title: Association between folate status and cervical intraepithelial neoplasia.
abstract: To investigate the effect of folate status on cervical intraepithelial neoplasia (CIN) progression and its relationship with high-risk human papillomavirus (hrHPV).
  
  
  
  We evaluated 20 000 sexually active women aged <65 years in Yangqu County by using a questionnaire; the subjects were also screened using the ThinPrep cytologic test (TCT). Patients with abnormal TCT results (other than glandular cell abnormalities) who were willing to provide informed consent were further diagnosed using colposcopy and histopathological examination. We investigated 247 cases of low-grade cervical squamous intraepithelial lesions (LSIL), 125 cases of high-grade cervical squamous intraepithelial lesions (HSIL) and 877 controls. A 24-item food frequency questionnaire was filled out by the investigator to estimate the consumption of dietary folate. Positivity for hrHPV from residual exfoliated cervical cells was tested; serum folate was also measured.
  
  
  
  The hrHPV infection rate in HSIL patients (77.6%) was higher than that in LSIL (33.2%) and control (32.0%) patients. Dietary folate intakes in controls, LSIL and HSIL were 306.9±176.6, 321.8±168.0 and 314.7±193.8 μg/kcal, respectively. The levels of serum folate in controls, LSIL and HSIL were 18.2±7.9, 15.9±7.1 and 14.3±7.5 nmol/l, respectively. Increased CIN correlated with higher rates of hrHPV infection and lower levels of serum folate.
  
  
  
  Low levels of serum folate may increase the risk of CIN progression. Furthermore, potential synergy may exist between low serum folate levels and hrHPV infection to promote CIN development.
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: M
authors.initials: M
authors.lastname: Hao
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: Y
authors.identifier: 0000-0002-1683-6721
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: N
authors.initials: N
authors.lastname: Feng
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
authors.forename: L
authors.initials: L
authors.lastname: Ding
mesh_terms: D016022:Case-Control Studies; D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology*; D002681:China; D003127:Colposcopy; D003584:Cytological Techniques; D004032:Diet; D004034:Diet Surveys; D002149:Energy Intake; D004847:Epithelial Cells / Q000473:pathology; D005247:Feeding Behavior; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D027383:Papillomaviridae; D030361:Papillomavirus Infections; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000473:pathology / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000097:blood* / Q000473:pathology / Q000821:virology
chemical_list: D005492:Folic Acid