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目的探讨膳食叶酸摄入、5,10-亚甲基四氢叶酸还原酶(MTHFR)基因多态性联合暴露与乳腺癌发病风险的关系。方法采用匹配病例对照研究,从2014年4月-2015年5月,序贯收集乳腺癌新发病例794例,从2015年4月~2015年6月,招募健康女性805例。采用问卷调查收集研究对象一般人口学特征、乳腺癌常见危险因素、膳食情况等信息;采用飞行时间质谱生物分析技术检测MTHFRC677T基因型;采用非条件多因素Logistic回归分析MTHFRC677T基因多态性及膳食叶酸(水果、蔬菜日摄入量)与乳腺癌发病风险的关系。结果调整年龄、婚姻状况、主动吸烟、被动吸烟、人工流产次数、乳腺良性疾病、日均能量摄入后,结果提示水果日摄入量低增加乳腺癌发病风险(OR=1.869,95%CI:1.494~2.337);以水果高摄入联合MTHFRC677T-CC型为参照,水果低摄入联合CC型或CT+TT型均增加乳腺癌发病风险(ORs>1.6,95%CI不包含1)。结论膳食叶酸(水果)的摄入可降低乳腺癌的发病风险,但与叶酸代谢相关的MTHFR C677T基因多态性可能不独立影响乳腺癌的发病风险。
Objective To investigate the relationship between dietary folic acid intake, 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and the risk of breast cancer. Methods A matched case-control study was conducted. From April 2014 to May 2015, 794 newly diagnosed cases of breast cancer were collected sequentially. From April 2015 to June 2015, 805 healthy women were enrolled. MTHFRC677T genotypes were detected by time of flight mass spectrometry bioassay using Multivariate Logistic regression to analyze the association between MTHFRC677T gene polymorphisms and dietary folic acid (Fruit, vegetable daily intake) and the risk of breast cancer. Results The results showed that low daily intake of fruits increased the risk of breast cancer (OR = 1.869, 95% CI: 1.494 ~ 2.337). The low intake of fruits combined with CC or CT + TT increased the incidence of breast cancer (OR> 1.6, 95% CI did not contain 1) with reference to the high intake of fruits in combination with MTHFRC677T-CC. Conclusion Dietary folic acid (fruit) intake may reduce the risk of breast cancer. However, MTHFR C677T gene polymorphism associated with folic acid metabolism may not affect the risk of breast cancer independently.