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Shang Y, Chen M, Wang T, Xia T. Baseline 25(OH)D level is a prognostic indicator for bariatric surgery readmission: a matched retrospective cohort study. Front Nutr 2024; 11:1362258. [PMID: 38803446 PMCID: PMC11128655 DOI: 10.3389/fnut.2024.1362258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Managing postsurgical complications is crucial in optimizing the outcomes of bariatric surgery, for which preoperative nutritional assessment is essential. In this study, we aimed to evaluate and validate the efficacy of vitamin D levels as an immunonutritional biomarker for bariatric surgery prognosis. Methods This matched retrospective cohort study included adult patients who underwent bariatric surgery at a tertiary medical center in China between July 2021 and June 2022. Patients with insufficient and sufficient 25(OH)D (< 30 ng/mL) were matched in a 1:1 ratio. Follow-up records of readmission at 3 months, 6 months, and 1 year were obtained to identify prognostic indicators. Results A matched cohort of 452 patients with a mean age of 37.14 ± 9.25 years and involving 69.47% females was enrolled. Among them, 94.25 and 5.75% underwent sleeve gastrectomy and gastric bypass, respectively. Overall, 25 patients (5.54%) were readmitted during the 1-year follow-up. The prognostic nutritional index and controlling nutritional status scores calculated from inflammatory factors did not efficiently detect malnourishment. A low 25(OH)D level (3.58 [95% CI, 1.16-11.03]) and surgery season in summer or autumn (2.68 [95% CI, 1.05-6.83]) increased the risk of 1-year readmission in both the training and validation cohorts. The area under the receiver operating characteristic curve was 0.747 (95% CI, 0.640-0.855), with a positive clinical benefit in the decision curve analyses. The relationship between 25(OH)D and 6-month readmission was U-shaped. Conclusion Serum 25(OH)D levels have prognostic significance in bariatric surgery readmission. Hence, preferable 25(OH)D levels are recommended for patients undergoing bariatric surgery.
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Affiliation(s)
- Yongguang Shang
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China
| | - Mengli Chen
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Tianlin Wang
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Tianyi Xia
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
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2
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Weinstein SJ, Mondul AM, Layne TM, Yu K, Huang J, Stolzenberg-Solomon RZ, Ziegler RG, Purdue MP, Huang WY, Abnet CC, Freedman ND, Albanes D. Prediagnostic Serum Vitamin D, Vitamin D Binding Protein Isoforms, and Cancer Survival. JNCI Cancer Spectr 2022; 6:pkac019. [PMID: 35603848 PMCID: PMC8982405 DOI: 10.1093/jncics/pkac019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 01/07/2022] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Higher circulating vitamin D has been associated with improved overall cancer survival, but data for organ-specific cancers are mixed. METHODS We examined the association between prediagnostic serum 25-hydroxyvitamin D [25(OH)D], the recognized biomarker of vitamin D status, and cancer survival in 4038 men and women diagnosed with 1 of 11 malignancies during 22 years of follow-up (median = 15.6 years) within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Multivariable-adjusted proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations between baseline 25(OH)D concentration and subsequent cancer survival; we also stratified on the common vitamin D binding protein isoforms (Gc1f, Gc1s, and Gc2) defined by two single-nucleotide polymorphisms (rs7041 and rs4588) in the vitamin D binding protein gene GC. All P values were 2-sided. RESULTS Higher 25(OH)D concentrations were associated with greater overall cancer survival (HR for cancer mortality = 0.83, 95% CI = 0.70 to 0.98 for highest vs lowest quintile; Ptrend = .05) and lung cancer survival (HR = 0.63, 95% CI = 0.44 to 0.90; Ptrend = .03). These associations were limited to cases expressing the Gc2 isoform (HR = 0.38 for Gc2-2, 95% CI = 0.14 to 1.05 for highest vs lowest quintile; Ptrend = .02; and HR = 0.30 for Gc1-2/Gc2-2 combined, 95% CI = 0.16 to 0.56; Ptrend < .001 for overall and lung cancer, respectively). CONCLUSIONS Higher circulating 25(OH)D was associated with improved overall and lung cancer survival. As this was especially evident among cases with the genetically determined Gc2 isoform of vitamin D binding protein, such individuals may gain a cancer survival advantage by maintaining higher 25(OH)D blood concentrations.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tracy M Layne
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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3
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Liao Z, Fang Z, Gou S, Luo Y, Liu Y, He Z, Li X, Peng Y, Fu Z, Li D, Chen H, Luo Z. The role of diet in renal cell carcinoma incidence: an umbrella review of meta-analyses of observational studies. BMC Med 2022; 20:39. [PMID: 35109847 PMCID: PMC8812002 DOI: 10.1186/s12916-021-02229-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/30/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Evidence associating diet with the incidence of renal cell carcinoma (RCC) is inconclusive. We aimed to summarize evidence associating dietary factors with RCC incidence and assess the strength and validity of this evidence. METHODS We conducted an umbrella review of systematic reviews or meta-analyses (SRoMAs) that assessed the association between diet and RCC incidence. Through April 2021, PubMed, Web of Science, Embase, The Cochrane Library, Scopus, and WCRF were searched. Two independent reviewers selected studies, extracted data, and appraised the quality of SRoMAs. According to credibility assessment criteria, evidence can be divided into five categories: convincing (class I), highly suggestive (class II), suggestive (class III), weak (class IV), and nonsignificant (class V). RESULTS Twenty-nine meta-analyses were obtained after screening. After excluding 7 overlapping meta-analyses, 22 meta-analyses including 502 individual studies and 64 summary hazard ratios for RCC incidence were included: dietary patterns or dietary quality indices (n = 6), foods (n = 13), beverages (n = 4), alcohol (n = 7), macronutrients (n =15), and micronutrients (n =19). No meta-analyses had high methodological quality. Five meta-analyses exhibited small study effects; one meta-analysis showed evidence of excess significance bias. No dietary factors showed convincing or highly suggestive evidence of association with RCC in the overall analysis. Two protective factors had suggestive evidence (vegetables (0.74, 95% confidence interval 0.63 to 0.86) and vitamin C (0.77, 0.66 to 0.90)) in overall analysis. One protective factor had convincing evidence (moderate drinking (0.77, 0.70 to 0.84)) in Europe and North America and one protective factor had highly suggestive evidence (cruciferous vegetables (0.78, 0.70 to 0.86)) in North America. CONCLUSIONS Although many meta-analyses have assessed associations between dietary factors and RCC, no high-quality evidence exists (classes I and II) in the overall analysis. Increased intake of vegetables and vitamin C is negatively associated with RCC risk. Moderate drinking might be beneficial for Europeans and North Americans, and cruciferous vegetables might be beneficial to North Americans, but the results should be interpreted with caution. More researches are needed in the future. TRIAL REGISTRATION PROSPERO CRD42021246619.
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Affiliation(s)
- Zhanchen Liao
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Zhitao Fang
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Siqi Gou
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Yong Luo
- The Second Affiliated Hospital, Trauma Center & Critical Care Medicine, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Yiqi Liu
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Zhun He
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Xin Li
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Yansong Peng
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Zheng Fu
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Dongjin Li
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Haiyun Chen
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
| | - Zhigang Luo
- The Second Affiliated Hospital, Institute of Urology and Organ Transplantation, Hengyang Medical School, University of South China, Hengyang, 421001 Hunan China
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Wu J, Yang N, Yuan M. Dietary and circulating vitamin D and risk of renal cell carcinoma: a meta-analysis of observational studies. Int Braz J Urol 2021; 47:733-744. [PMID: 33146974 PMCID: PMC8321484 DOI: 10.1590/s1677-5538.ibju.2020.0417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/25/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This meta-analysis is the first to evaluate the associations of circulating and dietary intake of vitamin D with risk of risk of renal cell carcinoma (RCC). Our findings showed that higher circulating vitamin D level and dietary vitamin D intake were associated with a reduced risk of RCC. The possible explanation might be attributed to the anti-inflammatory effect, inhibiting cell proliferation, inducing cell differentiation and apoptosis. MATERIALS AND METHODS We searched the MEDLINE, EMBASE, and Scopus databases from their inception points through December 2018 for observational studies. The pooled relative risks (RRs) with corresponding 95% CIs were calculated using random-effects or fixed-effects models. The Newcastle-Ottawa scale was employed to assess the quality of the included studies. RESULTS A total of 9 publications were included in this meta-analysis. An overall analysis of the highest versus lowest intake levels revealed that circulating vitamin D level was protectively associated with risk of RCC 0.76 (95% CI: 0.64-0.89, P=0.001), with no evidence of heterogeneity (I2=38.8%, P=0.162). In addition, dietary vitamin D intake was associated with a reduced risk of RCC (RR: 0.86; 95% CI: 75-0.99, P=0.030). Statistical heterogeneity was not identified (I2=28.8%, P=0.199). Subgroup analyses results showed the gender differences, and the associations were significant in results with women participants (RR: 0.70; 95% CI: 0.55-0.88) and case-control studies (RR: 0.80, 95% CI: 0.67-0.95). CONCLUSION Higher circulating vitamin D level and higher dietary vitamin D intake both might be associated with a reduced risk of RCC. Further high-quality randomized controlled trials are required in the future to confirm our results.
