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Tran DV, Luu XQ, Tran HT, Myung SK. Dietary and supplementary vitamin C intake and the risk of lung cancer: A meta‑analysis of cohort studies. Oncol Lett 2024; 27:10. [PMID: 38034488 PMCID: PMC10688485 DOI: 10.3892/ol.2023.14144] [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] [Received: 05/26/2023] [Accepted: 10/16/2023] [Indexed: 12/02/2023] Open
Abstract
Previous cohort studies reported inconsistent findings regarding the association between dietary or supplementary vitamin C intake and lung cancer risk. These associations were investigated by conducting a meta-analysis of cohort studies. The PubMed and EMBASE databases were utilized, using keywords related to the topic from inception to April 15, 2022. Pooled effect sizes, such as relative risk (RR) or hazard ratio (HR) with 95% confidence intervals (CIs), were calculated using a random-effects model. A total of 20 cohort studies from 13 articles were included in the final analysis. In a meta-analysis of all studies, there was no significant association between dietary or supplementary vitamin C intake and lung cancer risk (RR/HR, 0.90; 95% CI, 0.80-1.01; I2=56.4%; n=20). In the subgroup meta-analysis by the source of vitamin C, dietary vitamin C intake decreased the risk of lung cancer (RR/HR, 0.82; 95% CI, 0.73-0.92; I2=42.5%; n=14), whereas there was no association between supplementary vitamin C intake and lung cancer risk (RR/HR, 1.01; 95% CI, 0.84-1.22; n=4). The present meta-analysis of cohort studies found that dietary vitamin C intake is beneficial for preventing lung cancer, whereas its supplementary intake does not have a beneficial effect.
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Affiliation(s)
- Dung V. Tran
- Department of International Collaboration and Research, Vietnam National Cancer Hospital, Hanoi 110000, Vietnam
- Vietnam National Cancer Institute, Vietnam National Cancer Hospital, Hanoi 110000, Vietnam
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Gyeonggi-do 10408, Republic of Korea
| | - Xuan Quy Luu
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Gyeonggi-do 10408, Republic of Korea
| | - Huong T.T. Tran
- Department of International Collaboration and Research, Vietnam National Cancer Hospital, Hanoi 110000, Vietnam
- Vietnam National Cancer Institute, Vietnam National Cancer Hospital, Hanoi 110000, Vietnam
| | - Seung-Kwon Myung
- Department of Cancer AI and Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Gyeonggi-do 10408, Republic of Korea
- Cancer Epidemiology Branch, Division of Cancer Data Science, Research Institute, National Cancer Center, Goyang, Gyeonggi-do 10408, Republic of Korea
- Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Gyeonggi-do 10408, Republic of Korea
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Mei Z, Hu H, Zou Y, Li D. The role of vitamin D in menopausal women's health. Front Physiol 2023; 14:1211896. [PMID: 37378077 PMCID: PMC10291614 DOI: 10.3389/fphys.2023.1211896] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Vitamin D (VD) is known to play an important role in the maintenance of calcium homeostasis and bone metabolism. In recent years, there has also been a growing interest in Vitamin D for health issues beyond the bones. Menopausal women are at risk of reduced bone density and increased risk of fracture due to a decline in estrogen levels. There is also an increased risk of cardiovascular disease, diabetes and hyperlipidaemia due to impaired lipid metabolism. The menopausal and emotional symptoms due to menopause are also increasingly prominent. This article summarizes the role of Vitamin D in menopausal women's health, including the effects of Vitamin D on skeletal muscle, cardiovascular disease, Genitourinary Syndrome of Menopause (GSM), cancer and emotional symptoms. Vitamin D regulates the growth of vaginal epithelial cells and alleviates genitourinary tract problems in menopausal women. Vitamin D also modulates immune function and influences the production of adipokines. Vitamin D and its metabolites also have an anti-proliferative effect on tumour cells. This narrative review, by summarizing recent work on the role of Vitamin D in menopausal women and in animal models of menopause, aims to provide a basis for further development of the role of Vitamin D in the health of menopausal women.
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Affiliation(s)
- Zhaojun Mei
- Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Hong Hu
- Department of Gynaecology, Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Yi Zou
- Department of Nephrology, Luzhou Maternal and Child Health Hospital (Luzhou Second People’s Hospital), Luzhou, Sichuan, China
| | - Dandan Li
- School of Basic Medical Sciences, University of Chinese Academy of Sciences, Beijing, China
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Zhang Z, Zhang X, Gao Y, Chen Y, Qin L, Wu IX. Risk factors for the development of lung cancer among never smokers: A systematic review. Cancer Epidemiol 2022; 81:102274. [PMID: 36209662 DOI: 10.1016/j.canep.2022.102274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 11/29/2022]
Abstract
This review aimed to summarize the up-to-date evidence on non-genetic factors for the development of never smoking lung cancer (NSLC) and to explore reasons behind the conflicting results. Relevant literature was searched in three electronic databases (PubMed, Embase and Web of Science) from 1 January 2000-31 July 2022. Cohort studies that investigated non-genetic risk factors for primary lung cancer in never smokers were included. The effect of non-genetic factors about NSLC were summarized with pooled relative risk (RR) and 95 % confidence intervals (CIs) through meta-analysis or narrative description when unexplained statistical heterogeneity was observed. The Newcastle-Ottawa Scale was used to appraise the methodological quality of included studies. Sixty cohort studies were included, covering population from Asia, Europe and America. Most included studies (42, 70.0 %) were of high methodological quality. Over 50 years old (RR = 5.26), environmental tobacco smoke (Pooled RR = 1.30), Chronic obstructive pulmonary disease (COPD) (RR = 2.67), family history of lung cancer (Pooled RR = 1.83) and higher level of neutrophil-lymphocyte ratio (RR = 1.73) increased the risk of NSLC. Dairy foods consumption (RR = 0.79), isoflavone intake (Pooled RR = 0.65), and riboflavin intake (RR = 0.62) decreased the risk among female population. Inconsistency or unclear definition for never smokers and risk factors could be observed in included studies. Most life behavior factors associated with NSLC can be modified through lifestyle changes. Future cohort studies are suggested to adopt a clearer definition on never smokers and exposure, conducting subgroup analysis when evidence indicating there is heterogeneity between genders, and explore dose-response relationship between the identified factors and NSLC.
