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A comparison of complementary measures of vitamin B6 status, function, and metabolism in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

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Date

2021

Authors

Clasen, Joanna L
Heath, Alicia K
Van Puyvelde, Heleen
Huybrechts, Inge
Park, Jin Young
Ferrari, Pietro
Johansson, Mattias
Scelo, Ghislaine
Ulvik, Arve
Midttun, Øivind

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American Society of Clinical Nutrition
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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.

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MeSH Terms

Aged
Case-Control Studies
Europe
Female
Humans
Linear Models
Male
Middle Aged
Neoplasms
Nutritional Status
Vitamin B 6
Vitamin B 6 Deficiency

DeCS Terms

Neoplasias
Vitamina B 6
Estudios de Casos y Controles

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Keywords

PLP, dietary biomarkers, kynurenine pathway, transsulfuration pathway, vitamin B6

Citation

Clasen JL, Heath AK, Van Puyvelde H, Huybrechts I, Park JY, Ferrari P, et al. A comparison of complementary measures of vitamin B6 status, function, and metabolism in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr. 2021 Jul 1;114(1):338-347