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Affiliation(s)
- Jing Wu
- Second Affiliated Hospital of Harbin Medical UniversityDepartment of Cadre WardHarbinChinaDepartment of Cadre Ward, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Nan Yang
- Second Affiliated Hospital of Harbin Medical UniversityDepartment of Cadre WardHarbinChinaDepartment of Cadre Ward, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Mingxin Yuan
- Second Affiliated Hospital of Harbin Medical UniversityDepartment of Cadre WardHarbinChinaDepartment of Cadre Ward, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Sluyter JD, Manson JE, Scragg R. Vitamin D and Clinical Cancer Outcomes: A Review of Meta-Analyses. JBMR Plus 2020; 5:e10420. [PMID: 33553987 PMCID: PMC7839823 DOI: 10.1002/jbm4.10420] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022] Open
Abstract
The relationship between vitamin D status or supplementation and cancer outcomes has been examined in several meta‐analyses. To address remaining knowledge gaps, we conducted a systematic overview and critical appraisal of pertinent meta‐analyses. For meta‐analyses of trials, we assessed their quality using AMSTAR‐2 (A Measurement Tool to Assess Systematic Reviews), strength of associations using umbrella review methodology and credibility of evidence using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) criteria. Meta‐analyses of observational studies reported inverse associations of 25OHD with risk of cancer incidence and cancer mortality and, particularly for colorectal cancer, fulfilled some of Bradford‐Hill's causation criteria. In meta‐analyses of trials, vitamin D supplementation did not affect cancer incidence. However, we found credible evidence that vitamin D supplementation reduced total cancer mortality risk, with five out of six meta‐analyses reporting a relative risk (RR) reduction of up to 16%: RR, 0.84 (95% CI, 0.74–0.95). The strength of the association, however, was classified as weak. This was true among meta‐analyses of high, moderate, and lower quality (AMSTAR‐2–rated). Trials did not include large numbers of vitamin D‐deficient participants; many tested relatively low doses and lacked sufficiently powered data on site‐specific cancers. In conclusion, meta‐analyses show that, although observational evidence indicates that low vitamin D status is associated with a higher risk of cancer outcomes, randomized trials show that vitamin D supplementation reduces total cancer mortality, but not cancer incidence. However, trials with larger proportions of vitamin D‐insufficient participants and longer durations of follow‐up, plus adequately powered data on site‐specific common cancers, would provide further insight into the evidence base. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- John D Sluyter
- School of Population Health, University of Auckland Auckland New Zealand
| | - JoAnn E Manson
- Department of Medicine Brigham and Women's Hospital, and Harvard Medical School Boston MA USA.,Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
| | - Robert Scragg
- School of Population Health, University of Auckland Auckland New Zealand
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6
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Graves JS, Barcellos LF, Krupp L, Belman A, Shao X, Quach H, Hart J, Chitnis T, Weinstock-Guttman B, Aaen G, Benson L, Gorman M, Greenberg B, Lotze T, Soe M, Ness J, Rodriguez M, Rose J, Schreiner T, Tillema JM, Waldman A, Casper TC, Waubant E. Vitamin D genes influence MS relapses in children. Mult Scler 2020; 26:894-901. [PMID: 31081484 PMCID: PMC6851448 DOI: 10.1177/1352458519845842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether a vitamin D genetic risk score (vitDGRS) is associated with 25-hydroxyvitamin D (25(OH)D) level and multiple sclerosis (MS) relapses in children. METHODS DNA samples were typed for single nucleotide polymorphisms (SNPs) from four genes previously identified to be associated with 25(OH)D levels. SNPs with strong associations with 25(OH)D after multiple comparison correction were used to create a genetic risk score (vitDGRS). Cox regression models tested associations of vitDGRS with relapse hazard. RESULTS Two independent SNPs within or near GC and NADSYN1/DHCR7 genes were strongly associated with 25(OH)D levels in the discovery cohort (n = 182) after Bonferroni correction. The vitDGRS of these SNPs explained 4.5% of the variance of 25(OH)D level after adjustment for genetic ancestry. Having the highest versus lowest vitDGRS was associated with 11 ng/mL lower 25(OH)D level (95% confidence interval (CI) = -17.5, -4.5, p = 0.001) in the discovery cohort. Adjusting for ancestry, sex, disease-modifying therapy (DMT), and HLA-DRB1*15 carrier status, the highest versus lowest vitDGRS was associated with 2.6-fold (95% CI = 1.37, 5.03, p = 0.004) and 2.0-fold (95% CI = 0.75, 5.20, p = 0.16) higher relapse hazard in the discovery and replication cohorts, respectively. CONCLUSION The vitDGRS identifies children at greater risk of relapse. These findings support a causal role for vitamin D in MS course.
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Affiliation(s)
- Jennifer S Graves
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Lisa F Barcellos
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Lauren Krupp
- Pediatric Multiple Sclerosis Center, New York University Langone Medical Center, New York, NY, USA
| | | | - Xiaorong Shao
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Hong Quach
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Janace Hart
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Tanuja Chitnis
- Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital for Children, Boston, MA, USA
| | | | - Gregory Aaen
- Pediatric Multiple Sclerosis Center, Loma Linda University Children's Hospital, San Bernardino, CA, USA
| | - Leslie Benson
- Pediatric Multiple Sclerosis and Related Disorders Program, Boston Children's Hospital, Boston, MA, USA
| | - Mark Gorman
- Pediatric Multiple Sclerosis and Related Disorders Program, Boston Children's Hospital, Boston, MA, USA
| | | | - Timothy Lotze
- The Blue Bird Circle Clinic for Multiple Sclerosis, Texas Children's Hospital, Houston, TX, USA
| | - Mar Soe
- Pediatric MS & Demyelinating Disease Center, Washington University, St. Louis, MI, USA
| | - Jayne Ness
- Center for Pediatric-Onset Demyelinating Disease, Children's of Alabama, Birmingham, AL, USA
| | - Moses Rodriguez
- Pediatric Multiple Sclerosis Center, Mayo Clinic, Rochester, MA, USA
| | - John Rose
- Department of Neurology, The University of Utah, Salt Lake City, UT, USA
| | - Teri Schreiner
- Rocky Mountain MS Center, University of Colorado, Denver, Denver, CO, USA
| | | | - Amy Waldman
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - T Charles Casper
- Department of Pediatrics, The University of Utah, Salt Lake City, UT, USA
| | - Emmanuelle Waubant
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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7
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Li F, Zhao H, Hou L, Ling F, Zhang Y, Tan W. A higher circulating concentration of 25-hydroxyvitamin-D decreases the risk of renal cell carcinoma: a case-control study. Int Braz J Urol 2019; 45:523-530. [PMID: 30785699 PMCID: PMC6786115 DOI: 10.1590/s1677-5538.ibju.2018.0186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/17/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the relationship between vitamin D status, using circulating 25-hydroxyvitamin D [25 (OH) D], and renal cell carcinoma (RCC) risk in a case-control study, because the association between the two is unclear in China. MATERIALS AND METHODS A total of 135 incident RCC cases were matched with 135 controls by age and sex. The blood samples were collected on the first day of hospitalization before surgery to measure plasma 25 (OH) D. Logistic regression analyses were used to calculate odds ratios (ORs) and 95% confi dence intervals (95% CIs) with adjustment for several confounders (e.g. age, gender, smoking and season of blood draw). Furthermore, the association of RCC with 25 (OH) D in units of 10 ng / mL as a continuous variable were also examined. RESULTS The average plasma 25 (OH) D concentrations in RCC were signifi cantly lower compared with those of the controls (21.5 ± 7.4 ng / mL vs. 24.1 ± 6.6 ng / mL, respectively; P = 0.003). In the adjusted model, inverse associations were observed between circulating 25 (OH) D levels and RCC risk for 25 (OH) D insuffi ciency (20-30 ng / mL) with OR of 0.50 (95% CI: 0.29-0.88; P = 0.015) and a normal 25 (OH) D level (≥ 30 ng / mL) with OR of 0.30 (95% CI: 0.13-0.72; P = 0.007), compared with 25 (OH) D deficiency (< 20 ng / mL). Furthermore, results with 25 (OH) D as a linear variable indicated that each 10 ng / mL increment of plasma 25 (OH) D corresponded to a 12% decrease in RCC risk. CONCLUSIONS This case-control study on a Chinese Han population supports the protective effect of a higher circulating concentration of 25 (OH) against RCC, whether the confounding factors are adjusted or not.