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Affiliation(s)
- Zixuan Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuewei Zhang
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China; Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Lang Qin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Irene Xy Wu
- Xiangya School of Public Health, Central South University, Changsha, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, China.
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Qian M, Lin J, Fu R, Qi S, Fu X, Yuan L, Qian L. The Role of Vitamin D Intake on the Prognosis and Incidence of Lung Cancer: A Systematic Review and Meta-Analysis. J Nutr Sci Vitaminol (Tokyo) 2021; 67:273-282. [PMID: 34719612 DOI: 10.3177/jnsv.67.273] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The correlation between vitamin D intake and lung cancer development is controversial. This meta-analysis aims to evaluate the relationship between vitamin D and the prognosis and incidence of lung cancer. A comprehensive database search on PubMed, Web of Science, EBSCO, and Cochrane Library was carried out from the beginning to November 2020. Long-term survival and the incidence rate of patients with lung cancer were the primary outcomes of the study. Ten eligible studies were selected for the meta-analysis following specific inclusion and exclusion criteria. Four included studies, covering 5,007 patients, compared the overall survival (OS) and relapse-free survival (RFS) of lung cancer patients among total vitamin D users with non-users. Significantly, the estimated pooled hazard ratio (HR) revealed that vitamin D could improve OS and RFS of lung cancer patients [HR=0.83, 95% CI (0.72-0.95); HR=0.79, 95% CI (0.61-0.97), respectively]. Vitamin D intake was inversely associated with lung cancer incidence in six studies [OR=0.90, 95% CI (0.83-0.97)]. The present meta-analysis shows vitamin D not only improves the long-term survival of lung cancer patients but has a beneficial effect on the incidence of lung cancer. Notwithstanding, more studies are needed to confirm the study results.
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Affiliation(s)
- Mingxia Qian
- School of Public Health, Zhejiang Chinese Medical University
| | - Jun Lin
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital
| | - Rongrong Fu
- The First Clinical Medical College, Zhejiang Chinese Medical University
| | - Shuping Qi
- School of Public Health, Zhejiang Chinese Medical University
| | - Xiaojun Fu
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences
| | - Lingling Yuan
- Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences
| | - Lilin Qian
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital
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Story MJ. Zinc, ω-3 polyunsaturated fatty acids and vitamin D: An essential combination for prevention and treatment of cancers. Biochimie 2020; 181:100-122. [PMID: 33307154 DOI: 10.1016/j.biochi.2020.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 11/14/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
Zinc, ω-3 polyunsaturated fatty acids (PUFAs) and vitamin D are essential nutrients for health, maturation and general wellbeing. Extensive literature searches have revealed the widespread similarity in molecular biological properties of zinc, ω-3 PUFAs and vitamin D, and their similar anti-cancer properties, even though they have different modes of action. These three nutrients are separately essential for good health, especially in the aged. Zinc, ω-3 PUFAs and vitamin D are inexpensive and safe as they are fundamentally natural and have the properties of correcting and inhibiting undesirable actions without disturbing the normal functions of cells or their extracellular environment. This review of the anticancer properties of zinc, ω-3 PUFAs and vitamin D is made in the context of the hallmarks of cancer. The anticancer properties of zinc, ω-3 PUFAs and vitamin D can therefore be used beneficially through combined treatment or supplementation. It is proposed that sufficiency of zinc, ω-3 PUFAs and vitamin D is a necessary requirement during chemotherapy treatment and that clinical trials can have questionable integrity if this sufficiency is not checked and maintained during efficacy trials.
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Affiliation(s)
- Michael J Story
- Story Pharmaceutics Pty Ltd, PO Box 6086, Linden Park, South Australia, 5065, Australia.
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Sun K, Zuo M, Zhang Q, Wang K, Huang D, Zhang H. Anti-Tumor Effect of Vitamin D Combined with Calcium on Lung Cancer: A Systematic Review and Meta-Analysis. Nutr Cancer 2020; 73:2633-2642. [PMID: 33225749 DOI: 10.1080/01635581.2020.1850812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although many studies have demonstrated the impact of vitamin D and calcium on lung cancer, it remains the discrepancy for the effect of vitamin D and calcium on lung cancer. In this study, we aimed to verify the roles of vitamin D and calcium in the incidence and prognosis of lung cancer. A systematic literature search was performed by February 29, 2020. The relative risks (RRs) and hazard ratio (HRs) were pooled to evaluate the risk for the incidence and mortality of lung cancer. A total of 58,625 lung cancer cases from 40 studies were included. The risk (RR: 0.915, 95% Cl: 0.849-0.986) and mortality (RR: 0.718, 95% Cl: 0.530-0.973) of lung cancer were significantly decreased due to high circulating 25(OH)D level. Although the separate intake of vitamin D (RR: 0.909, 95% Cl: 0.801-1.031) and calcium (RR: 0.890, 95% Cl: 0.741-1.070) did not exhibit a protective effect on lung cancer, the combination supplement of vitamin D and calcium significantly decreased the incidence of lung cancer (RR: 0.811, 95% Cl: 0.659-0.999). High level of serum 25(OH)D could play the preventive role in lung cancer. Furthermore, vitamin D could be supplemented together with calcium against lung cancer.
