The EPIC-Norfolk Study
A comparison of complementary measures of vitamin B6 status, function, and metabolism in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
The American Journal of Clinical Nutrition 2020 ; 114: 338-347.
Clasen JL, Heath AK, Van Puyvelde H, Huybrechts I, Park JY, Ferrari P, Johansson M, Scelo G, Ulvik A, Midttun Ø, Ueland PM, Dahm CC, Halkjær J, Olsen A, Johnson T, Katzke V, Schulze MB, Masala G, Segrado F, De Magistris MS, Sacerdote C, Ocké MC, Luján-Barroso L, Ching-López A, Huerta JM, Ardanaz E, Amiano P, Ericson U, Manjer J, Gylling B, Johansson I, Schmidt J, Weiderpass E, Riboli E, Cross AJ, and Muller DC
DOI : 10.1093/ajcn/nqab045
PubMed ID : 33829249
PMCID : PMC8246608
URL : https://linkinghub.elsevier.com/retrieve/pii/S0002916522003343
Abstract
Vitamin B6 insufficiency has been linked to increased risk of cancer and other chronic diseases. The circulating concentration of pyridoxal 5'-phosphate (PLP) is a commonly used measure of vitamin B6 status. Ratios of substrates indicating PLP coenzymatic function and metabolism may be useful complementary measures to further explore the role of vitamin B6 in health.
We explored the sensitivity of 5 outcomes, namely PLP concentration, homocysteine:cysteine (Hcy:Cys), cystathionine:cysteine (Cysta:Cys), the 3´-hydroxykynurenine ratio (HKr), and the 4-pyridoxic acid ratio (PAr) to vitamin B6 intake as well as personal and lifestyle characteristics.
Dietary intake and biomarker data were collected from participants from 3 nested case-control studies within the European Prospective Investigation into Cancer and Nutrition (EPIC). Bayesian regression models assessed the associations of the 5 biomarker outcomes with vitamin B6 intake and personal and lifestyle covariates. Analogous models examined the relations of Hcy:Cys, Cysta:Cys, and HKr with PLP.
In total, 4608 participants were included in the analyses. Vitamin B6 intake was most strongly associated with PLP, moderately associated with Hcy:Cys, Cysta:Cys, and HKr, and not associated with PAr (fold change in marker given a doubling of vitamin B6 intake: PLP 1.60 [95% credible interval (CrI): 1.50, 1.71]; Hcy:Cys 0.87 [95% CrI: 0.84, 0.90]; Cysta:Cys 0.89 [95% CrI: 0.84, 0.94]; HKr 0.88 [95% CrI: 0.85, 0.91]; PAr 1.00 [95% CrI: 0.95, 1.05]). PAr was most sensitive to age, and HKr was least sensitive to BMI and alcohol intake. Sex and menopause status were strongly associated with all 5 markers.
We found that 5 different markers, capturing different aspects of vitamin B6-related biological processes, varied in their associations with vitamin B6 intake and personal and lifestyle predictors.