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Bounas N, Seretis K. Vitamin D and Cutaneous Melanoma Risk: An Umbrella Review of Systematic Reviews and Meta-Analyses. Photobiomodul Photomed Laser Surg 2024; 42:249-266. [PMID: 38662504 DOI: 10.1089/photob.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background: Vitamin D (VitD) properties can impact cancer cells. Despite the documented link between VitD levels and prevalence of several cancer types, conflicting findings have been reported for cutaneous melanoma (CM). Objective: This overview aims to compile the evidence from existing systematic reviews and meta-analyses, emphasizing the relationships between VitD serum levels, intake, receptor (VDR) gene polymorphisms, and CM risk. Methods: A literature search in electronic databases was conducted, based on certain inclusion criteria. Results: Twenty-one studies were included. Conflicting evidence between high VitD serum levels, dietary/supplementary intake, and CM risk is highlighted. VDR polymorphisms may play a role in the intricate CM pathogenesis. Also, high serum levels of VitD are associated with improved CM prognosis. Conclusions: This overview showed that the impact of VitD on CM is not clear, and thus further research is suggested to explore its true effect size on CM risk.
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Affiliation(s)
- Nikolaos Bounas
- Department of Plastic Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Ioannina, Greece
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2
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Stinson J, McCall C, Dobbs RW, Mistry N, Rosenberg A, Nettey OS, Sharma P, Dixon M, Sweis J, Macias V, Sharifi R, Kittles RA, Kajdacsy-Balla A, Murphy AB. Vitamin D and genetic ancestry are associated with apoptosis rates in benign and malignant prostatic epithelium. Prostate 2023; 83:352-363. [PMID: 36479698 PMCID: PMC9870946 DOI: 10.1002/pros.24467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Vitamin D metabolites may be protective against prostate cancer (PCa). We conducted a cross-sectional analysis to evaluate associations between in vivo vitamin D status, genetic ancestry, and degree of apoptosis using prostatic epithelial terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. EXPERIMENTAL DESIGN Benign and tumor epithelial punch biopsies of participants with clinically localized PCa underwent indirect TUNEL staining. Serum levels of 25 hydroxyvitamin D [25(OH)D] and 1,25 dihydroxyvitamin D were assessed immediately before radical prostatectomy; levels of prostatic 25(OH)D were obtained from the specimen once the prostate was extracted. Ancestry informative markers were used to estimate the percentage of genetic West African, Native American, and European ancestry. RESULTS One hundred twenty-one newly diagnosed men, age 40-79, were enrolled between 2013 and 2018. Serum 25(OH)D correlated positively with both tumor (ρ = 0.17, p = 0.03), and benign (ρ = 0.16, p = 0.04) prostatic epithelial TUNEL staining. Similarly, prostatic 25(OH)D correlated positively with both tumor (ρ = 0.31, p < 0.001) and benign (ρ = 0.20, p = 0.03) epithelial TUNEL staining. Only Native American ancestry was positively correlated with tumor (ρ = 0.22, p = 0.05) and benign (ρ = 0.27, p = 0.02) TUNEL staining. In multivariate regression models, increasing quartiles of prostatic 25(OH)D (β = 0.25, p = 0.04) and Native American ancestry (β = 0.327, p = 0.004) were independently associated with tumor TUNEL staining. CONCLUSIONS Physiologic serum and prostatic 25(OH)D levels and Native American ancestry are positively associated with the degree of apoptosis in tumor and benign prostatic epithelium in clinically localized PCa. Vitamin D may have secondary chemoprevention benefits in preventing PCa progression in localized disease.
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Affiliation(s)
- James Stinson
- Division of Urology, Cook County Health and Hospitals System, Chicago IL
| | - Cordero McCall
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Ryan W. Dobbs
- Division of Urology, Cook County Health and Hospitals System, Chicago IL
| | - Neil Mistry
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Adrian Rosenberg
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Oluwarotimi S. Nettey
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Pooja Sharma
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Michael Dixon
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Jamila Sweis
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
| | - Virgilia Macias
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago IL
| | | | - Rick A. Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Cancer Center, Duarte CA
| | - Andre Kajdacsy-Balla
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago IL
| | - Adam B. Murphy
- Division of Urology, Cook County Health and Hospitals System, Chicago IL
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago IL
- Section of Urology, Jesse Brown VA Medical Center, Chicago IL
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3
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Grant WB, Boucher BJ, Al Anouti F, Pilz S. Comparing the Evidence from Observational Studies and Randomized Controlled Trials for Nonskeletal Health Effects of Vitamin D. Nutrients 2022; 14:nu14183811. [PMID: 36145186 PMCID: PMC9501276 DOI: 10.3390/nu14183811] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 12/12/2022] Open
Abstract
Although observational studies of health outcomes generally suggest beneficial effects with, or following, higher serum 25-hydroxyvitamin D [25(OH)D] concentrations, randomized controlled trials (RCTs) have generally not supported those findings. Here we review results from observational studies and RCTs regarding how vitamin D status affects several nonskeletal health outcomes, including Alzheimer’s disease and dementia, autoimmune diseases, cancers, cardiovascular disease, COVID-19, major depressive disorder, type 2 diabetes, arterial hypertension, all-cause mortality, respiratory tract infections, and pregnancy outcomes. We also consider relevant findings from ecological, Mendelian randomization, and mechanistic studies. Although clear discrepancies exist between findings of observational studies and RCTs on vitamin D and human health benefits these findings should be interpreted cautiously. Bias and confounding are seen in observational studies and vitamin D RCTs have several limitations, largely due to being designed like RCTs of therapeutic drugs, thereby neglecting vitamin D’s being a nutrient with a unique metabolism that requires specific consideration in trial design. Thus, RCTs of vitamin D can fail for several reasons: few participants’ having low baseline 25(OH)D concentrations, relatively small vitamin D doses, participants’ having other sources of vitamin D, and results being analyzed without consideration of achieved 25(OH)D concentrations. Vitamin D status and its relevance for health outcomes can usefully be examined using Hill’s criteria for causality in a biological system from results of observational and other types of studies before further RCTs are considered and those findings would be useful in developing medical and public health policy, as they were for nonsmoking policies. A promising approach for future RCT design is adjustable vitamin D supplementation based on interval serum 25(OH)D concentrations to achieve target 25(OH)D levels suggested by findings from observational studies.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA 94164-1603, USA
- Correspondence:
| | - Barbara J. Boucher
- The London School of Medicine and Dentistry, The Blizard Institute, Barts, Queen Mary University of London, London E1 2AT, UK
| | - Fatme Al Anouti
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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McGrowder D, Tulloch-Reid MK, Coard KCM, McCaw-Binns AM, Ferguson TS, Aiken W, Harrison L, Anderson SG, Jackson MD. Vitamin D Deficiency at Diagnosis Increases All-Cause and Prostate Cancer-specific Mortality in Jamaican Men. Cancer Control 2022; 29:10732748221131225. [PMID: 36180132 PMCID: PMC9527998 DOI: 10.1177/10732748221131225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Background 25 hydroxyvitamin D [25(OH)D] and serum calcium have been associated with incident prostate cancer (PCa). However, there is limited data on whether these metabolites predict survival in men of African descent, a population disproportionately affected by PCa. We studied the relationship of 25(OH)D at PCa diagnosis with all-cause and cancer-specific mortality among Jamaican men and examined whether serum calcium modified any associations. Methods Serum 25(OH)D from 152 Jamaican men with incident PCa within the Prostate Cancer Risk Evaluation (PROSCARE) study were re-evaluated approximately 11 years after enrollment. 25(OH)D analyses were stratified using the using Holick criteria. PCa-specific and all-cause mortality were examined in Kaplan–Meier survival curves and Cox regression models adjusted for age, body mass index (BMI), smoking and Gleason score. Restricted cubic splines evaluated nonlinear associations. Serum calcium was assessed as an effect modifier of the association between 25(OH)D and mortality. Results Of cases with available 25(OH)D, 64 men with PCa survived, 38 deaths were PCa specific and 36 died of other causes. At baseline, 9.9% of cases were vitamin D deficient and 61.2% were vitamin D sufficient. Compared to 25(OH)D sufficient men, those with 25(OH)D <20.0 ng/mL concentrations were associated with higher PCa-specific mortality (adjusted HR, 4.95; 95% CI, 1.68, 14.63, P = .004) and all-cause mortality (adjusted HR, 2.40; 95%CI, 1.33, 4. 32, P = .003). Serum calcium was not associated with survival and did not modify any associations with 25(OH)D. Conclusions 25(OH)D deficiency at PCa diagnosis predicted decreased survival for overall and PCa-specific cancer in Caribbean men of African ancestry.