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Affiliation(s)
- Kang Sun
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Minghao Zuo
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Qin Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Keyi Wang
- Central Laboratory, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dongdong Huang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honghe Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
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Boucher BJ. Why do so many trials of vitamin D supplementation fail? Endocr Connect 2020; 9:R195-R206. [PMID: 33052876 PMCID: PMC7487184 DOI: 10.1530/ec-20-0274] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/11/2020] [Indexed: 12/12/2022]
Abstract
Our knowledge of vitamin D has come a long way since the 100 years it took for doctors to accept, between 1860 and 1890, that both sunlight and cod liver oil (a well-known folk remedy) cured and prevented rickets. Vitamins D2/D3 were discovered exactly a hundred years ago, and over the last 50 years vitamin D has been found to have many effects on virtually all human tissues and not just on bone health, while mechanisms affecting the actions of vitamin D at the cellular level are increasingly understood, but deficiency persists globally. Observational studies in humans have shown that better provision of vitamin D is strongly associated, dose-wise, with reductions in current and future health risks in line with the known actions of vitamin D. Randomised controlled trials, commonly accepted as providing a 'gold standard' for assessing the efficacy of new forms of treatment, have frequently failed to provide supportive evidence for the expected health benefits of supplementation. Such RCTs, however, have used designs evolved for testing drugs while vitamin D is a nutrient; the appreciation of this difference is critical to identifying health benefits from existing RCT data and for improving future RCT design. This report aims, therefore, to provide a brief overview of the evidence for a range of non-bony health benefits of vitamin D repletion; to discuss specific aspects of vitamin D biology that can confound RCT design and how to allow for them.
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Affiliation(s)
- Barbara J Boucher
- Blizard Institute, Barts & The London school of Medicine & Dentistry, Queen Mary University of London, London, UK
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Vitamin D Signaling in Inflammation and Cancer: Molecular Mechanisms and Therapeutic Implications. Molecules 2020; 25:molecules25143219. [PMID: 32679655 PMCID: PMC7397283 DOI: 10.3390/molecules25143219] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/28/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022] Open
Abstract
Vitamin D and its active metabolites are important nutrients for human skeletal health. UV irradiation of skin converts 7-dehydrocholesterol into vitamin D3, which metabolized in the liver and kidneys into its active form, 1α,25-dihydroxyvitamin D3. Apart from its classical role in calcium and phosphate regulation, scientists have shown that the vitamin D receptor is expressed in almost all tissues of the body, hence it has numerous biological effects. These includes fetal and adult homeostatic functions in development and differentiation of metabolic, epidermal, endocrine, neurological and immunological systems of the body. Moreover, the expression of vitamin D receptor in the majority of immune cells and the ability of these cells to actively metabolize 25(OH)D3 into its active form 1,25(OH)2D3 reinforces the important role of vitamin D signaling in maintaining a healthy immune system. In addition, several studies have showed that vitamin D has important regulatory roles of mechanisms controlling proliferation, differentiation and growth. The administration of vitamin D analogues or the active metabolite of vitamin D activates apoptotic pathways, has antiproliferative effects and inhibits angiogenesis. This review aims to provide an up-to-date overview on the effects of vitamin D and its receptor (VDR) in regulating inflammation, different cell death modalities and cancer. It also aims to investigate the possible therapeutic benefits of vitamin D and its analogues as anticancer agents.
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Alsharairi NA. The Effects of Dietary Supplements on Asthma and Lung Cancer Risk in Smokers and Non-Smokers: A Review of the Literature. Nutrients 2019; 11:nu11040725. [PMID: 30925812 PMCID: PMC6521315 DOI: 10.3390/nu11040725] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/12/2019] [Accepted: 03/22/2019] [Indexed: 12/31/2022] Open
Abstract
Smoking is one of the major global causes of death. Cigarette smoke and secondhand (passive) smoke have been causally related to asthma and lung cancer. Asthma is a potential risk factor for developing lung cancer in both smokers and non-smokers. Prospective studies and randomized control trials (RCTs) of dietary supplements and lung cancer risk in adult smokers and non-smokers have yielded inconsistent results. A few prospective studies have shown that long-term use of high doses of some supplements, such as retinol, β-carotene, B vitamins, and vitamin E, increase lung cancer risk in current and former smokers. Limited evidence from RCTs suggests that vitamin D supplementation is effective in improving lung function and reducing asthma risk in current/former smokers. The relationship between dietary supplements and lung cancer risk has never before been examined in asthmatic smokers and non-smokers. This short review aims to examine the evidence from existing studies for the effects of dietary supplements on asthma/lung cancer risk and mortality in smokers and non-smokers.