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Affiliation(s)
- Fei Li
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - HongFan Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Lina Hou
- Department of Healthy Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P. R. China
| | - Fengsheng Ling
- Department of Urology, Foshan Women and Children Hospital_Foshan_Guangdong, P.R. China
| | - Yue Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - WanLong Tan
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
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8
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Weinstein SJ, Mondul AM, Yu K, Layne TM, Abnet CC, Freedman ND, Stolzenberg-Solomon RZ, Lim U, Gail MH, Albanes D. Circulating 25-hydroxyvitamin D up to 3 decades prior to diagnosis in relation to overall and organ-specific cancer survival. Eur J Epidemiol 2018; 33:1087-1099. [PMID: 30073448 PMCID: PMC6195863 DOI: 10.1007/s10654-018-0428-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/17/2018] [Indexed: 12/14/2022]
Abstract
While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. We examined the accepted biomarker of vitamin D status, serum 25-hydroxyvitamin D [25(OH)D], and cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up and 1732 survived or died of other causes. Proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnostic 25(OH)D and overall and site-specific survival. Serum 25(OH)D was significantly lower among cases who subsequently died from their malignancy compared with those who did not (medians 34.7 vs. 36.5 nmol/L, respectively; p = 0.01). Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76, 95% CI 0.67-0.85 for highest vs. lowest quintile, p-trend < 0.0001). Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74, 95% CI 0.55-1.01, p-trend = 0.005), kidney (HR = 0.59, 95% CI 0.35-0.98, p-trend = 0.28), and melanoma (HR = 0.39, 95% CI 0.20-0.78, p-trend = 0.01), but increased mortality from lung cancer (HR = 1.28, 95% CI 1.02-1.61, p-trend = 0.19). Improved survival was also suggested for head and neck, gastric, pancreatic, and liver cancers, though not statistically significantly, and case numbers for the latter two organ sites were small. Higher 25(OH)D status years prior to diagnosis was related to improved survival for overall and some site-specific cancers, associations that should be examined in other prospective populations that include women and other racial-ethnic groups.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Tracy M Layne
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Racheal Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Unhee Lim
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
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9
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Stucci LS, D'Oronzo S, Tucci M, Macerollo A, Ribero S, Spagnolo F, Marra E, Picasso V, Orgiano L, Marconcini R, De Rosa F, Di Guardo L, Galli G, Gandini S, Palmirotta R, Palmieri G, Queirolo P, Silvestris F. Vitamin D in melanoma: Controversies and potential role in combination with immune check-point inhibitors. Cancer Treat Rev 2018; 69:21-28. [PMID: 29864718 DOI: 10.1016/j.ctrv.2018.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
The role of vitamin D in melanoma is still controversial. Although several Authors described a correlation between vitamin D deficiency and poor survival in metastatic melanoma patients, clinical trials exploring the effects of vitamin D supplementation in this clinical setting were mostly inconclusive. However, recent evidence suggests that vitamin D exerts both anti-proliferative effects on tumor cells and immune-modulating activities, that have been widely explored in auto-immune disorders. On the one hand, vitamin D has been shown to inhibit T-helper17 lymphocytes, notoriously involved in the pathogenesis of immune-related adverse events (iAEs) which complicate immune-checkpoint inhibitor (ICI) treatment. On the other hand, vitamin D up-regulates PDL-1 expression on both epithelial and immune cells, suggesting a synergic effect in combination with ICIs, for which further investigation is needed.
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Affiliation(s)
- Luigia Stefania Stucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Stella D'Oronzo
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy.
| | - Marco Tucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, United Kingdom
| | - Simone Ribero
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Francesco Spagnolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Elena Marra
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Virginia Picasso
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Laura Orgiano
- Department of Medical Oncology, University of Cagliari, Cagliari, Italy
| | - Riccardo Marconcini
- Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Istituto Toscano Tumori, Santa Chiara Hospital, Pisa, Italy
| | - Francesco De Rosa
- Immunotherapy-Cell Therapy and Biobank Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorenza Di Guardo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulia Galli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Raffaele Palmirotta
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | | | - Paola Queirolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Silvestris
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
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Mondul AM, Weinstein SJ, Layne TM, Albanes D. Vitamin D and Cancer Risk and Mortality: State of the Science, Gaps, and Challenges. Epidemiol Rev 2018; 39:28-48. [PMID: 28486651 DOI: 10.1093/epirev/mxx005] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/19/2017] [Indexed: 12/31/2022] Open
Abstract
There has been substantial enthusiasm recently regarding the potential role of vitamin D in the primary and secondary prevention of cancer. Laboratory studies demonstrate a range of anticarcinogenic effects for vitamin D compounds, but human studies have yielded little consistent evidence supporting a protective association. Higher circulating levels of vitamin D (i.e., 25-hydroxyvitamin D or 25(OH)D) appear to be associated with reduced risk of colorectal and bladder malignancies, but higher risk of prostate and possibly pancreatic cancers, with no clear association for most other organ sites examined. Despite there being no official institutional recommendations regarding the use of vitamin D supplements for cancer prevention, screenings for vitamin D deficiency and vitamin D supplement use have increased substantially over the past decade. These widespread practices demonstrate that population sociobehavioral changes are often adopted before scientifically well-informed policies and recommendations are available. This review critically examines the currently available epidemiologic literature regarding the associations between circulating 25(OH)D, vitamin D supplementation, and vitamin D-related genetic variation and cancer risk and mortality, with a particular emphasis on prospective studies. We identify several important gaps in our scientific knowledge that should be addressed in order to provide sufficient reproducible data to inform evidence-based recommendations related to optimal 25(OH)D concentrations (and any role for vitamin D supplementation) for the primary and secondary prevention of cancer. With few exceptions, such recommendations cannot be made at this time.
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Platz EA. Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes. Epidemiol Rev 2017; 39:1-10. [PMID: 28460082 PMCID: PMC5868280 DOI: 10.1093/epirev/mxx009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 12/14/2022] Open
Abstract
"Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers). Authors discuss policies, systems, and environment (PSE) changes that may be supported by epidemiologic evidence, for example, how existing public health and clinical policies and guidelines targeting noncancer outcomes may indirectly reduce cancer burden and how some cancer control policies could be refined to enhance effectiveness. Authors also discuss where systems and environment changes are necessary to ensure routine implementation of up-to-date, evidence-based policies and guidelines. Two other articles discuss infrastructure to support identification of existing and emerging cancer problems that could be reduced or avoided, including by PSE changes. These frameworks may guide impactful cancer research relevant to cancer centers' catchment areas, as well as cancer control efforts in countries where noncommunicable diseases including cancer are on the rise. The weight of the evidence of these reviews supports opportunities for PSE changes and infrastructure that could reduce the cancer burden in populations.