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Affiliation(s)
- Donovan McGrowder
- Department of Pathology, Faculty of Medical Sciences, 462834The University of the West Indies, Mona, Jamaica
| | - Marshall K Tulloch-Reid
- Epidemiology Research Unit, Caribbean Institute for Health Research, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| | - Kathleen C M Coard
- Department of Pathology, Faculty of Medical Sciences, 462834The University of the West Indies, Mona, Jamaica
| | - Afette M McCaw-Binns
- Department of Community Health & Psychiatry, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| | - Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| | - William Aiken
- Department of Surgery, Radiology, Anaesthesia, & Intensive Care, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| | | | - Simon G Anderson
- George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, The University of the West Indies, Cave Hill, Barbados
| | - Maria D Jackson
- Department of Community Health & Psychiatry, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
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Hektoen HH, Gislefoss RE, Stenehjem JS, Langseth H, Axcrona K, Mondul AM, Robsahm TE, Andreassen BK. Prediagnostic Serum 25-Hydroxyvitamin D and Mortality Among Bladder Cancer Patients in the Janus Serum Bank Cohort. Clin Epidemiol 2021; 13:801-811. [PMID: 34548821 PMCID: PMC8449552 DOI: 10.2147/clep.s319620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Circulating 25-hydroxyvitamin D (25(OH)D) is inversely associated with overall cancer mortality and selected cancers, while for urothelial bladder cancer (BC) this relationship is unclear. We aimed to examine the association between 25(OH)D and BC mortality. Materials and Methods We used prediagnostic serum from 378 BC cases within the population-based Janus Cohort. Cox regression models estimated hazard ratios (HRs), with 95% confidence intervals (CIs), for the association between 25(OH)D and BC-specific and all-cause mortality. Restricted cubic splines were assessed to examine non-linear risk associations. Analyses were stratified by tumor invasiveness (non-muscle invasive BC (NMIBC) and muscle invasive BC (MIBC)). Additionally, the association between 25(OH)D and all-cause mortality was assessed for 378 cancer-free matched controls. Results 25(OH)D deficiency (<50 nmol/L) was associated with higher BC-specific mortality (HR 1.87, 95% CI 1.10-3.20), when compared with insufficient levels (50-74 nmol/L). Stratification by tumor invasiveness revealed that this result was evident for NMIBC only, both with respect to BC-specific mortality (HR 2.84, 95% CI 1.14-7.12) and all-cause mortality (HR 1.97, 95% CI 1.06-3.65). No association between 25(OH)D levels and all-cause mortality was found in cancer-free controls. Conclusion 25(OH)D deficiency (<50 nmol/L) prior to a BC diagnosis was associated with increased risk of BC-specific mortality, when compared to insufficient levels (50-74 nmol/L). The results were evident among NMIBC patients only, suggesting a more critical role of vitamin D deficiency in an early stage of the disease.
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Affiliation(s)
- Helga H Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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6
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Prediagnostic serum 25-hydroxyvitamin D and melanoma risk. Sci Rep 2020; 10:20129. [PMID: 33208828 PMCID: PMC7676247 DOI: 10.1038/s41598-020-77155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/04/2020] [Indexed: 11/17/2022] Open
Abstract
Previous studies of serum 25-hydroxyvitamin D (25(OH)D) in relation to melanoma have shown conflicting results. We conducted a nested case–control study of 708 cases and 708 controls, using prediagnostically collected serum, to study 25(OH)D and melanoma risk in the population-based Janus Serum Bank Cohort. Stratified Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for ultraviolet radiation (UVR) indicators and stratified by ambient UVB of residence and body mass index (BMI). Non-linear associations were studied by restricted cubic splines. Missing data were handled with multiple imputation by chained equations. We found an HR of melanoma risk of 1.01 (95% CI: 0.99, 1.04) and an HRimputed of 1.02 (95% CI: 1.00, 1.04) per 5-nmol/L increase. The spline model showed exposure-risk curves with significantly reduced melanoma risk between 60 and 85 nmol/L 25(OH)D (reference 50 nmol/L). Non-significant J-shaped curves were found in sub-analyses of subjects with high ambient UVB of residence and of subjects with BMI < 25 kg/m2. Our data did not yield persuasive evidence for an association between 25(OH)D and melanoma risk overall. Serum levels within the medium range might be associated with reduced risk, an association possibly mediated by BMI.
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Voutsadakis IA. Vitamin D baseline levels at diagnosis of breast cancer: A systematic review and meta-analysis. Hematol Oncol Stem Cell Ther 2020; 14:16-26. [PMID: 33002425 DOI: 10.1016/j.hemonc.2020.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Vitamin D is a steroid hormone that exerts its actions through ligation of the vitamin D receptor (VDR), a transcription factor of the nuclear receptor family. VDR has not only physiologic actions in calcium metabolism but also several other cellular effects through extensive binding to the DNA and modification of genome expression. In cancer, it has neoplasia-suppressive effects and various mechanisms of action mediating cancer cell inhibition have been described. Vitamin D deficiency has been linked to increased risk of breast cancer. A role of the vitamin once the disease has been diagnosed is also probable. METHODS A systematic review and meta-analysis of studies that report on vitamin D levels (in the form of its main circulating metabolite, 25-hydroxyvitamin D [25-OHD]) in patients with newly diagnosed breast cancer was performed. Outcomes of interest included the levels of serum 25-OHD in patients with breast cancer, those of matched controlled, in studies that included controls, as well as respective percentages of patients and controls with deficient and insufficient 25-OHD levels. RESULTS A total of 25 studies (10 with controls and 15 without controls) provided data on the outcomes of interest. Populations from all continents, besides Australia, were represented in the studies. The mean level of 25-OHD in patients with breast cancer was 26.88 ng/mL (95% CI 22.8-30.96 ng/mL) and the mean level of 25-OHD in control patients was 31.41 ng/mL (95% CI 19.31-43.5 ng/mL). In the patients with breast cancer group, 45.28% (95% CI 24.37%-53.51%) had levels of 25-OHD below 20 ng/mL, whereas this percentage was 33.71% (95% CI 21.61%-45.82%) in controls. Similarly, 67.44% (95% CI 48.32%-86.55%) of patients with breast cancer had a baseline level of 25-OHD below 30 ng/mL, whereas this percentage was 33.71% (95% CI 21.61%-45.82%) in controls. CONCLUSION A high prevalence of vitamin D insufficiency is observed in patients with newly diagnosed breast cancer and may be linked pathophysiologically with breast cancer development or progression. Therapeutic benefits may be provided by manipulation of the vitamin D pathway in breast cancer.
