Document Detail


Association of hyperhomocysteinemia and folate deficiency with colon tumors in patients with inflammatory bowel disease.
MedLine Citation:
PMID:  17941074     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Folate deficiency associated with hyperhomocysteinemia might increase the risk of developing colorectal cancer. The aim of this study was to evaluate factors associated with colonic carcinogenesis, in particular, folate and homocysteinemia levels, in a cross-sectional study of patients with inflammatory bowel disease (IBD). METHODS: IBD patients with carcinogenic lesions discovered during colonoscopy [dysplasia-associated lesion or masses (DALM), colorectal cancer] were included and compared with the whole population of IBD patients with a normal colonoscopy performed during the same period. The following parameters were collected at the time of colonoscopy: age, sex, type, duration, activity, and extent of the disease, treatment, smoking status, and vitamin B12, folate, and homocysteinemia levels. Univariate and multivariate analyses were performed after adjusting for the main parameters. RESULTS: One hundred and fourteen patients [41 with ulcerative colitis (UC), 73 with Crohn's disease (CD)] were included. Twenty-six carcinogenic lesions were isolated: 18 DALM (7 high-grade and 11 low-grade dysplasia) and 8 colorectal cancers. In univariate analysis, the factors associated with carcinogenesis were: active smoking (P = 0.03), folate level < 145 pmol/L (P = 0.02), hyperhomocysteinemia > 15 micromol/L (P = 0.003), duration of disease > 10 years (P = 0.006), and UC (P = 0.02). In multivariate analysis, patients with hyperhomocysteinemia associated with folate deficiency had 17 times as many carcinogenic lesions as patients with normal homocysteinemia whatever the folate status and duration of the disease (P = 0.01). Patients with hyperhomocysteinemia without folate deficiency had 2.5 times as many carcinogenic lesions as patients with normal homocysteinemia (P = 0.08). CONCLUSIONS: Our data suggest that in IBD patients with normal homocysteinemia, the increase in carcinogenic risk is negligible. Conversely, in patients with hyperhomocysteinemia, folate deficiency may be associated with increased colorectal carcinogenesis in IBD patients.
Authors:
Jean Marc Phelip; Veronique Ducros; Jean Luc Faucheron; Bernard Flourie; Xavier Roblin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  14     ISSN:  1078-0998     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-10     Completed Date:  2008-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, University Hospital of Grenoble, France. JMPhelip@chu-grenoble.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Colonic Neoplasms / epidemiology,  etiology*,  pathology
Cross-Sectional Studies
Female
Folic Acid Deficiency / complications*
France / epidemiology
Humans
Hyperhomocysteinemia / complications*
Inflammatory Bowel Diseases / complications*
Logistic Models
Male
Multivariate Analysis
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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