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Affiliation(s)
- Naser A Alsharairi
- Menzies Health Institute Queensland, Heart, Mind and Body Research Group, Griffith University, Gold Coast 4222, Australia.
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Repurposing vitamin D for treatment of human malignancies via targeting tumor microenvironment. Acta Pharm Sin B 2019; 9:203-219. [PMID: 30972274 PMCID: PMC6437556 DOI: 10.1016/j.apsb.2018.09.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/04/2018] [Accepted: 07/19/2018] [Indexed: 02/06/2023] Open
Abstract
Tumor cells along with a small proportion of cancer stem cells exist in a stromal microenvironment consisting of vasculature, cancer-associated fibroblasts, immune cells and extracellular components. Recent epidemiological and clinical studies strongly support that vitamin D supplementation is associated with reduced cancer risk and favorable prognosis. Experimental results suggest that vitamin D not only suppresses cancer cells, but also regulates tumor microenvironment to facilitate tumor repression. In this review, we have outlined the current knowledge on epidemiological studies and clinical trials of vitamin D. Notably, we summarized and discussed the anticancer action of vitamin D in cancer cells, cancer stem cells and stroma cells in tumor microenvironment, providing a better understanding of the role of vitamin D in cancer. We presently re-propose vitamin D to be a novel and economical anticancer agent.
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Key Words
- 1,25(OH)2D3, 1α,25-dihydroxyvitamin D3
- 1α,25-Dihydroxyvitamin D3
- 25(OH)D, 25-hydroxyvitamin D
- CAF, cancer-associated fibroblast
- CRC, colorectal cancer
- CSC, cancer stem cell
- Cancer stem cell
- Cancer-associated fibroblast
- DBP/GC, vitamin D-binding protein
- ESCC, esophageal squamous cell carcinoma
- GI, gastrointestinal
- NSCLC, non-small cell lung cancer
- PC, pancreatic adenocarcinoma
- PG, prostaglandin
- PSC, pancreatic stellate cells
- TDEC, tumor derived endothelial cell
- TIC, tumor initiating cell
- TIL, tumor-infiltrating lymphocyte
- TME, tumor microenvironment
- Tumor microenvironment
- Tumor-derived endothelial cell
- Tumor-infiltrating lymphocyte
- VDR, vitamin D receptor
- VDRE, VDR element
- VEGF, vascular endothelial growth factor
- Vitamin D
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Abstract
While lung cancer has been the leading cause of cancer-related deaths for many years in the United States, incidence and mortality statistics - among other measures - vary widely worldwide. The aim of this study was to review the evidence on lung cancer epidemiology, including data of international scope with comparisons of economically, socially, and biologically different patient groups. In industrialized nations, evolving social and cultural smoking patterns have led to rising or plateauing rates of lung cancer in women, lagging the long-declining smoking and cancer incidence rates in men. In contrast, emerging economies vary widely in smoking practices and cancer incidence but commonly also harbor risks from environmental exposures, particularly widespread air pollution. Recent research has also revealed clinical, radiologic, and pathologic correlates, leading to greater knowledge in molecular profiling and targeted therapeutics, as well as an emphasis on the rising incidence of adenocarcinoma histology. Furthermore, emergent evidence about the benefits of lung cancer screening has led to efforts to identify high-risk smokers and development of prediction tools. This review also includes a discussion on the epidemiologic characteristics of special groups including women and nonsmokers. Varying trends in smoking largely dictate international patterns in lung cancer incidence and mortality. With declining smoking rates in developed countries and knowledge gains made through molecular profiling of tumors, the emergence of new risk factors and disease features will lead to changes in the landscape of lung cancer epidemiology.
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Affiliation(s)
- Julie A. Barta
- Division of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, US
| | - Charles A. Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Juan P. Wisnivesky
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
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Abstract
INTRODUCTION Vitamin D deficiency is common, world-wide, but vitamin D repletion throughout life, and into older age, has accepted health benefits for bone. Many mechanisms through which vitamin D also benefits soft tissues are understood, and clinical evidence of such benefits is now accumulating, especially following re-analyses of trial data, which are revealing previously missed health benefits with correction of deficiency. AREAS COVERED The sources of vitamin D, its activation, mechanistic effects; problems of trials of supplementation for reducing health risks, the benefits shown for mortality, cardiovascular disease, infection and cancer; the global problem of vitamin D deficiency; age-related reductions in vitamin D efficacy, and currently recommended intakes. EXPERT COMMENTARY High prevalence of vitamin D deficiency and insufficiency worldwide have proven ill-effects on health. Governmental efforts to improve population repletion by recommending minimal daily intakes does benefit some but is not effective at the population-level. However, food fortification with vitamin D3, already implemented in some countries, can solve this highly avoidable problem cost-effectively and is probably the best way to abolish vitamin D inadequacy, allowing public health benefits to emerge over time, thereby allowing future research on vitamin D to be directed at emerging issues on vitamin D.