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Affiliation(s)
- Ioannis A Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON, Canada; Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON, Canada.
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8
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Post-treatment levels of plasma 25- and 1,25-dihydroxy vitamin D and mortality in men with aggressive prostate cancer. Sci Rep 2020; 10:7736. [PMID: 32385370 PMCID: PMC7210996 DOI: 10.1038/s41598-020-62182-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/02/2020] [Indexed: 11/08/2022] Open
Abstract
Vitamin D may reduce mortality from prostate cancer (PC). We examined the associations of post-treatment plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations with PC mortality. Participants were PC cases from the New South Wales Prostate Cancer Care. All contactable and consenting participants, at 4.9 to 8.6 years after diagnosis, were interviewed and had plasma 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) measured in blood specimens. Cox regression allowing for left-truncation was used to calculate adjusted mortality hazards ratios (HR) and 95% confidence intervals (95% CI) for all-cause and PC-specific mortality in relation to vitamin D levels and other potentially-predictive variables. Of the participants (n = 111; 75·9% response rate), there were 198 deaths from any cause and 41 from PC in the study period. Plasma 25(OH)D was not associated with all-cause or PC-specific mortality (p-values > 0·10). Plasma 1,25(OH)2D was inversely associated with all-cause mortality (HR for highest relative to lowest quartile = 0·45; 95% CI: 0·29-0·69), and PC-specific mortality (HR = 0·40; 95% CI: 0·14-1·19). These associations were apparent only in men with aggressive PC: all-cause mortality HR = 0·28 (95% CI·0·15-0·52; p-interaction = 0·07) and PC-specific mortality HR = 0·26 (95% CI: 0·07-1.00). Time spent outdoors was also associated with lower all-cause (HR for 4th relative to 1st exposure quartile = 0·42; 95% CI: 0·24-0·75) and PC-specific (HR = 0·48; 95% CI: 0·14-1·64) mortality, although the 95% CI for the latter was wide. The inverse association between post-treatment plasma 1,25(OH)2D levels and all-cause and PC-specific mortality in men with aggressive PC, suggest a possible beneficial effect of vitamin D supplementation in these men.
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Tsai TY, Kuo CY, Huang YC. The association between serum vitamin D level and risk and prognosis of melanoma: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2020; 34:1722-1729. [PMID: 31919907 DOI: 10.1111/jdv.16189] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vitamin D has antineoplastic effects, but the synthesis of vitamin D requires ultraviolet radiation, a known risk factor for melanoma. OBJECTIVE To investigate the correlations between serum vitamin D levels and risk and prognosis of melanoma. METHODS A systematic review and meta-analysis were conducted. Online databases were searched on 31 Oct 2018. RESULTS Twenty-five studies with a total of 11166 patients with melanoma were included. There was no significant difference in serum vitamin D levels between patients with melanoma and controls [standardized mean difference (SMD), -0.185; 95% confidence interval (CI), -0.533 to 0.162]. However, the prevalence of vitamin D deficiency was significantly higher in patients with melanoma than that in controls (odds ratio, 2.115; 95% CI, 1.151-3.885). In terms of prognosis, serum vitamin D levels were significantly higher in melanoma patients with lower Breslow thickness (≦1 vs. >1 mm: SMD, 0.243; 95% CI, 0.160-0.327). Moreover, melanoma patients with lower vitamin D levels had a significantly higher mortality rate (hazard ratio, 1.558; 95% CI, 1.258-1.931). CONCLUSIONS Vitamin D deficiency is associated with higher Breslow thickness and mortality in melanoma patients.
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Affiliation(s)
- T-Y Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - C-Y Kuo
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Y-C Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Shamsi U, Khan S, Azam I, Habib Khan A, Maqbool A, Hanif M, Gill T, Iqbal R, Callen D. A multicenter case control study of association of vitamin D with breast cancer among women in Karachi, Pakistan. PLoS One 2020; 15:e0225402. [PMID: 31967989 PMCID: PMC6975526 DOI: 10.1371/journal.pone.0225402] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan. Methods A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration. Results Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43). Conclusions and recommendation Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer. In Pakistani women, where vitamin D deficiency is common, raising and maintaining serum vitamin D at population level is a safe and affordable strategy. It may play a role in reducing the incidence of both vitamin D deficiency and breast cancer, particularly among poor women where the breast cancer mortality is highest due to limited resources for early detection, diagnosis, and treatment. The effects of vitamin D with regard to breast cancer risk in Karachi Pakistan should be further evaluated.
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Affiliation(s)
- Uzma Shamsi
- School of Medicine, University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Shaista Khan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Aysha Habib Khan
- Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Amir Maqbool
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Mohammad Hanif
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Tiffany Gill
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - David Callen
- School of Medicine, University of Adelaide, Adelaide, Australia
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Kanstrup C, Teilum D, Rejnmark L, Bigaard JV, Eiken P, Kroman N, Tjønneland A, Mejdahl MK. 25-Hydroxyvitamin D at time of breast cancer diagnosis and breast cancer survival. Breast Cancer Res Treat 2019; 179:699-708. [PMID: 31707511 DOI: 10.1007/s10549-019-05486-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/28/2019] [Indexed: 01/24/2023]
Abstract
PURPOSE Previous studies have shown that low levels of 25-hydroxyvitamin D (25(OH)D) are associated with a poorer breast cancer survival. The relationship between vitamin D status and breast cancer outcomes is however still debated. The aim of the present study was to investigate the association between 25(OH)D blood levels measured at time of diagnosis and event-free survival (EFS) and overall survival (OS) in a large cohort of patients with early-stage primary invasive breast cancer. METHODS From April 2008 to April 2013, 25(OH)D status was measured at time of diagnosis in all women operated for early stage primary invasive breast cancer at Rigshospitalet, Copenhagen, Denmark. Associations between 25(OH)D and EFS and OS were investigated using a Cox Proportional hazards model, adjusting for age, disease characteristics, time period, and BMI. Differences in survival were evaluated by hazard ratios (HR). RESULTS In the present study, 2510 women with primary invasive breast cancer were included. Women with the lowest 25(OH)D levels (≤ 52 nmol/L) had an inferior EFS with a HR of 1.63 (95% CI 1.21-2.19) compared to women in the third quartile (76-99 nmol/L). Women with the highest 25(OH)D levels (≥ 99 nmol/L) also had an inferior EFS with a HR of 1.37 (95% CI 1.02-1.83). Plotting 25(OH)D status against EFS, the association was inversely J-shaped. For OS, a similar association with 25(OH)D status was observed. CONCLUSION We confirmed previous findings suggesting that a low 25(OH)D status is associated with an inferior breast cancer survival, but unlike previous findings, we found an indication of poorer breast cancer survival also among women with high 25(OH)D levels.