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Affiliation(s)
- Elizabeth A. Platz
- Correspondence to Dr. Elizabeth A. Platz, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E6132, Baltimore, MD 21205 (e-mail: )
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12
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Darling AL, Abar L, Norat T. WCRF-AICR continuous update project: Systematic literature review of prospective studies on circulating 25-hydroxyvitamin D and kidney cancer risk. J Steroid Biochem Mol Biol 2016; 164:85-89. [PMID: 26454157 DOI: 10.1016/j.jsbmb.2015.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/17/2015] [Accepted: 10/01/2015] [Indexed: 01/20/2023]
Abstract
As part of the World Cancer Research Fund/American Institute for Cancer Research (WCRF-AICR) Continuous Update project we performed a systematic review of prospective studies with data for both measured or predicted 25(OH)D concentration and kidney cancer risk. PubMed was searched from inception until 1st December 2014 using WCRF/AICR search criteria. The search identified 4 papers suitable for inclusion, reporting data from three prospective cohort studies, one nested case-control study and the Vitamin D Pooling Project of Rarer Cancers (8 nested case-control studies). Summary effect sizes could not be computed due to incompatibility between studies. All studies except the Pooling Project suggested a reduced risk of kidney cancer by 19-40% with higher or adequate vitamin D status,. However, these estimates only reached statistical significance in one cohort (Copenhagen City Heart Study; CCHS, HR=0.75 (0.58 to 0.96)). In the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a significant reduction in risk by 18% was seen when using combined matched and non-matched controls OR=0.82 (0.68, 0.99), but not when using only matched controls (OR=0.81 (0.65, 1.00). Pooled (but not single cohort) data for predicted 25(OH)D from the Nurses' Health Study (NHS) and Health Professionals Follow-up Study (HPFS) showed a statistically significant reduction in risk by 37% (HR=0.63 (0.44, 0.91)). There is no clear explanation for the inconsistency of results between studies, but reasons may include prevalence of smoking or other study population characteristics. Methods for assessing circulating 25(OH)D levels and control for confounders including seasonality or hypertension do not seem explanatory.
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Affiliation(s)
- Andrea L Darling
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
| | - Leila Abar
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
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13
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Krajewski W, Dzięgała M, Kołodziej A, Dembowski J, Zdrojowy R. Vitamin D and urological cancers. Cent European J Urol 2016; 69:139-47. [PMID: 27551550 PMCID: PMC4986303 DOI: 10.5173/ceju.2016.784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/06/2016] [Accepted: 03/21/2016] [Indexed: 12/18/2022] Open
Abstract
Introduction Vitamin D controls calcium and phosphate homeostasis. Additionally, it has been proven that vitamin D is an important modulator of cellular differentiation and proliferation in a number of normal and malignant cells. Vitamin D can regulate proliferation, apoptosis, and cell adhesion at the tumor cell level. It also modifies tumor angiogenesis, invasion, and metastasis and also decreases oxidative DNA damage. Material and methods The Medline and Web of Science databases were searched without time limit on October 2015 using the terms ‘vitamin D’ in conjunction with ‘kidney cancer’, ‘bladder cancer’, ‘prostate cancer’, and ‘testis cancer’. Autoalerts in Medline were also run and reference lists of original articles, review articles, and book chapters were searched for further eligible articles. Results In recent years, vitamin D has received vast attention due to suggestions that it may have a crucial role in the prevention and therapy of various cancers. Many epidemiologic studies have reported the impact of VD3 on preventing several cancers and other pathologies. Assuming that vitamin D status changes cancer risk, enough vitamin D supply would be an easy, economical, and safe cancer incidence and mortality reduction method. However, despite numerous researches, the role of vitamin D in cancer incidence and therapy remains unclear. Conclusions The impact of vitamin D is well described in breast, colon, and prostate cancer; yet, there is only little published about other malignancies.
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Affiliation(s)
- Wojciech Krajewski
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Mateusz Dzięgała
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Anna Kołodziej
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Janusz Dembowski
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Romuald Zdrojowy
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
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14
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Lin G, Ning L, Gu D, Li S, Yu Z, Long Q, Hou LN, Tan WL. Examining the association of circulating 25-hydroxyvitamin D with kidney cancer risk: a meta-analysis. Int J Clin Exp Med 2015; 8:20499-20507. [PMID: 26884966 PMCID: PMC4723811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the relationship between circulating 25-hydroxy-vitamin D (25 (OH) D) and risk of kidney cancer. METHODS We searched PubMed, EMBASE, and Web of Science databases through August 31, 2015 for eligible studies. Pooled ORs with 95% confidence interval were calculated using fixed effect models. All data analyses were performed with STATA version 12.0. RESULTS The final analysis included 2 prospective cohort studies and 7 nested case-control studies, with a total of 130, 609 participants and 1, 815 cases of kidney cancer. No obvious heterogeneity was observed between individual studies. The results of this study revealed that higher circulating 25-hydroxyvitamin D levels were associated with lower risk of kidney cancer (OR=0.79, 95% CI 0.69-0.91; P value for heterogeneity: 0.61, I(2)=0%). After stratified by geographical region, the similar association was detected in European studies (OR=0.81, 95% CI 0.69-0.94; P value for heterogeneity: 0.38, I(2)=0%), though no significant association was observed in the USA studies (OR=0.73, 95% CI 0.51-1.04; P value for heterogeneity: 0.44, I(2)=0%). CONCLUSION Our present findings suggest that higher levels of circulating 25-hydroxyvitamin D could reduce the risk of kidney cancer by 21%. Further well-designed large-scaled prospective studies and randomized controlled trials are warranted to provide more conclusive evidence.
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Affiliation(s)
- Guangzheng Lin
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Ling Ning
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Di Gu
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Shi Li
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Zhe Yu
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Qicheng Long
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Li-Na Hou
- Department of Health Management, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
| | - Wan-Long Tan
- Department of Urology, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong, P. R. China
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15
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Karami S, Colt JS, Stewart PA, Schwartz K, Davis FG, Ruterbusch JJ, Chow WH, Wacholder S, Graubard BI, Purdue MP, Moore LE. A case-control study of occupational sunlight exposure and renal cancer risk. Int J Cancer 2015; 138:1626-33. [PMID: 26505275 DOI: 10.1002/ijc.29902] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/09/2015] [Indexed: 12/18/2022]
Abstract
Epidemiological evidence of a relationship between vitamin D and kidney cancer risk has been inconsistent despite experimental data indicating that vitamin D and its metabolites may inhibit carcinogenesis. Previously we reported an inverse association between renal cell carcinoma (RCC) risk and occupational ultraviolet (UV) exposure among European men. In this study, we examined the association between occupational UV exposure and RCC risk among US residents and investigated whether this association varied by race and sex. Lifetime occupational data for 1,217 RCC cases and 1,235 controls in a population-based case-control study, conducted from 2002 to 2007, were assessed for occupational UV exposure. We evaluated exposure metrics in quartiles based on control exposure levels and calculated associations between RCC risk and occupational UV exposure using unconditional logistic regression adjusted for sex, race, body mass index, smoking, hypertension, center, education, family history of cancer and dietary vitamin D intake. A general pattern of decreasing RCC risk with increasing UV exposure was observed. Cases had significantly lower cumulative occupational UV exposure than controls (fourth quartile vs. first: odds ratio = 0.74 [95% confidence interval = 0.56-0.99], p-trend = 0.03). Similar results were observed for other UV exposure metrics. The association with occupational UV exposure was stronger for women than for men, but did not differ by race. Our findings suggest an inverse association between occupational UV exposure and RCC, particularly among women. Given the sex finding discrepancies in this study versus our previous study, additional research is need to clarify whether the protective effects of occupational UV exposure and RCC risk are real.
