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American Journal of Epidemiology Advance Access originally published online on November 6, 2007
American Journal of Epidemiology 2008 167(3):287-294; doi:10.1093/aje/kwm307
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Nutrients Contributing to One-Carbon Metabolism and Risk of Non-Hodgkin Lymphoma Subtypes

Stella Koutros1,2, Yawei Zhang1, Yong Zhu1, Susan T. Mayne1, Sheila Hoar Zahm2, Theodore R. Holford1, Brian P. Leaderer1, Peter Boyle3 and Tongzhang Zheng1

1 Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT
2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
3 International Agency for Research on Cancer, Lyon, France

Correspondence to Stella Koutros, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Executive Plaza South 8111, MSC 7240, Rockville, MD 20852 (e-mail: koutross{at}mail.nih.gov).

Received for publication May 22, 2007. Accepted for publication September 21, 2007.

Because little is known about the etiology of non-Hodgkin lymphoma (NHL), a heterogeneous disease, and because dietary factors are modifiable, the authors examined the associations between nutrients related to one-carbon metabolism and risk of NHL in a population-based case-control study of Connecticut women diagnosed between 1996 and 2000. A total of 594 cases and 710 controls completed a food frequency questionnaire for determination of intakes of folate, vitamins B2, B6, and B12, and methionine. Through unconditional logistic regression, the authors estimated the risk of NHL associated with intake of each nutrient. Comparing the highest quartile of intake with the lowest, the authors found lower risks of all NHL associated with increasing intakes of folate and methionine. Analysis by NHL subtype indicated lower risks of diffuse large B-cell lymphoma (highest quartile vs. lowest: odds ratio (OR) = 0.54, 95% confidence interval (CI): 0.30, 0.98; p-trend = 0.02) and marginal zone lymphoma (highest quartile vs. lowest: OR = 0.08, 95% CI: 0.02, 0.26; p-trend < 0.0001) associated with folate. Vitamin B6 intake was also associated with lower risk of NHL overall and of marginal zone lymphoma (highest quartile vs. lowest: OR = 0.23, 95% CI: 0.08, 0.65; p-trend = 0.002). These findings suggest that these nutrients may be important for susceptibility to NHL.

case-control studies; diet; folic acid; lymphoma, non-Hodgkin; metabolism; methionine; vitamins

Abbreviations: CI, confidence interval; CLL, chronic lymphocytic leukemia; NHL, non-Hodgkin lymphoma; OR, odds ratio; SLL, small lymphocytic lymphoma


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