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Affiliation(s)
- Charlotte Kanstrup
- Department of Breast Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Dorthe Teilum
- Department of Breast Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Pia Eiken
- Department of Endocrinology and Nephrology, Nordsjaellands Hospital, Hilleroed, Denmark
| | - Niels Kroman
- Department of Breast Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark.,Danish Cancer Society, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Kvist Mejdahl
- Department of Breast Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark. .,Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
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12
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Robsahm TE, Tretli S, Torjesen PA, Babigumira R, Schwartz GG. Serum 25-hydroxyvitamin D levels predict cancer survival: a prospective cohort with measurements prior to and at the time of cancer diagnosis. Clin Epidemiol 2019; 11:695-705. [PMID: 31496824 PMCID: PMC6690592 DOI: 10.2147/clep.s207230] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022] Open
Abstract
Purpose Circulating 25-hydroxyvitamin D (25-OHD) levels have been inversely associated with cancer death, but the nature of this relationship is unclear. We investigated this association using repeated measurements of serum 25-OHD. Patients and methods Pre-diagnostic serum samples were collected in population health surveys in Norway (1973–2004). Participants who subsequently developed cancer (1984–2004) provided a second serum sample at the time of cancer diagnosis. Samples were stored in the Janus Serum Bank. Repeated samples existed from 202 breast cancers, 193 lung cancers, 124 lymphomas, and 37 colon cancers. Serum 25-OHD was measured via competitive radioimmunoassay. Cox regression models assessed associations between 25-OHD and cancer-specific death (case fatality) through 2012, given as hazard ratios (HRs) with 95% confidence intervals (CIs). Results The median time between pre-diagnostic and diagnostic samples was 14.4 years. The median 25-OHD levels were 63.3 and 62.5 nmol/L, respectively. During follow-up, 313 cancer deaths occurred. Compared to low pre-diagnostic 25-OHD levels (<46 nmol/L), higher levels (≥46 nmol/L) had significantly lower HRs (39–54%) of case fatality. This result was also seen for the diagnostic samples. Donors who had both samples at high (≥62 nmol/L) levels had 59% lower HR of case fatality, compared to those for whom both samples were at low levels (<46 nmol/L). Furthermore, versus a decline in serum 25-OHD (median −22.4 nmol/L) from pre-diagnostic to diagnostic samples, a rise (median 22.3 nmol/L) was associated with lower case fatality (HR 0.57, 95% CI 0.43−0.75). Conclusion Our findings suggest a causal relationship between vitamin D and cancer case fatality.
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Affiliation(s)
- Trude Eid Robsahm
- The Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Steinar Tretli
- The Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Peter Abusdal Torjesen
- The Hormone Laboratory, Department of Endocrinology, Oslo University Hospital Health Authority, Oslo, Norway
| | - Ronnie Babigumira
- The Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Gary G Schwartz
- Department of Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
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13
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Cattaruzza MS, Pisani D, Fidanza L, Gandini S, Marmo G, Narcisi A, Bartolazzi A, Carlesimo M. 25-Hydroxyvitamin D serum levels and melanoma risk: a case-control study and evidence synthesis of clinical epidemiological studies. Eur J Cancer Prev 2019; 28:203-211. [PMID: 29438161 DOI: 10.1097/cej.0000000000000437] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There is accumulating evidence that the vitamin D pathway may play a role in melanoma. The aim of this study was to investigate the association between 25-hydroxyvitamin D [25(OH)D] serum levels and the risk of cutaneous melanoma. A case-control study with 137 incident cases of melanoma (serum samples collected at the time of diagnosis) and 99 healthy controls (serum samples collected between October and April) was carried out and evaluated in the framework of an evidence synthesis of clinical epidemiological studies on the topic to facilitate comparisons and summarize the scientific evidence produced so far. There was a statistically significant difference in the median levels of serum vitamin D between melanoma patients and healthy controls (18.0 vs. 27.8 ng/ml, P<0.001). Among melanoma patients, 66.2%, compared with 15.2% of healthy controls, had vitamin D deficiency (≤20 ng/ml), whereas vitamin D sufficiency (≥30 ng/ml) was observed in only 7.4% of melanoma patients and in 37.4% of the healthy controls (P<0.001). A multivariate model including age, sex, and BMI showed a statistically significant inverse association between melanoma and vitamin D sufficiency versus deficiency (odds ratio=0.04; 95% confidence interval: 0.02-0.10, P<0.001). Also, vitamin D insufficiency versus deficiency was significantly inversely associated with melanoma (odds ratio=0.13; 95% confidence interval: 0.06-0.27, P<0.001). These results suggest that both deficient and insufficient serum levels of vitamin D are associated with melanoma and that a trend seems to be present with a reduced risk of melanoma when vitamin D approaches normal values.
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Affiliation(s)
| | | | - Laura Fidanza
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Giovanna Marmo
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Alessandra Narcisi
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Armando Bartolazzi
- Pathology Research Laboratory, Sant'Andrea Hospital, Rome.,Molecular and Cellular Tumor Pathology Laboratory, Cancer Center Karolinska, Karolinska Hospital, Stockholm, Sweden
| | - Marta Carlesimo
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
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14
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Torfadottir JE, Aspelund T, Valdimarsdottir UA, Cotch MF, Tryggvadottir L, Harris TB, Gudnason V, Adami HO, Mucci LA, Giovannucci EL, Stampfer MJ, Steingrimsdottir L. Pre-diagnostic 25-hydroxyvitamin D levels and survival in cancer patients. Cancer Causes Control 2019; 30:333-342. [PMID: 30805814 DOI: 10.1007/s10552-019-01143-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 02/11/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Our main aim was to explore whether pre-diagnostic circulating levels of 25-hydroxyvitamin D (25(OH)D) among older individuals with cancer were associated with overall and cancer-specific survival after diagnosis. DESIGN We used data from the Reykjavik-AGES Study on participants (n = 4,619) without cancer at entry, when blood samples were taken for 25(OH)D standardized measurements. The association with cancer risk, all-cause- and cancer-specific mortality was assessed among those later diagnosed with cancer, comparing four 25(OH)D categories, using 50-69.9 nmol/L as the reference category. RESULTS Cancer was diagnosed in 919 participants on average 8.3 years after blood draw. No association was observed between the reference group and other 25(OH)D groups and total cancer incidence. Mean age at diagnosis was 80.9 (± 5.7) years. Of those diagnosed, 552 died during follow-up, 67% from cancer. Low pre-diagnostic levels of 25(OH)D < 30 nmol/L were significantly associated with increased total mortality (HR: 1.39, 95% CI 1.03, 1.88) and non-significantly with cancer-specific mortality (HR: 1.33, 95% CI 0.93, 1.90). Among patients surviving more than 2 years after diagnosis, higher pre-diagnostic 25(OH)D levels (≥ 70 nmol/L) were associated with lower risk of overall (HR: 0.68, 95% CI 0.46, 0.99) and cancer-specific mortality (HR: 0.47, 95% CI 0.26, 0.99). CONCLUSIONS Among elderly cancer patients, low pre-diagnostic serum 25(OH)D levels (< 30 nmol/L) were associated with increased overall mortality.