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Affiliation(s)
- Sara Karami
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Joanne S Colt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | | | - Kendra Schwartz
- Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | | | | | - Wong-Ho Chow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Sholom Wacholder
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Lee E Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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16
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Muller DC, Scelo G, Zaridze D, Janout V, Holcatova I, Navratilova M, Mates D, Midttun Ø, Ueland PM, Brennan P, Johansson M. Circulating 25-hydroxyvitamin D3 and survival after diagnosis with kidney cancer. Cancer Epidemiol Biomarkers Prev 2015; 24:1277-81. [PMID: 26021552 PMCID: PMC4526455 DOI: 10.1158/1055-9965.epi-14-1351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/18/2015] [Indexed: 11/16/2022] Open
Abstract
Prospective cohort studies have provided some evidence that circulating vitamin D is associated with risk of, and survival from, renal cell carcinoma (RCC), but it is unclear whether concentrations of vitamin D at the time of diagnosis of RCC are associated with prognosis. We conducted a case-cohort study of 630 RCC cases, including 203 deaths, from a multicenter case-control study in Eastern Europe. Vitamin D was assessed as 25-hydroxyvitamin D3 [25(OH)D3], and we used weighted Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI) by categories of season-adjusted 25(OH)D3. Higher concentrations of 25(OH)D3 were associated with lower risk of death after adjusting for stage, age, sex, and country (HR highest vs. lowest category 0.57; 95% CI, 0.34-0.97). The inverse associations of 25(OH)D3 with death were most notable among those who died from non-RCC causes and those diagnosed with early-stage disease. In summary, 25(OH)D3 concentration at diagnosis of RCC was inversely associated with all-cause mortality rates, but not specifically with RCC outcome.
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Affiliation(s)
- David C Muller
- International Agency for Research on Cancer (IARC), Lyon, France.
| | - Ghislaine Scelo
- International Agency for Research on Cancer (IARC), Lyon, France
| | - David Zaridze
- Russian N.N. Blokhin Cancer Research Centre, Moscow, Russian Federation
| | - Vladimir Janout
- Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Ivana Holcatova
- Charles University in Prague, First Faculty of Medicine, Institute of Hygiene and Epidemiology, Prague, Czech Republic
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Per Magne Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway. Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France
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The authors respond. Epidemiology 2015; 26:e49. [PMID: 25899997 DOI: 10.1097/ede.0000000000000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Muller DC, Fanidi A, Midttun Ø, Steffen A, Dossus L, Boutron-Ruault MC, Severi G, Kühn T, Katzke V, de la Torre RA, González CA, Sánchez MJ, Dorronsoro M, Santiuste C, Barricarte A, Khaw KT, Wareham N, Travis RC, Trichopoulou A, Giotaki M, Trichopoulos D, Palli D, Krogh V, Tumino R, Vineis P, Panico S, Tjønneland A, Olsen A, Bueno-de-Mesquita HB, Peeters PH, Ljungberg B, Wennberg M, Weiderpass E, Murphy N, Riboli E, Ueland PM, Boeing H, Brennan P, Johansson M. Circulating 25-hydroxyvitamin D3 in relation to renal cell carcinoma incidence and survival in the EPIC cohort. Am J Epidemiol 2014; 180:810-20. [PMID: 25205830 DOI: 10.1093/aje/kwu204] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Normal renal function is essential for vitamin D metabolism, but it is unclear whether circulating vitamin D is associated with risk of renal cell carcinoma (RCC). We assessed whether 25-hydroxyvitamin D3 (25(OH)D3) was associated with risk of RCC and death after RCC diagnosis in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC recruited 385,747 participants with blood samples between 1992 and 2000. The current study included 560 RCC cases, 557 individually matched controls, and 553 additional controls. Circulating 25(OH)D3 was assessed by mass spectrometry. Conditional and unconditional logistic regression models were used to calculate odds ratios and 95% confidence intervals. Death after RCC diagnosis was assessed using Cox proportional hazards models and flexible parametric survival models. A doubling of 25(OH)D3 was associated with 28% lower odds of RCC after adjustment for season of and age at blood collection, sex, and country of recruitment (odds ratio = 0.72, 95% confidence interval: 0.60, 0.86; P = 0.0004). This estimate was attenuated somewhat after additional adjustment for smoking status at baseline, circulating cotinine, body mass index (weight (kg)/height (m)(2)), and alcohol intake (odds ratio = 0.82, 95% confidence interval: 0.68, 0.99; P = 0.038). There was also some indication that both low and high 25(OH)D3 levels were associated with higher risk of death from any cause among RCC cases.
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Shanmugalingam T, Crawley D, Bosco C, Melvin J, Rohrmann S, Chowdhury S, Holmberg L, Van Hemelrijck M. Obesity and cancer: the role of vitamin D. BMC Cancer 2014; 14:712. [PMID: 25255691 PMCID: PMC4182855 DOI: 10.1186/1471-2407-14-712] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/21/2014] [Indexed: 12/14/2022] Open
Abstract
Background It is estimated that 20% of all cancer cases are caused by obesity. Vitamin D is thought to be one of the mechanisms underlying this association. This review aims to summarise the evidence for the mediating effect of vitamin D on the link between obesity and cancer. Methods Three literature searches using PubMed and Embase were conducted to assess whether vitamin D plays an important role in the pathway between obesity and cancer: (1) obesity and cancer; (2) obesity and vitamin D; and (3) vitamin D and cancer. A systematic review was performed for (1) and (3), whereas a meta-analysis including random effects analyses was performed for (2). Results (1) 32 meta-analyses on obesity and cancer were identified; the majority reported a positive association between obesity and risk of cancer. (2) Our meta-analysis included 12 original studies showing a pooled relative risk of 1.52 (95% CI: 1.33-1.73) for risk of vitamin D deficiency (<50 nmol/L) in obese people (body mass index >30 kg/m2). (3) 21 meta-analyses on circulating vitamin D levels and cancer risk were identified with different results for different types of cancer. Conclusion There is consistent evidence for a link between obesity and cancer as well as obesity and low vitamin D. However, it seems like the significance of the mediating role of vitamin D in the biological pathways linking obesity and cancer is low. There is a need for a study including all three components while dealing with bias related to dietary supplements and vitamin D receptor polymorphisms. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-712) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thurkaa Shanmugalingam
- King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, UK.
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Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JPA. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 2014; 348:g2035. [PMID: 24690624 PMCID: PMC3972415 DOI: 10.1136/bmj.g2035] [Citation(s) in RCA: 636] [Impact Index Per Article: 63.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the breadth, validity, and presence of biases of the associations of vitamin D with diverse outcomes. DESIGN Umbrella review of the evidence across systematic reviews and meta-analyses of observational studies of plasma 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D concentrations and randomised controlled trials of vitamin D supplementation. DATA SOURCES Medline, Embase, and screening of citations and references. ELIGIBILITY CRITERIA Three types of studies were eligible for the umbrella review: systematic reviews and meta-analyses that examined observational associations between circulating vitamin D concentrations and any clinical outcome; and meta-analyses of randomised controlled trials assessing supplementation with vitamin D or active compounds (both established and newer compounds of vitamin D). RESULTS 107 systematic literature reviews and 74 meta-analyses of observational studies of plasma vitamin D concentrations and 87 meta-analyses of randomised controlled trials of vitamin D supplementation were identified. The relation between vitamin D and 137 outcomes has been explored, covering a wide range of skeletal, malignant, cardiovascular, autoimmune, infectious, metabolic, and other diseases. Ten outcomes were examined by both meta-analyses of observational studies and meta-analyses of randomised controlled trials, but the direction of the effect and level of statistical significance was concordant only for birth weight (maternal vitamin D status or supplementation). On the basis of the available evidence, an association between vitamin D concentrations and birth weight, dental caries in children, maternal vitamin D concentrations at term, and parathyroid hormone concentrations in patients with chronic kidney disease requiring dialysis is probable, but further studies and better designed trials are needed to draw firmer conclusions. In contrast to previous reports, evidence does not support the argument that vitamin D only supplementation increases bone mineral density or reduces the risk of fractures or falls in older people. CONCLUSIONS Despite a few hundred systematic reviews and meta-analyses, highly convincing evidence of a clear role of vitamin D does not exist for any outcome, but associations with a selection of outcomes are probable.
