Serum Levels of Vitamin A E B-Carotene and Folate in cases with Cervical Intraepithelial Neoplasia

Background A number of case-control and cohort studies have demonstrated a relationship between high intake of foods rich in carotenoids, Tocopherols, and vitamin C with a reduced risk of certain human malignancies. Objective The purpose of this study was to investigate the comparative plasma levels of a profile of known dietary antioxidants, namely, vitamin A, vitamin E, B-Carotene together with Folate levels in cases with Cervical Intraepithelial Neoplasia, (CIN). Design Cross-Sectional Study Setting Al-Hussein University Hospital, El-Darassa, Cairo-Egypt. Subjects and Methods The target population was women with a histopathological diagnosis of cervical intraepithelial neoplasia (CIN) and a control group. All women resided in the same catchment area (E-Darassa, Cairo-Egypt) and were of similar socio-economic background, representing a fairly homogenous population group. No limitation or changes were introduced in each participant’s dietary habits. Sample of 200 women (100 women with CIN & 100 women as control) was recruited with informed consent. Plasma levels of vitamin A, vitamin E, B-Carotene and folate were measured. Results compared between cases and controls and among cases with CIN. Results Mean plasma level of vitamin A was significantly higher in control group than cases with CIN (P<0.001); vitamin E cases showed significantly low mean level in cases with CIN (P<0.001); mean level of B-carotene was significantly low in cases with CIN (P<0.001) and mean folate levels were significantly higher in control group than in cases with CIN (P<0.001). There were significantly lower levels of vitamin A, vitamin E, B-carotene and Folate in cases with CIN compared to control group. Levels of vitamin A and B-carotene decreases significantly with increasing CIN stage. Levels of vitamin E and folate, were insignificantly low with advanced stage of CIN. Conclusion The finding of a decrease in all plasma antioxidant nutrients levels, namely, vitamin A; B-Carotene and vitamin E in women with CIN suggest a potential role for antioxidant deficiency in the pathogenesis of CIN. Also Coexisting deficiency of antioxidant and folate may potentially increase the risk for CIN and consequently cancer cervix. Introduction Malignancy of the lower genital tract should be considered generally preventable because of indolent growth of most tumors, the fact that most have defined biology and precursor lesions and for many of availability of active screening method such as Pap smear. Worldwide cervical cancer is second only to breast cancer as the most common malignancy in both incidence and mortality (1). The cervix is an ideal model for the study of chemoprevention in humans. The evidence is strong that normal cervical epithelium proceeds through a precancerous stage (cervical intraepithelial neoplasia, CIN) prior to the development of invasive cancer. In addition, the anatomical location of