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Affiliation(s)
- Johanna E Torfadottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland. .,Unit for Nutrition Research, Faculty for Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,The Icelandic Heart Association, Kopavogur, Iceland
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laufey Tryggvadottir
- The Icelandic Cancer Registry, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lorelei A Mucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Meir J Stampfer
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laufey Steingrimsdottir
- Unit for Nutrition Research, Faculty for Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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15
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Rosenberg A, Nettey OS, Gogana P, Sheikh U, Macias V, Kajdacsy-Balla A, Sharifi R, Kittles RA, Murphy AB. Physiologic serum 1,25 dihydroxyvitamin D is inversely associated with prostatic Ki67 staining in a diverse sample of radical prostatectomy patients. Cancer Causes Control 2019; 30:207-214. [PMID: 30730018 DOI: 10.1007/s10552-019-1128-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 01/03/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To investigate the correlation between serum 25 hydroxyvitamin D, prostatic 25 hydroxyvitamin D, and serum 1,25 dihydroxyvitamin D, and their respective associations with prostatic tumor proliferation at the time of radical prostatectomy. METHODS In this cross-sectional analysis of 119 men undergoing radical prostatectomy, serum from whole blood and expressed prostatic fluid was collected on the day of surgery. Tumor proliferation was measured in the dominant tumor on formalin-fixed prostatectomy tissues by immunohistochemical staining for Ki67 and quantified by Aperio imaging analysis. RESULTS The sample included 88 African Americans (74%) and 31 (26%) European Americans. Serum and prostatic levels of 25 hydroxyvitamin D were correlated with each other (Spearman's rho (ρ) = 0.27, p = 0.004), and there was also a correlation between serum 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D (ρ = 0.34, p < 0.001). Serum and prostatic 25 hydroxyvitamin D levels were not correlated with Ki67 staining in tumor cells. Serum 1,25 dihydroxyvitamin D was inversely correlated with Ki67 staining in tumor cells (ρ = - 0.30, p = 0.002). On linear regression, serum 1,25 dihydroxyvitamin D was negatively associated with Ki67 staining in tumor cells (β - 0.46, 95% CI - 0.75, - 0.04, p = 0.04). CONCLUSION The correlation between physiologic serum levels of 25 hydroxyvitamin D with both prostatic 25 hydroxyvitamin D and serum 1,25 dihydroxyvitamin D suggests that serum levels are reasonable biomarkers of vitamin D status. Furthermore, serum 1,25 dihydroxyvitamin D has an inverse association with Ki67 staining in tumor cells at physiologic levels and may protect against tumor progression.
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Affiliation(s)
- Adrian Rosenberg
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Oluwarotimi S Nettey
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pooja Gogana
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ujalla Sheikh
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago, IL, USA
| | - Virgilia Macias
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago, IL, USA
| | - Andre Kajdacsy-Balla
- Department of Pathology, University of Illinois at Chicago School of Medicine, Chicago, IL, USA
| | - Roohollah Sharifi
- Section of Urology, Jesse Brown VA Medical Center, Chicago, IL, USA
- Department of Urology, University of Illinois at Chicago School of Medicine, Chicago, IL, USA
| | - Rick A Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Cancer Center, Duarte, CA, USA
| | - Adam B Murphy
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Section of Urology, Jesse Brown VA Medical Center, Chicago, IL, USA.
- , 303 E Chicago Avenue, Tarry Building 16-729, 60611, Chicago, IL, USA.
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16
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Karthikayan A, Sureshkumar S, Kadambari D, Vijayakumar C. Low serum 25-hydroxy vitamin D levels are associated with aggressive breast cancer variants and poor prognostic factors in patients with breast carcinoma. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:452-459. [PMID: 30304110 PMCID: PMC10118730 DOI: 10.20945/2359-3997000000062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/24/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study was conducted to assess the serum 25-hydroxy (OH) vitamin D levels in patients with breast cancer compared to healthy controls and to identify its association with aggressive breast cancer phenotypes. MATERIALS AND METHODS Serum 25-OH vitamin D levels of 78 breast cancer patients and 78 matched healthy controls were estimated using ELISA. The cases and controls were matched with respect to age, menopausal status, parity, weight, height and co-morbidities. Prognostic factors like grade of tumour, hormone receptor status, HER2 neu status and lymphovascular invasion were compared with 25-OH vitamin D levels. RESULTS The mean serum 25-OH vitamin D levels of cases were significantly lower compared to the controls (22.33 ± 8.19 vs. 37.41 ± 12.9 ng/mL; p = 0.0001). Patients with higher grades of tumour, non-luminal types of breast cancer and breast cancers with estrogen receptor negativity had significantly lower serum 25-OH vitamin D levels than their opposing groups. Patients with excellent and good Nottingham's prognostic Index (NPI) had significantly higher serum 25-OH vitamin D levels than the moderate and poor NPI groups. CONCLUSION Newly diagnosed breast cancer patients have significantly lower serum 25-OH vitamin D levels than healthy controls. Lower level of serum 25-OH vitamin D correlates with aggressive breast cancer phenotypes.
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Affiliation(s)
- Arunkumar Karthikayan
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Sathasivam Sureshkumar
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Dharanipragada Kadambari
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Chellappa Vijayakumar
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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17
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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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18
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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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19
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Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma. Blood Cancer J 2017; 7:e595. [PMID: 28841207 PMCID: PMC5596381 DOI: 10.1038/bcj.2017.70] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 12/04/2022] Open
Abstract
We evaluated whether vitamin D insufficiency (VDI; 25(OH)D <20 ng/ml) was associated with adverse outcomes among follicular lymphoma (FL) patients using an observational prospective cohort study of 642 FL patients enrolled from 2002–2012. The median age at diagnosis was 60 years. At a median follow-up of 59 months, 297 patients (46%) had an event (progression, treatment failure), 78 had died and 42 (6.5%) had a lymphoma-related death. VDI was associated with inferior event-free survival (EFS) at 12 months (EFS12, odds ratio (OR)=2.05; 95% confidence interval (CI) 1.18–3.54), overall survival (OS, hazards ratio (HR)=2.35; 95%CI 1.37–4.02), and lymphoma-specific survival (LSS, HR=2.97; 95% CI 1.52–5.80) for the full cohort. Among patients treated with immunochemotherapy (IC), VDI was associated with inferior EFS12 (OR=3.00; 95% CI 1.26–7.13), OS (HR=2.86; 95% CI 1.39–5.85), and LSS (HR=2.96; 95% CI 1.29–6.79). For observed patients, VDI was associated with inferior OS (HR=2.85; 95% CI 1.20–6.76). For other therapies, VDI was associated with inferior OS (HR=3.06; 95% CI 1.01–9.24). Our work is the first to reveal an association of VDI with early clinical failure, and to demonstrate an association of VDI with adverse outcomes among patients who are observed or treated with therapies other than IC. Our findings suggest a potentially modifiable prognostic factor to address in patients with FL.