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Affiliation(s)
- Evropi Theodoratou
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK
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21
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Mondul AM, Weinstein SJ, Moy KA, Männistö S, Albanes D. Vitamin D-binding protein, circulating vitamin D and risk of renal cell carcinoma. Int J Cancer 2014; 134:2699-706. [PMID: 24214881 DOI: 10.1002/ijc.28596] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/28/2013] [Indexed: 12/31/2022]
Abstract
Cell culture experiments suggest that vitamin D may inhibit renal carcinogenesis, but human studies of circulating 25-hydroxyvitamin D [25(OH)D], the accepted measure of vitamin D status, and kidney cancer have been null. Limited research has examined the role of circulating vitamin D-binding protein (DBP) in the association between 25(OH)D and disease risk, and it is unclear whether free 25(OH)D in circulation is a better measure of effective exposure, or if DBP may independently impact outcomes. We conducted a nested case-control analysis within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study to examine whether circulating DBP concentration was prospectively associated with risk of renal cell carcinoma, and whether it modified the association with 25(OH)D. Renal cell carcinoma cases (n = 262) were matched 1:1 to controls on age (±1 year) and date of blood collection (± 30 days). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) of renal cell carcinoma risk by quartiles of 25(OH)D, DBP and the molar ratio of 25(OH)D:DBP, a proxy for free circulating 25(OH)D. Men with higher DBP concentrations were at significantly decreased risk of kidney cancer (Q4 vs. Q1: OR = 0.17, 95% CI = 0.08-0.33; p-trend < 0.0001), a finding unchanged by adjustment for 25(OH)D. Although we observed no association with total 25(OH)D, we found slightly increased risk with higher levels of estimated free 25(OH)D [Q4 vs. Q1 of the 25(OH)D:DBP ratio, OR = 1.61, 95% CI = 0.95-2.73; p-trend = 0.09]. The strong protective association observed between higher circulating DBP concentration and kidney cancer risk requires replication but suggests a vitamin D-independent influence of DBP.
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Affiliation(s)
- Alison M Mondul
- Nutritional Epidemiology Branch Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD
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Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL. Plasma vitamin D levels, menopause, and risk of breast cancer: dose-response meta-analysis of prospective studies. Medicine (Baltimore) 2013; 92:123-131. [PMID: 23625163 PMCID: PMC4553988 DOI: 10.1097/md.0b013e3182943bc2] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Previous evidence suggests that higher circulating 25-hydroxyvitamin D (25[OH]D) levels are variably associated with lower breast cancer risk; however, prospective studies and clinical trials have been inconsistent, particularly between older and younger women of differing menopausal status. We conducted a quantitative nonlinear dose-response meta-analysis of prospective studies evaluating the association between circulating 25(OH)D and breast cancer risk, stratified by menopause. A systematic search of MEDLINE and EMBASE included studies published through May 2011. We reviewed references from retrieved articles and contacted relevant investigators for additional data from prospective studies on circulating 25(OH)D levels and incident breast cancers. Prospective studies of circulating vitamin D and breast cancer risk were reviewed, and no language restrictions were imposed. Information on study population, menopausal status, 25(OH)D levels, and relative risk (RR) estimates were extracted using a standardized protocol.A total of 9 prospective studies were included, comprising 5206 cases and 6450 controls. Data were pooled using dose-response random-effects meta-regression models. Identifying nonlinear effects, spline models were optimized for thresholds. The relationship between circulating 25(OH)D and breast cancer risk differed by menopausal status (p = 0.05 for effect modification). While no association was found in premenopausal women, dose-response modeling revealed a nonlinear inverse association among postmenopausal women. Notably, a flat association was observed in the lowest range of 25(OH)D levels <27 ng/mL (RR = 1.01 per 5 ng/mL; 95% confidence interval [CI], 0.98-1.04). In contrast, postmenopausal breast cancer risk decreased with 25(OH)D levels 27-<35 ng/mL (p = 0.02 for nonlinear risk change), where a 5 ng/mL increase in 25(OH)D was associated with a 12% lower risk of breast cancer (RR = 0.88 per 5 ng/mL; 95% CI, 0.79-0.97), with suggestive flattening at higher doses >35 ng/mL. The significant inverse association did not appear to vary across strata of invasive/in-situ cases, body mass index adjustment, region, postmenopausal hormone use, or assay method.In summary, this dose-response meta-analysis of prospective studies of plasma 25(OH)D suggested a breast cancer risk differential by menopause, whereby a step-wise inverse association was observed beyond a threshold of 27 ng/mL, but with flattening of effects above 35 ng/mL, in postmenopausal women. These findings help resolve prior inconsistent findings and may carry important clinical and public health implications.
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Affiliation(s)
- Scott R Bauer
- From Channing Laboratory (SRB, SEH, ELD), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology (SRB, SEH) and Department of Nutrition (ELD), Harvard School of Public Health, Boston, Massachusetts; and Department of Public Health (SEH, ERB-J), School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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Joh HK, Giovannucci EL, Bertrand KA, Lim S, Cho E. Predicted plasma 25-hydroxyvitamin D and risk of renal cell cancer. J Natl Cancer Inst 2013; 105:726-32. [PMID: 23568327 DOI: 10.1093/jnci/djt082] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although the kidney is a primary organ for vitamin D metabolism, the association between vitamin D and renal cell cancer (RCC) remains unclear. METHODS We prospectively evaluated the association between predicted plasma 25-hydroxyvitamin D [25(OH)D] and RCC risk among 72,051 women and 46,380 men in the period from 1986 to 2008. Predicted plasma 25(OH)D scores were computed using validated regression models that included major determinants of vitamin D status (race, ultraviolet B flux, physical activity, body mass index, estimated vitamin D intake, alcohol consumption, and postmenopausal hormone use in women). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. All statistical tests were two-sided. RESULTS During 22 years of follow-up, we documented 201 cases of incident RCC in women and 207 cases in men. The multivariable hazard ratios between extreme quintiles of predicted 25(OH)D score were 0.50 (95% CI = 0.32 to 0.80) in women, 0.59 (95% CI = 0.37 to 0.94) in men, and 0.54 (95% CI = 0.39 to 0.75; P trend < .001) in the pooled cohorts. An increment of 10 ng/mL in predicted 25(OH)D score was associated with a 44% lower incidence of RCC (pooled HR = 0.56, 95% CI = 0.42 to 0.74). We found no statistically significant association between vitamin D intake estimated from food-frequency questionnaires and RCC incidence. CONCLUSION Higher predicted plasma 25(OH)D levels were associated with a statistically significantly lower risk of RCC in men and women. Our findings need to be confirmed by other prospective studies using valid markers of long-term vitamin D status.
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Affiliation(s)
- Hee-Kyung Joh
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Afzal S, Bojesen SE, Nordestgaard BG. Low plasma 25-hydroxyvitamin D and risk of tobacco-related cancer. Clin Chem 2013; 59:771-80. [PMID: 23503722 DOI: 10.1373/clinchem.2012.201939] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Tobacco smoke chemicals may influence vitamin D metabolism and function, and conversely vitamin D may modify the carcinogenicity of tobacco smoke chemicals. We tested the hypothesis that lower plasma 25-hydroxyvitamin D [25(OH)D] is associated with a higher risk of tobacco-related cancer in the general population. METHODS A prospective population-based cohort of 9791 individuals from the Copenhagen City Heart Study who were free of cancer at baseline was followed from 1981-1983 until December 2008 with 100% complete follow-up. RESULTS During up to 28 years of follow-up, 1081 participants developed a tobacco-related cancer and 1506 developed other cancers. Decreasing 25(OH)D concentrations, subdivided by clinical categories or by seasonally adjusted percentile categories, were associated with increasing cumulative incidence of tobacco-related cancer (log-rank trend P = 2 × 10(-6) and P = 5 × 10(-9)). Multivariable adjusted hazard ratios of tobacco-related cancer were 1.75 (95% CI, 1.33-2.30) for 25(OH)D <5 vs ≥20 ng/mL, and 2.07 (1.63-2.62) for ≤5th vs >66th percentile. Also, multivariable adjusted hazard ratios for a 50% reduction in 25(OH)D were 1.20 (1.13-1.28) for any tobacco-related cancer, 1.19 (95% CI, 1.09-1.31) for lung cancer, 1.44 (1.19-1.73) for head and neck cancer, 1.28 (1.06-1.54) for bladder cancer, 1.34 (1.04-1.73) for kidney cancer, and 0.95 (0.89-1.01) for other cancers. CONCLUSIONS Lower plasma 25(OH)D was associated with higher risk of tobacco-related cancers, but not with risk of other cancers.