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Wei H, Jing H, Wei Q, Wei G, Heng Z. Associations of the risk of lung cancer with serum 25-hydroxyvitamin D level and dietary vitamin D intake: A dose-response PRISMA meta-analysis. Medicine (Baltimore) 2018; 97:e12282. [PMID: 30212966 PMCID: PMC6155959 DOI: 10.1097/md.0000000000012282] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The associations of the risk of lung cancer with the vitamin D intake and serum level are controversial. We performed a comprehensive dose-response meta-analysis to evaluate the precise relationships between the above mentioned parameters.We performed a web search of the PubMed, Medline, and Embase databases to identify potential studies that evaluated the relationships between vitamin D intake or serum 25-hydroxyvitamin D (25([OH]D) levels and the risk of lung cancer on December 5, 2017. According to the inclusion and exclusive criteria, 16 studies were included in this meta-analysis. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to assess the strength of the associations. A dose-response analysis was conducted to quantitate the relationship between the serum 25(OH)D or vitamin D intake and the risk of lung cancer.The pooled RR (highest level vs lowest level) showed that the serum 25(OH)D level was not associated with the risk of lung cancer (RR = 1.046, 95% CI = 0.945-1.159). A high vitamin D intake was inversely correlated with the lung cancer risk (RR = 0.854, 95% CI = 0.741-0.984). No significant dose-response relationship was observed between the serum 25(OH)D level and the lung cancer risk. The linearity model of the dose-response analysis indicated that with every 100 IU/day increase in vitamin D intake, the risk of lung cancer decreased by 2.4% (RR = 0.976, 95% CI = 0.957-0.995, P = .018).A high vitamin D intake provides limited protection against lung cancer carcinogenesis.
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Affiliation(s)
- Hu Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Hu Jing
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Qian Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Guo Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Zhou Heng
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
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14
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Pirie K, Beral V, Heath AK, Green J, Reeves GK, Peto R, McBride P, Olsen CM, Green AC. Heterogeneous relationships of squamous and basal cell carcinomas of the skin with smoking: the UK Million Women Study and meta-analysis of prospective studies. Br J Cancer 2018; 119:114-120. [PMID: 29899391 PMCID: PMC6035218 DOI: 10.1038/s41416-018-0105-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Published findings on the associations between smoking and the incidence of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are inconsistent. We aimed to generate prospective evidence on these relationships overall and by anatomical site. METHODS We followed 1,223,626 women without prior cancer by electronic linkage to national cancer registration data. Questionnaire information about smoking and other factors was recorded at recruitment (1996-2001) and every 3-5 years subsequently. Cox regression yielded adjusted relative risks (RRs) comparing smokers versus never-smokers. RESULTS After 14 (SD4) years follow-up per woman, 6699 had a first registered cutaneous SCC and 48,666 a first BCC. In current versus never-smokers, SCC incidence was increased (RR = 1.22, 95% CI 1.15-1.31) but BCC incidence was decreased (RR = 0.80, 0.78-0.82). RRs varied substantially by anatomical site; for the limbs, current smoking was associated with an increased incidence of SCC (1.55, 1.41-1.71) and a decreased incidence of BCC (0.72, 0.66-0.79), but for facial lesions there was little association of current smoking with either SCC (0.93, 0.82-1.06) or BCC (0.92, 0.88-0.96). Findings in meta-analyses of results from this and seven other prospective studies were largely dominated by the findings in this study. CONCLUSIONS Smoking-associated risks for cutaneous SCC and BCC are in the opposite direction to each other and appear to vary by anatomical site.
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Affiliation(s)
- Kirstin Pirie
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Valerie Beral
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alicia K Heath
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Richard Peto
- Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Penelope McBride
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Adèle C Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK
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15
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Haznadar M, Krausz KW, Margono E, Diehl CM, Bowman ED, Manna SK, Robles AI, Ryan BM, Gonzalez FJ, Harris CC. Inverse association of vitamin D 3 levels with lung cancer mediated by genetic variation. Cancer Med 2018; 7:2764-2775. [PMID: 29726119 PMCID: PMC6010700 DOI: 10.1002/cam4.1444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/11/2018] [Accepted: 02/19/2018] [Indexed: 12/31/2022] Open
Abstract
Vitamin D is an essential micronutrient required for normal physiological function and recognized for its role regulating calcium metabolism. Recent work is beginning to emerge demonstrating a role for vitamin D in chronic illnesses, such as cancer. Circulating serum levels of 25(OH)D2/3 were quantitatively measured using sensitive ultraperformance liquid chromatography coupled to tandem mass spectrometry (UPLC‐MS/MS) in 406 lung cancer cases and 437 population controls, while 1,25(OH)2D2/3 levels were measured in a subset of 90 cases and 104 controls using the same method, from the NCI‐MD case–control cohort. 25(OH)D3 levels were inversely associated with lung cancer status across quartiles (Q2 vs. Q1: ORadjusted = 0.5, 95% CI = 0.3–0.8; Q3 vs. Q1: ORadjusted = 0.5, 95% CI = 0.3–0.8; Q4 vs. Q1: ORadjusted = 0.5, 95% CI = 0.2–0.9; Ptrend = 0.004). Levels of 1,25(OH)2D3 were also inversely associated with lung cancer status (Q2 vs. Q1: ORadjusted = 0.2, 95% CI = 0.03–0.7; Q3 vs. Q1: ORadjusted = 0.1, 95% CI = 0.01–0.4; Q4 vs. Q1: ORadjusted = 0.04, 95% CI = 0.01–0.3; Ptrend<0.0001). Although the observed trends were similar for the 25(OH)D2 (Ptrend = 0.08), no significant associations were seen between vitamin D2 and lung cancer status. Additionally, genotyping of 296 SNPs in the same subjects resulted in findings that 27 SNPs, predominantly in CYP24A1 and VDR genes, were significantly associated with lung cancer status, affected mRNA expression, and modulated vitamin D levels. These findings suggest a protective role for vitamin D3 in lung cancer, with similar trends but insignificant findings for D2. Vitamin D3 levels appeared to be modulated by genetic variation in CYP24A1 and VDR genes. Additional research to illuminate the mechanism(s) through which vitamin D exacerbates effects against lung carcinogenesis is warranted.