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20
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Stenehjem JS, Grimsrud TK, Rees JR, Vos L, Babigumira R, Veierød MB, Robsahm TE. A protocol for prospective studies of 25-hydroxyvitamin D, leptin and body mass index in relation to cutaneous melanoma incidence and survival. BMJ Open 2017; 7:e014829. [PMID: 28637727 PMCID: PMC5623373 DOI: 10.1136/bmjopen-2016-014829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/22/2017] [Accepted: 03/31/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The incidence and mortality rates of cutaneous melanoma (CM) are increasing among fair-skinned populations worldwide. Ultraviolet radiation (UVR) is the principal risk factor for CM, but is also the main source of 25-hydroxyvitamin D (25(OH)D), which has been associated with reduced risk and better prognosis of some cancer types. However, both low and high 25(OH)D levels have been associated with increased risk of CM. Obesity as measured by body mass index (BMI) is associated with risk of several cancers and has also been suggested as a risk factor for CM, and may also be related to insufficient 25(OH)D and/or high leptin levels. Moreover, contracting a CM diagnosis has been associated with increased risk of developing second cancer. We aim to study whether low prediagnostic serum levels of 25(OH)D, high prediagnostic levels of BMI and high serum leptin levels influence CM incidence, Breslow thickness and CM mortality, and risk of second cancer and survival after a CM diagnosis. METHODS AND ANALYSIS Cohort and nested case-control studies will be carried out using the population-based Janus Serum Bank Cohort (archival prediagnostic sera, BMI, smoking and physical activity), with follow-up from 1972 to 2014. Additional data will be received from the Cancer Registry of Norway, the national Cause of Death Registry, Statistics Norway (education and occupation) and exposure matrices of UVR. Time-to-event regression models will be used to analyse the cohort data, while the nested case-control studies will be analysed by conditional logistic regression. A multilevel approach will be applied when incorporating group-level data. ETHICS AND DISSEMINATION The project is approved by the Regional Committee for Medical Research Ethics and is funded by the Norwegian Cancer Society. Results will be published in peer-reviewed journals, at scientific conferences and in the news media.
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Affiliation(s)
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Judith R Rees
- New Hampshire State Cancer Registry, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Linda Vos
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Marit B Veierød
- Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
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21
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Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng TYD, Hong CC, McCann SE, Tang L, Davis W, Liu S, Quesenberry CP, Lee MM, Ambrosone CB, Kushi LH. Association of Serum Level of Vitamin D at Diagnosis With Breast Cancer Survival: A Case-Cohort Analysis in the Pathways Study. JAMA Oncol 2017; 3:351-357. [PMID: 27832250 DOI: 10.1001/jamaoncol.2016.4188] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance There are long-standing interests in the potential benefits of vitamin D for preventing breast cancer recurrence and mortality, yet data from prospective cohort studies are limited. Objective To investigate a serum biomarker of vitamin D status, 25-hydroxyvitamin D (25OHD) measured at the time of breast cancer diagnosis, to determine the association with prognosis. Design, Setting, and Participants The Pathways Study is a prospective cohort study of breast cancer survivors established in 2006. Enrollment was completed in 2013; follow-up is ongoing. The cohort was established in Kaiser Permanente Northern California, a large integrated health care delivery system in northern California. Women with a diagnosis of incident invasive breast cancer were typically consented and enrolled within 2 months of diagnosis. The overall enrollment rate was 46% (4505 of 9820). Participants are followed for health outcomes and comorbidities at 12, 24, 48, 72, and 96 months after baseline interview. A case-cohort design was used for efficiency assay of 25OHD, selecting 1666 cohort members with serum samples and ensuring representation in the subcohort of races and clinical subtypes. The data analysis was performed from January 5, 2014, to March 15, 2015. Main Outcomes and Measures Primary outcomes are breast cancer recurrence, second primary cancer, and death. Results Mean (SD) age was 58.7 (12.4) years. Serum 25OHD concentrations were lower in women with advanced-stage tumors, and the lowest in premenopausal women with triple-negative cancer. Levels were also inversely associated with hazards of disease progression and death. Compared with the lowest tertile, women with the highest tertile of 25OHD levels had superior overall survival (OS). This association remained after adjustment for clinical prognostic factors (hazard ratio [HR], 0.72; 95% CI, 0.54-0.98). Among premenopausal women, the association with OS was stronger, and there were also associations with breast cancer-specific survival and invasive disease-free survival (OS: HR, 0.45; 95% CI, 0.21-0.96; breast cancer-specific survival: HR, 0.37; 95% CI, 0.15-0.93; invasive disease-free survival: HR, 0.58; 95% CI, 0.34-1.01; all after full adjustment). Conclusions and Relevance Serum 25OHD levels were independently associated with breast cancer prognostic characteristics and patient prognosis, most prominently among premenopausal women. Our findings from a large, well-characterized prospective cohort provide compelling observational evidence on associations of vitamin D with lower risk of breast cancer morbidity and mortality.
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Affiliation(s)
- Song Yao
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Isaac J Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Ting-Yuan David Cheng
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Warren Davis
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Song Liu
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Marion M Lee
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland
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Grant WB. The UVB-vitamin D 3 -pigment hypothesis is alive and well. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:752-755. [PMID: 27554177 DOI: 10.1002/ajpa.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/11/2016] [Indexed: 12/26/2022]
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, CA, 94164-1603, USA
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Vashi PG, Edwin P, Popiel B, Gupta D. The relationship between circulating 25-hydroxyvitamin D and survival in newly diagnosed advanced non-small-cell lung cancer. BMC Cancer 2015; 15:1012. [PMID: 26704811 PMCID: PMC4691020 DOI: 10.1186/s12885-015-2043-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 12/21/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Serum 25-hydroxyvitamin D [25(OH)D], the major circulating form of vitamin D used for evaluating the vitamin D status of patients, has been associated with survival in a variety of cancers with conflicting evidence. We aimed to investigate this association in newly diagnosed advanced non-small-cell lung cancer (NSCLC) patients. METHODS This was a consecutive cohort of 359 newly diagnosed stages III-IV NSCLC patients who underwent a baseline serum 25(OH)D evaluation prior to receiving any treatment at our institution between January 2008 and December 2010. We used the vitamin D categories of "deficient (<20 ng/ml)" and "not deficient (> = 20 ng/ml)". Cox regression was used to evaluate the prognostic significance of serum 25(OH)D after adjusting for relevant confounders. RESULTS Mean age at diagnosis was 57.4 years. Of the 359 patients, 151 (42.1 %) were deficient in vitamin D at the time of diagnosis. The median survival in deficient and not deficient cohorts was 11.7 and 12.8 months respectively (p = 0.06). Season of diagnosis, performance status, smoking status and hospital location significantly predicted vitamin D status. On univariate Cox analysis, gender, stage of disease, hospital location, histologic subtype, subjective global assessment (SGA), performance status, smoking status, body mass index and serum albumin were significantly associated with survival (p <0.05 for all). On multivariate Cox analysis, six variables demonstrated statistically significant associations with survival: stage of disease, hospital location, histologic subtype, SGA, smoking status and serum albumin (p <0.05 for all). Serum vitamin D, which was borderline significant in univariate analysis, lost its significance in multivariate analysis. CONCLUSIONS We found season of diagnosis, performance status and smoking history to be predictive of vitamin D status. Consistent with previously published research in advanced NSCLC, we did not find any significant association between pre-treatment serum 25(OH)D and survival in our patients.
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Affiliation(s)
- Pankaj G Vashi
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, IL, 60099, USA.
| | - Persis Edwin
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, IL, 60099, USA.
| | - Brenten Popiel
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, IL, 60099, USA.
| | - Digant Gupta
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, IL, 60099, USA.
