Carcinogenesis Advance Access originally published online on March 13, 2008
Carcinogenesis 2008 29(9):1765-1773; doi:10.1093/carcin/bgn074
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Associations of dietary methyl donor intake with MLH1 promoter hypermethylation and related molecular phenotypes in sporadic colorectal cancer
1 Department of Epidemiology, GROW—School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
2 Department of Pathology, GROW—School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
3 Department of Methodology and Statistics, Maastricht University, PO BOX 616, 6200MD Maastricht, The Netherlands
4 Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands
* To whom correspondence should be addressed. Tel: +31 43 3882236; Fax: +31 43 3884128; Email: stefan.devogel{at}epid.unimaas.nl
Intake of dietary factors that serve as methyl group donors may influence promoter hypermethylation in colorectal carcinogenesis. We investigated whether dietary folate, vitamin B2 and vitamin B6, methionine and alcohol were associated with mutL homologue 1 (MLH1) hypermethylation and the related molecular phenotypes of MLH1 protein expression, microsatellite instability (MSI) and BRAF mutations in patients with colorectal carcinomas. Within the Netherlands Cohort Study on diet and cancer (n = 120 852), 648 cases (367 men and 281 women) and 4059 subcohort members were available for data analyses from a follow-up period between 2.3 and 7.3 years after baseline. Gender-specific adjusted incidence rate ratios (RRs) were calculated over categories of dietary intake in case-cohort analyses. The intakes of folate, vitamin B2, methionine and alcohol were not associated with risk of tumors showing MLH1 hypermethylation, those lacking MLH1 protein expression or with MSI. Among men, we observed strong positive associations between folate and BRAF-mutated tumors (RR = 3.04 for the highest versus lowest tertile of intake, Ptrend = 0.03) and between vitamin B6 and tumors showing MLH1 hypermethylation (highest versus lowest tertile: RR = 3.23, Ptrend = 0.03). Among women, the relative risks of tumors with BRAF mutations or MLH1 hypermethylation were also increased in the highest tertiles of folate and vitamin B6 intake, respectively, but these did not reach statistical significance. The positive associations between folate intake and tumors harboring BRAF mutations and between vitamin B6 intake and those showing MLH1 hypermethylation were most pronounced among men and may suggest that these vitamins enhance colorectal cancer risk through genetic as well as epigenetic aberrations.
Abbreviations: CI, confidence interval; CRC, colorectal cancer; FFQ, food frequency questionnaire; MLH1, mutL homologue 1; MSI, microsatellite instability; MSP, methylation-specific PCR; PALGA, Pathologisch Anatomisch Landelijk Geautomatiseerd Archief; PCR, polymerase chain reaction; RR, rate ratio
Received January 25, 2008; revised March 3, 2008; accepted March 6, 2008.
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