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Affiliation(s)
- Majda Haznadar
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Kristopher W Krausz
- Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Ezra Margono
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Christopher M Diehl
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Elise D Bowman
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics (HBNI), Kolkata, 700064, India
| | - Ana I Robles
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Bríd M Ryan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Frank J Gonzalez
- Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
| | - Curtis C Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, 20892
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16
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Narita S, Saito E, Sawada N, Shimazu T, Yamaji T, Iwasaki M, Ishihara J, Takachi R, Shibuya K, Inoue M, Tsugane S. Dietary consumption of antioxidant vitamins and subsequent lung cancer risk: The Japan Public Health Center-based prospective study. Int J Cancer 2018; 142:2441-2460. [PMID: 29355932 DOI: 10.1002/ijc.31268] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 12/13/2022]
Abstract
While many epidemiological studies have studied the association between lung cancer risk and fruits and vegetable consumption (the major sources of antioxidant vitamins), only a few have investigated the direct association with antioxidants in consideration of cancer subtypes and smoking status. Here, we examined the association between consumption of antioxidant vitamins and lung cancer risk in one of the largest prospective cohort studies in Japan. We investigated the association of dietary antioxidant vitamins intake, namely retinol, vitamin C, vitamin E, α-carotene, and β-carotene and subsequent incidence of lung cancer among 38,207 men and 41,498 women in the Japan Public Health Center-based prospective study. Cox proportional hazard regression was performed with adjustment for potential confounders and by strata of cancer subtypes and smoking status. Antioxidant and other dietary intakes were assessed using a food frequency questionnaire (FFQ). During 1,233,096 person-years of follow-up between 1995 and 2013, a total of 1,690 lung cancer cases were newly diagnosed. In a multivariate regression model, while higher retinol intake was positively associated with overall lung cancer risk in men (HR 1.26; 95% CI 1.05-1.51; ptrend = 0.003), the estimates were more evident with small cell carcinoma (HR 1.92; 95% CI 1.13-3.24; ptrend < 0.001). Null associations were observed for other antioxidant vitamins. Our prospective study suggests that higher consumption of retinol may be associated with an increased risk of lung cancer in men, especially with small cell carcinoma, although confirmation is required.
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Affiliation(s)
- Saki Narita
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Eiko Saito
- Division of Cancer Statistics and Integration, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Junko Ishihara
- Department of Food and Life Science, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, 252-5201, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Faculty of Human Life and Environment, Nara Women's University, Kitauoya Higashimachi, Nara, 630-8506, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Zhang L, Wang S, Zhu Y, Yang T. Vitamin D3 as adjunctive therapy in the treatment of depression in tuberculosis patients: a short-term pilot randomized double-blind controlled study. Neuropsychiatr Dis Treat 2018; 14:3103-3109. [PMID: 30532541 PMCID: PMC6241718 DOI: 10.2147/ndt.s183039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE We aimed to evaluate whether high-dose cholecalciferol has beneficial effects on depression in pulmonary tuberculosis (PTB) patients. METHODS This pilot, randomized, and double-blind trial enrolled 123 recurrent PTB patients (aged ≥18 years) meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria of major depressive disorder from four hospitals in Southeast China. Patients were randomly assigned to 8-week oral treatment with 100,000 IU/week cholecalciferol (Vit D group) or a matching placebo (control group). The primary outcome was treatment response, defined as a 50% reduction in symptoms and change in scores of the Chinese version of Beck Depression Inventory (BDI) from baseline to 8 weeks. Relative risks of depression were estimated using multivariable logistic regression. RESULTS Finally, 120 patients were enrolled, including 56 test patients and 64 controls. After 8 weeks, the treatment response or BDI scores did not differ significantly between groups. Multivariate logistic regression showed that BDI scores were not significantly improved in the Vit D group after adjustment for age, time to first negative smear, or 25-hydroxyvitamin D level. CONCLUSION The use of high-dose Vit D3 supplementation may not be warranted for reducing depressive symptoms in the PTB population. Nevertheless, this finding should be validated by further large-scale studies according to different kinds of depression or Vit D receptor polymorphism genotype.