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Schöttker B, Brenner H. Vitamin D as a Resilience Factor, Helpful for Survival of Potentially Fatal Conditions: A Hypothesis Emerging from Recent Findings of the ESTHER Cohort Study and the CHANCES Consortium. Nutrients 2015; 7:3264-78. [PMID: 25954901 PMCID: PMC4446751 DOI: 10.3390/nu7053264] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/02/2015] [Accepted: 04/24/2015] [Indexed: 12/14/2022] Open
Abstract
There is debate on whether vitamin D deficiency is a risk factor for major chronic diseases and premature death or whether observed associations were just confounded by general health status. Here, we review recent results from the Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen in der älteren Bevölkerung (ESTHER) cohort study and the Consortium on Heatlh and Ageing: Network of Cohorts from Europe and the United States (CHANCES) that suggest that vitamin D deficiency may not be a risk factor for the development of cardiovascular diseases and cancer but may be a risk factor for fatal instances of these diseases. Furthermore, analyses comprehensively adjusted for the health status showed that the association of vitamin D and mortality was very likely not confounded by general health status. These results suggest that vitamin D could be a marker of resilience to fatality of potentially fatal diseases. Sufficient vitamin D serum concentrations may be needed to regulate the response of the immune system when it is challenged by severe diseases to prevent a fatal course of the disease. If this hypothesis can be verified through basic research studies and adequately designed randomized controlled trials, it could have important public health implications because vitamin D deficiency is very common worldwide, and interventions could be implemented easily.
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Affiliation(s)
- Ben Schöttker
- German Cancer Research Center (DKFZ)-Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Hermann Brenner
- German Cancer Research Center (DKFZ)-Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
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25
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Kelly JL, Salles G, Goldman B, Fisher RI, Brice P, Press O, Casasnovas O, Maloney DG, Soubeyran P, Rimsza L, Haioun C, Xerri L, LeBlanc M, Tilly H, Friedberg JW. Low Serum Vitamin D Levels Are Associated With Inferior Survival in Follicular Lymphoma: A Prospective Evaluation in SWOG and LYSA Studies. J Clin Oncol 2015; 33:1482-90. [PMID: 25823738 DOI: 10.1200/jco.2014.57.5092] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. PATIENTS AND METHODS SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography-tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). RESULTS After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). CONCLUSION Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.
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Affiliation(s)
- Jennifer L Kelly
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Gilles Salles
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Bryan Goldman
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Richard I Fisher
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Pauline Brice
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Oliver Press
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Olivier Casasnovas
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - David G Maloney
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Pierre Soubeyran
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Lisa Rimsza
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Corinne Haioun
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Luc Xerri
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Michael LeBlanc
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Hervé Tilly
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ
| | - Jonathan W Friedberg
- Jennifer L. Kelly and Jonathan W. Friedberg, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; Gilles Salles, Hospices Civils de Lyon, Université Claude Bernard Lyon-1, Pierre Benite; Pauline Brice, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris; Olivier Casasnovas, Centre Hospitalo-Universitaire de Dijon, Dijon; Pierre Soubeyran, Institut Bergonié and Université Victor Segalen Bordeaux 2, Bordeaux; Corinne Haioun, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil; Luc Xerri, Institut Paoli Calmettes, Marseille; Hervé Tilly, Centre Henri Becquerel, Rouen, France; Bryan Goldman, Oliver Press, and Michael LeBlanc, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Richard I. Fisher, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA; and Lisa Rimsza, University of Arizona, Tucson, AZ.
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Gupta D, Trukova K, Popiel B, Lammersfeld C, Vashi PG. The association between pre-treatment serum 25-hydroxyvitamin D and survival in newly diagnosed stage IV prostate cancer. PLoS One 2015; 10:e0119690. [PMID: 25774530 PMCID: PMC4361634 DOI: 10.1371/journal.pone.0119690] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/15/2015] [Indexed: 12/31/2022] Open
Abstract
Background/Aims Emerging evidence in the literature suggests a positive association between serum 25-hydroxyvitamin D [25(OH)D], a standard indicator of vitamin D status, and survival in certain types of cancer. We investigated this relationship in newly diagnosed stage IV prostate cancer patients. Methods A consecutive cohort of 125 newly diagnosed stage IV prostate cancer patients underwent a baseline serum 25(OH)D evaluation prior to receiving any treatment at our institution between January 2008 and December 2011. We used the vitamin D categories of “deficient (<20 ng/ml)”, “insufficient (20 to 32 ng/ml)”, and “sufficient (>32 ng/ml)”. Cox regression was used to evaluate the prognostic significance of serum 25(OH)D after adjusting for relevant confounders. Results Mean age at diagnosis was 60 years. Of the 125 patients, 32 (25.6%) were deficient, 49 (39.2%) were insufficient and 44 (35.2%) were sufficient in vitamin D at the time of diagnosis. The median survival in deficient, insufficient and sufficient cohorts was 47.8, 44.0 and 52.6 months respectively (p = 0.60). On univariate analysis, four variables demonstrated a statistically significant association with survival: nutritional status, bone metastasis, corrected serum calcium and serum albumin (p<0.05 for all). On multivariate analysis, five variables demonstrated statistically significant associations with survival: hospital location, age, bone metastasis, serum albumin and corrected serum calcium (p<0.05 for all). Serum vitamin D status was not significant on either univariate or multivariate analysis. Conclusion Contrary to previously published research, we found no significant association between pre-treatment serum 25(OH)D and survival in newly diagnosed stage IV prostate cancer patients. The lack of a significant association between serum vitamin D and survival in our study could perhaps be due to the fact that the disease was far too advanced in our patients for vitamin D levels to have any impact on prognosis.
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Affiliation(s)
- Digant Gupta
- Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, United States of America
- * E-mail:
| | - Kristen Trukova
- Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, United States of America
| | - Brenten Popiel
- Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, United States of America
| | - Carolyn Lammersfeld
- Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, United States of America
| | - Pankaj G. Vashi
- Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, United States of America
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27
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Rossdeutscher L, Li J, Luco AL, Fadhil I, Ochietti B, Camirand A, Huang DC, Reinhardt TA, Muller W, Kremer R. Chemoprevention activity of 25-hydroxyvitamin D in the MMTV-PyMT mouse model of breast cancer. Cancer Prev Res (Phila) 2014; 8:120-8. [PMID: 25468832 DOI: 10.1158/1940-6207.capr-14-0110] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Development of oncologic conditions is often accompanied by inadequate vitamin D status. The chemoprevention ability of this molecule is of high interest for breast cancer, the most common malignancy in women worldwide. Because current effective vitamin D analogues, including the naturally occurring active metabolite 1,25-dihydroxycholecalciferol (1,25(OH)2D), frequently cause hypercalcemia at pharmacologic doses, the development of safer molecules for clinical chemopreventive use is essential. This study examines whether exogenously supplied prohormone 25-hydroxycholecalciferol (25(OH)D) can delay tumor progression in vivo without hypercalcemic effects. A low vitamin D diet (25 IU/kg) in the non-immunodeficient MMTV-PyMT mouse model of metastatic breast cancer revealed a significant acceleration of mammary neoplasia compared with normal diet (1,000 IU/kg). Systemic perfusion of MMTV-PyMT mice with 25(OH)D or 1,25(OH)2D delayed tumor appearance and significantly decreased lung metastasis, and both metabolites reduced Ki-67, cyclin D1, and ErbB2 levels in tumors. Perfusion with 25(OH)D caused a 50% raise in tumor 1,25(OH)2D levels, indicating good tumor penetration and effective activation. Importantly, in contrast with 1,25(OH)2D, perfusion with 25(OH)D did not cause hypercalcemia. In vitro treatment of cultured MMTV-PyMT mammary tumor cells with 25(OH)D inhibited proliferation, confirming local activation of the prohormone in this system. This study provides an in vivo demonstration in a non-immunodeficient model of spontaneous breast cancer that exogenous 25(OH)D delays neoplasia, tumor growth, and metastasis, and that its chemoprevention efficacy is not accompanied by hypercalcemia.