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Affiliation(s)
- Shoaib Afzal
- The Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark
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Southard EB, Roff A, Fortugno T, Richie JP, Kaag M, Chinchilli VM, Virtamo J, Albanes D, Weinstein S, Wilson RT. Lead, calcium uptake, and related genetic variants in association with renal cell carcinoma risk in a cohort of male Finnish smokers. Cancer Epidemiol Biomarkers Prev 2012; 21:191-201. [PMID: 22086884 PMCID: PMC3601826 DOI: 10.1158/1055-9965.epi-11-0670] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lead is classified as a probable human carcinogen. However, its role in renal cell cancer (RCC) has not been established. Calcium and vitamin D may off-set toxicity in vivo. METHODS In this nested case-control study, whole blood lead, total serum calcium, and serum 25-hydroxyvitamin D levels were measured in blood drawn prior to diagnosis among male smokers participating in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Single-nucleotide polymorphisms (SNP) in five genes (CALB1, TRPV5, TRPV6, VDR, and ALAD) related to lead toxicity or calcium transport were genotyped. Logistic and linear regressions were used to determine RCC risk and time to diagnosis (respectively), adjusting for other risk factors. RESULTS Among 154 newly diagnosed cases and 308 matched controls, RCC was associated with higher whole blood lead [OR = 2.0; 95% confidence interval (CI), 1.0-3.9; quartile 4 (Q4) vs. Q1, P(trend) = 0.022] and CALB1 rs1800645 (P(trend) = 0.025, minor 'T' allele frequency = 0.34). Higher total serum calcium (P(trend) ≤ 0.001) was associated with reduced RCC risk. Total serum calcium and 25-hydroxyvitamin D levels did not alter the association observed with lead. Time from enrollment to RCC diagnosis was positively associated with serum calcium (P(trend) = 0.002) and 25-hydroxyvitamin D (P(trend) = 0.054) among cases. CONCLUSIONS Higher blood lead concentrations, below the 10 μg/dL level of concern, were associated with RCC, independent from serum calcium and CALB1 promoter polymorphism. IMPACT Increased risk of RCC is associated with lower serum calcium and higher whole blood lead in smokers. The clinical prognostic value of serum calcium and vitamin D in RCC should be further investigated.
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Affiliation(s)
- Emily B. Southard
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
| | - Alanna Roff
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
| | - Tracey Fortugno
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
| | - John P. Richie
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
| | - Matthew Kaag
- Pennsylvania State University, College of Medicine, Department of Surgery, Division of Urology, Hershey, PA, USA
| | - Vernon M. Chinchilli
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
| | - Jarmo Virtamo
- National Institute for Health and Welfare, Helsinki, Finland
| | - Demetrius Albanes
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Stephanie Weinstein
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Robin Taylor Wilson
- Pennsylvania State University, College of Medicine, Department of Public Health Sciences, Hershey, PA, USA
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Wu Y, Miyamoto T, Li K, Nakagomi H, Sawada N, Kira S, Kobayashi H, Zakohji H, Tsuchida T, Fukazawa M, Araki I, Takeda M. Decreased expression of the epithelial Ca2+ channel TRPV5 and TRPV6 in human renal cell carcinoma associated with vitamin D receptor. J Urol 2011; 186:2419-25. [PMID: 22019165 DOI: 10.1016/j.juro.2011.07.086] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Indexed: 01/02/2023]
Abstract
PURPOSE We investigated the expression of epithelial Ca(2+) channel TRPV (transient receptor potential vanilloid subfamily) 5 and 6, and vitamin D receptor in primary human renal cell carcinoma and benign peritumor tissues, and assessed the possible association between TRPV5/6 and vitamin D receptor expression. MATERIALS AND METHODS Fresh-frozen primary tumor and peritumor tissues from 27 patients diagnosed with renal cell carcinoma were analyzed for TRPV5/6 and vitamin D receptor expression by quantitative reverse transcriptase-polymerase chain reaction, Western blot and immunohistochemistry. RESULTS Quantitative reverse transcriptase-polymerase chain reaction revealed that TRPV5/6 and vitamin D receptor expression was decreased 38.11, 4.44 and 3.20 times in renal cell carcinoma vs normal kidney tissue (p = 0.012, 0.002 and 0.020, respectively). Relatively higher expression was noted for chromophobe renal cell carcinoma than for the other renal cell carcinoma subtypes. Vitamin D receptor mRNA expression significantly correlated with that of TRPV6 (r = 0.508, p = 0.007) and TRPV5 (r = 0.697, p = 0.032) in renal cell carcinoma. Western blot showed results similar to those of reverse transcriptase-polymerase chain reaction. Different expression was detected between kidney and renal cell carcinoma tissue. Immunohistochemical analysis verified strong detection of TRPV5/6 and vitamin D receptor in distal nephrons but demonstrated weak or no immunostaining much more often in renal cell carcinoma. CONCLUSIONS Decreased TRPV5/V6 expression was noted in renal cell carcinoma, which correlated with vitamin D receptor. Different expression was also detected among the different renal cell carcinoma histopathological subtypes. Our observations suggest that altered vitamin D receptor expression may be associated with renal cell carcinoma carcinogenesis via TRPV5/6.
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Affiliation(s)
- Yongyang Wu
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
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Abstract
There are substantial preclinical and epidemiologic data that suggest that vitamin D plays a role in the prevention and treatment of cancer. Numerous observational studies have shown that low blood levels of 25(OH) vitamin D (cholecalciferol), estimated by geographical location, diet and activity assessment or measured serum levels are associated with a higher risk of cancer and worse cancer-specific survival as well as numerous morbidities to e.g. cardiovascular disease, stroke, infection, autoimmune disease, and neuromuscular dysfunction among large populations. A considerable number of in vitro and in vivo studies indicate that the most active metabolite of vitamin D--1,25-dihydroxycholecalciferol or calcitriol--has anti-proliferative, pro-apoptotic, pro-differentiating, and anti-angiogenic properties. Combined treatment of calcitriol and many types of cytotoxic agents has synergistic or at least additive effects. However, clinical trials testing these hypotheses have been less encouraging, though a number of methodological, pharmacological, and pharmaceutical issues confound all trials ever conducted. In order to properly assess the clinical value of vitamin D, its metabolites and analogs in cancer prevention and treatment, more studies are needed.