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Affiliation(s)
- Li Zhang
- Second Department of Pulmonary Medicine, Ningbo No 2 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Shanshan Wang
- Department of Psychology, Ningbo No 2 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Yuyin Zhu
- Second Department of Pulmonary Medicine, Ningbo No 2 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Tianchi Yang
- Department of Tuberculosis Control, Ningbo Municipal Center for Disease Control & Prevention, Ningbo, Zhejiang, People's Republic of China,
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18
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Cheng TYD, Song X, Beresford SAA, Ho GYF, Johnson KC, Datta M, Chlebowski RT, Wactawski-Wende J, Qi L, Neuhouser ML. Serum 25-hydroxyvitamin D concentrations and lung cancer risk in never-smoking postmenopausal women. Cancer Causes Control 2017; 28:1053-1063. [PMID: 28900765 PMCID: PMC5963264 DOI: 10.1007/s10552-017-0956-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/07/2017] [Indexed: 12/26/2022]
Abstract
PURPOSE Vitamin D has been implicated in lowering lung cancer risk, but serological data on the association among never-smoking women are limited. We report results examining the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with lung cancer risk among female never smokers. We also examined whether the association was modified by vitamin D supplementation and serum vitamin A concentrations. METHODS In the Women's Health Initiative, including the calcium/vitamin D (CaD) Trial, we selected 298 incident cases [191 non-small cell lung cancer (NSCLC) including 170 adenocarcinoma] and 298 matched controls of never smokers. Baseline serum 25(OH)D was assayed by a chemiluminescent method. Logistic regression was used to estimate odds ratios (ORs) for quartiles and predefined clinical cutoffs of serum 25(OH)D concentrations. RESULTS Comparing quartiles 4 versus 1 of serum 25(OH)D concentrations, ORs were 1.06 [95% confidence interval (CI) 0.61-1.84] for all lung cancer, 0.94 (95% CI 0.52-1.69) for NSCLC, and 0.91 (95% CI 0.49-1.68) for adenocarcinoma. Comparing serum 25(OH)D ≥ 75 (high) versus <30 nmol/L (deficient), ORs were 0.76 (95% CI 0.31-1.84) for all lung cancer, 0.71 (95% CI 0.27-1.86) for NSCLC, and 0.81 (95% CI 0.31-2.14) for adenocarcinoma. There is suggestive evidence that CaD supplementation (1 g calcium + 400 IU D3/day) and a high level of circulating vitamin A may modify the associations of 25(OH)D with lung cancer overall and subtypes (p interaction <0.10). CONCLUSIONS In this group of never-smoking postmenopausal women, the results did not support the hypothesis of an association between serum 25(OH)D and lung cancer risk.
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Affiliation(s)
- Ting-Yuan David Cheng
- Department of Epidemiology, University of Florida, 2004 Mowry Road, 4th Floor, RM4213, P. O. Box 100231, Gainesville, FL, 32610, USA.
| | - Xiaoling Song
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shirley A A Beresford
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Gloria Y F Ho
- Feinstein Institute for Medical Research, Manhasset, NY, USA
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mridul Datta
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Jean Wactawski-Wende
- Department of Epidemiology and Environment Health, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lihong Qi
- Division of Biostatistics, Department of Public Health Sciences, University of California-Davis, Davis, CA, USA
| | - Marian L Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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19
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Marian MJ. Dietary Supplements Commonly Used by Cancer Survivors: Are There Any Benefits? Nutr Clin Pract 2017; 32:607-627. [PMID: 28813230 DOI: 10.1177/0884533617721687] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Following a cancer diagnosis, dietary supplements are reportedly used by 20%-80% of individuals. Supplements are most commonly used by breast cancer survivors, followed by patients with prostate, colorectal, and lung cancers, which is not surprising since these are the most common types of cancer diagnosed in adults. Reasons cited for such use include improving quality of life, reducing symptoms related to treatment and/or the disease process, and recommendation from medical practitioners; family and friends may also be an influence. However, controversy surrounds the use of dietary supplements, particularly during treatment-specifically, whether supplements affect treatment efficacy is unknown. This article discusses the evidence related to common dietary supplements used to prevent cancer or a recurrence.
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20
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Liu J, Dong Y, Lu C, Wang Y, Peng L, Jiang M, Tang Y, Zhao Q. Meta-analysis of the correlation between vitamin D and lung cancer risk and outcomes. Oncotarget 2017; 8:81040-81051. [PMID: 29113365 PMCID: PMC5655260 DOI: 10.18632/oncotarget.18766] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/11/2017] [Indexed: 12/14/2022] Open
Abstract
In this meta-analysis, we analyzed the association between vitamin D levels and lung carcinoma risk and outcomes. Two authors independently searched the Web of Science, Pubmed, EBSCO and Ovid MEDLINE resources with the key words “vitamin D, lung cancer, solar and latitude” and enrolled 22 studies that satisfied the inclusion criteria. The summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the random (or fixed)-effects model. Potential confounders were carefully adjusted. High vitamin D (or calcium) intake and serum 25(OH)D levels each correlated inversely with lung cancer risk [OR = 0.72 (95% CI: 0.61–0.85, p < 0.001) and OR = 0.89 (95% CI: 0.83–0.97, p < 0.05)]. High circulating 25(OH)D levels also reduced lung cancer mortality with the pooled OR reached 0.39 (95% CI: 0.28–0.54, p < 0.001)]. A positive trend was presented in the relationship between serum 25(OH) D and survival (OR = 1.01, 95% CI: 0.87–1.18, p = 0.87). Subgroup analysis revealed that nonsmokers had higher vitamin D levels, which correlated negatively with lung cancer risk (OR = 0.76, 95% CI: 0.65–0.88, p < 0.01). Moreover, lower sun exposure and high latitude associated with lower vitamin D levels. This meta-analysis shows that high vitamin D (or calcium) intake and serum 25(OH)D levels correlate with lower lung cancer risk and better prognosis. UVB and latitude may play a vital role in lung cancer occurrence and progression, although a direct evidence hasn't been obtained.