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Affiliation(s)
- Lionel Rossdeutscher
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Jiarong Li
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Aimée-Lee Luco
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Ibtihal Fadhil
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Benoit Ochietti
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Anne Camirand
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Dao Chao Huang
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Timothy A Reinhardt
- United States Dept of Agriculture (ARS), National Animal Disease Center, Ames, Iowa
| | - William Muller
- Goodman Cancer Research Centre, McGill University, Montréal, Quebec, Canada
| | - Richard Kremer
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada.
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28
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Brożyna AA, Jochymski C, Janjetovic Z, Jóźwicki W, Tuckey RC, Slominski AT. CYP24A1 expression inversely correlates with melanoma progression: clinic-pathological studies. Int J Mol Sci 2014; 15:19000-17. [PMID: 25334067 PMCID: PMC4227257 DOI: 10.3390/ijms151019000] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/08/2014] [Accepted: 10/09/2014] [Indexed: 01/11/2023] Open
Abstract
The major role of 24-hydroxylase (CYP24A1) is to maintain 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) homeostasis. Recently, it has been discovered that CYP24A1 also catalyses the hydroxylation of 20(OH)D3, producing dihydroxy-derivatives that show very effective antitumorigenic activities. Previously we showed a negative correlation of vitamin D receptor (VDR) and CYP27B1 expression with progression, aggressiveness and overall or disease-free survivals of skin melanomas. Therefore, we analyzed CYP24A1 expression in relation to clinicopathomorphological features of nevi, skin melanomas and metastases. In melanocytic tumors, the level of CYP24A1 was higher than in the normal epidermis. The statistically highest mean CYP24A1 level was found in nevi and early stage melanomas. With melanoma progression, CYP24A1 levels decreased and in advanced stages were comparable to the normal epidermis and metastases. Furthermore, the CYP24A1 expression positively correlated with VDR and CYP27B1, and negatively correlated with mitotic activity. Lower CYP24A1 levels correlated with the presence of ulceration, necrosis, nodular type and amelanotic phenotypes. Moreover, a lack of detectable CYP24A1 expression was related to shorter overall and disease-free survival. In conclusion, the local vitamin D endocrine system affects melanoma behavior and an elevated level of CYP24A1 appears to have an important impact on the formation of melanocytic nevi and melanomagenesis, or progression, at early stages of tumor development.
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Affiliation(s)
- Anna A Brożyna
- Department of Tumor Pathology and Pathomorphology, the Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-796 Bygoszcz, Poland.
| | - Cezary Jochymski
- Department of Tumor Pathology and Pathomorphology, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, 85-796 Bygoszcz, Poland.
| | - Zorica Janjetovic
- Departments of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Wojciech Jóźwicki
- Department of Tumor Pathology and Pathomorphology, the Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-796 Bygoszcz, Poland.
| | - Robert C Tuckey
- School of Chemistry and Biochemistry, the University of Western Australia, Crawley, WA 6009, Australia.
| | - Andrzej T Slominski
- Departments of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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29
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Weyland PG, Grant WB, Howie-Esquivel J. Does sufficient evidence exist to support a causal association between vitamin D status and cardiovascular disease risk? An assessment using Hill's criteria for causality. Nutrients 2014; 6:3403-30. [PMID: 25184368 PMCID: PMC4179168 DOI: 10.3390/nu6093403] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/31/2014] [Accepted: 08/18/2014] [Indexed: 12/18/2022] Open
Abstract
UNLABELLED Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill's criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. CONCLUSION all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor.
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Affiliation(s)
- Patricia G Weyland
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco (UCSF), #2 Koret Way Box 0610, San Francisco, CA 94143, USA.
| | - William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.
| | - Jill Howie-Esquivel
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco (UCSF), #2 Koret Way Box 0610, San Francisco, CA 94143, USA.
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Caini S, Boniol M, Tosti G, Magi S, Medri M, Stanganelli I, Palli D, Assedi M, Marmol VD, Gandini S. Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: a comprehensive review and meta-analysis. Eur J Cancer 2014; 50:2649-58. [PMID: 25087185 DOI: 10.1016/j.ejca.2014.06.024] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 06/25/2014] [Accepted: 06/28/2014] [Indexed: 12/24/2022]
Abstract
Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60-3.53) and 1.64 (95% CI 1.02-2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63-1.13) for CM and 1.03 (95% CI 0.95-1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.
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Affiliation(s)
- Saverio Caini
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy.
| | - Mathieu Boniol
- International Prevention Research Institute, Lyon, France
| | - Giulio Tosti
- Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy
| | - Serena Magi
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Matelda Medri
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Ignazio Stanganelli
- Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Domenico Palli
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy
| | - Melania Assedi
- Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy
| | - Veronique Del Marmol
- Department of Dermatology. Hopital Erasme. Université Libre de Bruxelles, Brussels, Belgium
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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31
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Abstract
OBJECTIVE Black and Hispanic individuals synthesize less vitamin D per unit of sun exposure than white individuals. The relationship between UV radiation and vitamin D insufficiency in minorities has not been well explored. DESIGN Prospective cohort study. SETTING Using the National Health and Nutrition Examination Survey, we obtained serum vitamin D levels for non-Hispanic Whites, Hispanics and non-Hispanic Blacks aged ≥18 years from 2000-2006. We linked these data with the average monthly solar UV index by census tract and data on sun exposure, vitamin D supplementation, health and demographics. We used multivariable regression analyses to assess vitamin D deficiency (<15 ng/ml) and insufficiency (<20 ng/ml) in January (when the UV index was lowest) by race/ethnicity and geography. SUBJECTS Adults (n 14,319) aged ≥18 years. RESULTS A 1-point increase in the UV index was associated with a 0·51 ng/ml increase in vitamin D (95% CI 0·35, 0·67 ng/ml; P<0·001). Non-Hispanic Black race and Hispanic ethnicity were associated with a 7·47 and 3·41 ng/ml decrease in vitamin D, respectively (both P<0·001). In January, an estimated 65·4% of non-Hispanic Blacks were deficient in vitamin D, compared with 28·9% of Hispanics and 14·0% of non-Hispanic Whites. An estimated 84·2% of non-Hispanic Blacks were insufficient in vitamin D v. 56·3% of Hispanics and 34·8% of non-Hispanic Whites. More non-Hispanic Blacks were estimated to be deficient in vitamin D in January in the highest UV index quartile than were non-Hispanic Whites in the lowest UV index quartile (60·2% v. 25·7%). CONCLUSIONS Wintertime vitamin D insufficiency is pervasive among minority populations, and not uncommon among non-Hispanic Whites.
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