title: People with low serum folate levels have higher risk of colorectal adenoma/advanced colorectal adenoma occurrence and recurrence in China.
abstract: OBJECTIVE
  To investigate the potential association between serum folate levels and colorectal adenoma (CRA) occurrence and recurrence.
  
  
  METHODS
  This prospective study measured baseline serum folate levels in outpatients who were screened for CRA using colonoscopy. Participants were then randomly selected to produce one group with CRA and one without CRA. These two subgroups underwent further follow-up observations of colonoscopy to determine the occurrence of new and recurrent CRA.
  
  
  RESULTS
  A total of 1310 participants were screened at baseline: 888 were healthy subjects without CRA; and 422 had CRA. Two subgroups were randomly selected (n = 200 per group) for follow-up. In the overall population, baseline serum folate levels were significantly lower in patients with CRA or advanced CRA (A-CRA) compared with healthy participants without CRA. Similar findings were shown for the follow-up study in terms of the association between CRA and A-CRA occurrence and recurrence and baseline serum folate levels. After controlling for confounders, increased serum folate was associated with a reduced risk of occurrence of CRA (odds ratio [OR] 0.993, 95% confidence interval [CI] 0.924, 1.066) and recurrence of CRA (OR 0.749, 95% CI 0.322, 1.742).
  
  
  CONCLUSIONS
  Higher serum folate levels may be protective against CRA and/or A-CRA.
authors.affiliation: Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Ding
authors.affiliation: Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
authors.forename: Qin-Yan
authors.initials: QY
authors.lastname: Gao
authors.affiliation: Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China fangjingyuan_new@163.com.
authors.forename: Jing-Yuan
authors.initials: JY
authors.lastname: Fang
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000453:epidemiology / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000473:pathology*; D009367:Neoplasm Staging; D012307:Risk Factors; D055815:Young Adult
chemical_list: D005492:Folic Acid
keywords: Folate levels; advanced colorectal adenoma; colorectal adenoma; confounders