – page 1 of 1.