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Affiliation(s)
- Anna Woloszynska-Read
- Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Candace S. Johnson
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Donald L. Trump
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
- Corresponding author: (D.L. Trump)
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Weinstein SJ, Yu K, Horst RL, Parisi D, Virtamo J, Albanes D. Serum 25-hydroxyvitamin D and risk of lung cancer in male smokers: a nested case-control study. PLoS One 2011; 6:e20796. [PMID: 21695165 PMCID: PMC3112221 DOI: 10.1371/journal.pone.0020796] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 05/09/2011] [Indexed: 12/31/2022] Open
Abstract
Background A role for vitamin D in cancer risk reduction has been hypothesized, but few data exist for lung cancer. We investigated the relationship between vitamin D status, using circulating 25-hydroxyvitamin D [25(OH)D], and lung cancer risk in a nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of Finnish male smokers. Methods Lung cancer cases (n = 500) were randomly selected based on month of blood collection, and 500 controls were matched to them based on age and blood collection date. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariate-adjusted conditional logistic regression. To account for seasonal variation in 25(OH)D concentrations, season-specific and season-standardized quintiles of 25(OH)D were examined, and models were also stratified on season of blood collection (darker season = November–April and sunnier season = May–October). Pre-determined, clinically-defined cutpoints for 25(OH)D and 25(OH)D as a continuous measure were also examined. Results Overall, 25(OH)D was not associated with lung cancer. Risks were 1.08 (95% CI 0.67–1.75) and 0.83 (95% CI 0.53–1.31) in the highest vs. lowest season-specific and season-standardized quintiles of 25(OH)D, respectively, and 0.91 (95% CI 0.48–1.72) for the ≥75 vs. <25 nmol/L clinical categories. Inverse associations were, however, suggested for subjects with blood collections from November–April, with ORs of 0.77 (95% CI 0.41–1.45, p-trend = 0.05) and 0.65 (95% CI 0.37–1.14, p-trend = 0.07) in the highest vs. lowest season-specific and season-standardized quintiles of 25(OH)D, respectively, and 0.61 (95% CI 0.24–1.52, p-trend = 0.01) for ≥75 vs. <25 nmol/L. We also found 11% lower risk for a 10 nmol/L increase in 25(OH)D in the darker season based on the continuous measure (OR = 0.89, 95% CI 0.81–0.98, p = 0.02). Conclusion In this prospective study of male smokers, circulating 25(OH)D was not associated with lung cancer risk overall, although inverse associations were suggested among those whose blood was drawn during darker months.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
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Arem H, Weinstein SJ, Horst RL, Virtamo J, Yu K, Albanes D, Abnet CC. Serum 25-hydroxyvitamin D and risk of oropharynx and larynx cancers in Finnish men. Cancer Epidemiol Biomarkers Prev 2011; 20:1178-84. [PMID: 21527582 PMCID: PMC3111816 DOI: 10.1158/1055-9965.epi-11-0153] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Published studies suggesting a relationship between vitamin D and some common cancers sparked interest in the association of vitamin D with head and neck cancers. Prolonged darker months in Finland are associated with lower levels of ultraviolet B radiation, raising concerns about low vitamin D levels. METHODS We used a nested case--control study in the prospective Alpha-Tocopherol Beta Carotene (ATBC) Study of male smokers in Finland, to examine the relationship between serum 25(OH)D and risk of developing squamous cancers of the head and neck. Using conditional logistic regression, we calculated the multivariate adjusted ORs and CIs comparing those with serum 25(OH)D adequate levels of 50 to <75 nmol/L to those <25.0. RESULTS We identified incident cancers of the oral cavity (n = 134), pharynx (n = 48), and larynx (n = 158). Median serum vitamin D was 31 nmol/L (interquartile range: 21-48), which is below the 50 nmol/L cutoff point was considered adequate for bone and overall health. Comparing those with serum 25(OH)D below 25 nmol/L to those 50 to <75 nmol/L as the referent, the OR was 1.35 (95% CI: 0.53-3.43, P(trend) = 0.65) for overall head and neck cancers. Stratification by cancer subsites of the oral cavity, pharynx, and larynx (P(trend) = 0.93, 0.78, 0.26, respectively) or by season of blood draw also showed no association. CONCLUSIONS Our study showed no association between serum 25(OH)D and risk of head and neck cancers. IMPACT This study does not support the hypothesis that greater vitamin D exposure would reduce the risk of developing head and neck squamous cancers.
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Affiliation(s)
- Hannah Arem
- Yale School of Public Health, Department ofChronic Disease Epidemiology, New Haven, Connecticut, USA
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Weinstein SJ, Yu K, Horst RL, Ashby J, Virtamo J, Albanes D. Serum 25-hydroxyvitamin D and risks of colon and rectal cancer in Finnish men. Am J Epidemiol 2011; 173:499-508. [PMID: 21248311 PMCID: PMC3105436 DOI: 10.1093/aje/kwq398] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 10/21/2010] [Indexed: 12/14/2022] Open
Abstract
Prospective investigations of circulating vitamin D concentrations suggest inverse associations with colorectal cancer risk, although inconsistencies remain and few studies have examined the impact of season. The authors conducted a prospective case-control study of 239 colon cancer cases and 192 rectal cancer cases (diagnosed in 1993-2005) and 428 controls matched on age and blood collection date within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, a cohort study of Finnish male smokers. Baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations were categorized using a priori defined cutpoints of <25, 25-<37.5, 37.5-<50, 50-<75, and ≥75 nmol/L and by season-specific and season-standardized 25(OH)D quartiles. Conditional logistic regression models yielded multivariate-adjusted odds ratios for the predefined cutpoints of 0.63, 0.91, 0.73, 1.00 (referent), and 1.44 for colon cancer and 0.64, 0.58, 0.84, 1.00, and 0.76 for rectal cancer, respectively (all 95% confidence intervals included 1.00). Colon cancer risks were significantly elevated for the highest season-specific and season-standardized quartiles versus the lowest quartiles (OR = 2.11 (95% CI: 1.20, 3.69) and OR = 1.88 (95% CI: 1.07, 3.28), respectively), while rectal cancer risk estimates were null. These results provide no evidence to support an inverse association between vitamin D status and colon or rectal cancer risk; instead, they suggest a positive association for colon cancer.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
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31
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Stolzenberg-Solomon R, Weinstein SJ, Helzlsouer K. Three Authors Reply. Am J Epidemiol 2011. [DOI: 10.1093/aje/kwq431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mondul AM, Weinstein SJ, Männistö S, Snyder K, Horst RL, Virtamo J, Albanes D. Serum vitamin D and risk of bladder cancer. Cancer Res 2010; 70:9218-23. [PMID: 20978193 PMCID: PMC2982924 DOI: 10.1158/0008-5472.can-10-0985] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Vitamin D may protect against several cancers, but data about the association between circulating vitamin D and bladder cancer are limited. Within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, a randomized controlled trial conducted to determine the effects of α-tocopherol and β-carotene supplements on cancer incidence in male smokers, 250 bladder cancer cases were randomly sampled by month of blood collection. Controls were matched 1:1 to cases on age at randomization and date of blood collection. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) of bladder cancer by a priori categories of baseline serum 25-hydroxyvitamin D [25(OH)D; i.e., <25, 25 to <37.5, 37.5 to <50, ≥50 nmol/L] and by season-specific quartiles. After multivariable adjustment, we found that lower 25(OH)D was associated with a statistically significantly increased risk of bladder cancer (versus ≥50 nmol/L; <25 nmol/L: OR, 1.73; 95% CI, 1.03-2.91; 25 to <37.5 nmol/L: OR, 1.81; 95% CI, 1.05-3.14; 37.5 to <50 nmol/L: OR, 1.76; 95% CI, 1.02-3.02; P trend=0.04). Similarly, increased risks for the lowest vitamin D category were observed when season-specific quartiles were used (Q1 versus Q4: OR, 1.63; 95% CI, 0.96-2.75; P trend=0.03). In this prospective study of male smokers, lower serum 25(OH)D was associated with an increased risk of bladder cancer. Future studies should examine the association in other populations, especially nonsmokers and women.
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Affiliation(s)
- Alison M Mondul
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland, USA.
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Helzlsouer KJ. Overview of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010; 172:4-9. [PMID: 20562193 PMCID: PMC2892542 DOI: 10.1093/aje/kwq119] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/12/2010] [Indexed: 12/31/2022] Open
Abstract
The Cohort Consortium Vitamin D Pooling Project of Rarer Cancers (VDPP) brought together 10 cohorts to conduct a prospective study of the association between vitamin D status, measured as serum concentrations of 25-hydroxyvitamin D (25(OH)D), and the development of 7 rarer cancer sites: endometrial, esophageal, gastric, kidney, non-Hodgkin lymphoma, ovarian, and pancreatic cancers. The cohorts come from 3 continents, with participants from a wide range of latitude who are racially diverse. Across each cancer site, there was no evidence of a protective association between higher concentrations of 25-hydroxyvitamin D (>75 nmol/L) and cancer outcome. An increased risk at very high levels (> or =100 nmol/L) was noted for pancreatic cancer, confirming previous reports. The articles included in this issue detail the overall design and governance of the project, correlates of vitamin D status, and results from the cancer site-specific investigations. The Vitamin D Pooling Project realizes a major goal of consortium efforts, namely, to rigorously test hypotheses for rarer cancer outcomes that may not be adequately addressed in any one prospective cohort study. The results of this study have application for the planning and conduct of intervention trials, especially in determining potential risks.
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