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Affiliation(s)
- Jian Liu
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Yongquan Dong
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Chao Lu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Yina Wang
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Ling Peng
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Mengjie Jiang
- Department of Radiotherapy, The First Affiliated Hospital, College of Medicine, Zhejiang Traditional Chinese Medical University, Hangzhou, Zhejiang Province, 310006, China
| | - Yemin Tang
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Qiong Zhao
- Department of Thoracic Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
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21
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Booth GC, Zhang Z, Shannon J, Bobe G, Takata Y. Calcium Intake and Cancer Risk: Current Evidence and Future Research Directions. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0193-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Diet-derived 25-hydroxyvitamin D3 activates vitamin D receptor target gene expression and suppresses EGFR mutant non-small cell lung cancer growth in vitro and in vivo. Oncotarget 2016; 7:995-1013. [PMID: 26654942 PMCID: PMC4808047 DOI: 10.18632/oncotarget.6493] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/15/2015] [Indexed: 12/24/2022] Open
Abstract
Epidemiologic studies implicate vitamin D status as a factor that influences growth of EGFR mutant lung cancers. However, laboratory based evidence of the biological effect of vitamin D in this disease is lacking. To fill this knowledge gap, we determined vitamin D receptor (VDR) expression in human lung tumors using a tissue microarray constructed of lung cancer cases from never-smokers (where EGFR gene mutations are prevalent). Nuclear VDR was detected in 19/19 EGFR mutant tumors. Expression tended to be higher in tumors with EGFR exon 19 deletions than those with EGFR L858R mutations. To study anti-proliferative activity and signaling, EGFR mutant lung cancer cells were treated with the circulating metabolite of vitamin D, 25-hydroxyvitamin D3 (25D3). 25D3 inhibited clonogenic growth in a dose-dependent manner. CYP27B1 encodes the 1α-hydroxylase (1αOHase) that converts 25D3 to the active metabolite, 1,25-dihydroxyvitamin D3 (1,25D3). Studies employing VDR siRNA, CYP27B1 zinc finger nucleases, and pharmacologic inhibitors of the vitamin D pathway indicate that 25D3 regulates gene expression in a VDR-dependent manner but does not strictly require 1αOHase-mediated conversion of 25D3 to 1,25D3. To determine the effects of modulating serum 25D3 levels on growth of EGFR mutant lung tumor xenografts, mice were fed diets containing 100 or 10,000 IU vitamin D3/kg. High dietary vitamin D3 intake resulted in elevated serum 25D3 and significant inhibition of tumor growth. No toxic effects of supplementation were observed. These results identify EGFR mutant lung cancer as a vitamin D-responsive disease and diet-derived 25D3 as a direct VDR agonist and therapeutic agent.
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23
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Efficacy of High-Dose Supplementation With Oral Vitamin D3 on Depressive Symptoms in Dialysis Patients With Vitamin D3 Insufficiency: A Prospective, Randomized, Double-Blind Study. J Clin Psychopharmacol 2016; 36:229-35. [PMID: 27022679 DOI: 10.1097/jcp.0000000000000486] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Psychological problems are common among end-stage renal disease patients undergoing dialysis. We aim to evaluate whether high-dose vitamin D3 (VD3) supplementation has beneficial effects on depressive symptoms in dialysis patients. This prospective, randomized, and double-blind trial includes 746 dialysis patients with depression treated in 3 hospitals in Southeast China. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Patients were randomly assigned to 52-week treatment of oral 50,000 IU/wk VD3 (cholecalciferol) (test group) or a placebo (control group). The presence of depressive symptoms was evaluated using the Chinese version of Beck Depression Inventory (BDI) II both before and after treatment. Sociodemographic data, clinical data, nutritional indexes, inflammatory biomarkers, and plasma VD3 concentrations were also determined. Finally, 726 patients completed the experiments, including 362 tested patients and 364 controls. After 52 weeks, the depressive symptoms were not significantly improved in the test group (mean BDI II scores changed from -1.1 ± 0.3 to -3.1 ± 0.6) versus the control group. Multivariable logistic regression showed BDI scores were not significantly improved in the test group versus the control group with adjustment for age, sex, comorbidity index, dialysis modality, or (OH)D levels (multivariable-adjusted mean change or MAMC [95% confidence interval (CI)], -2.3 [-2.48 to -1.83]) in the whole dialysis population. After stratification by depression types, the findings do support a significant relationship between the VD3 supplementation and the improvement in BDI II scores in dialysis patients with vascular depression (MAMC [95% CI], -4.4 [-5.08 to -2.76]), but the effect was not significant for major depressive disorders (MAMC [95% CI], -0.9 [-1.52 to -0.63]). The high-dose VD3 supplementation did not significantly reduce the depressive symptoms in our total dialysis population, but a beneficial effect on vascular depression was found, probably mainly based on the improvement of cardiovascular risk factors.
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McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, Lappe JM, Heaney RP. Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml Are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study. PLoS One 2016; 11:e0152441. [PMID: 27049526 PMCID: PMC4822815 DOI: 10.1371/journal.pone.0152441] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/14/2016] [Indexed: 12/31/2022] Open
Abstract
Background Higher serum 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with a lower risk of multiple cancer types across a range of 25(OH)D concentrations. Objectives To investigate whether the previously reported inverse association between 25(OH)D and cancer risk could be replicated, and if a 25(OH)D response region could be identified among women aged 55 years and older across a broad range of 25(OH)D concentrations. Methods Data from two cohorts representing different median 25(OH)D concentrations were pooled to afford a broader range of 25(OH)D concentrations than either cohort alone: the Lappe cohort (N = 1,169), a randomized clinical trial cohort (median 25(OH)D = 30 ng/ml) and the GrassrootsHealth cohort (N = 1,135), a prospective cohort (median 25(OH)D = 48 ng/ml). Cancer incidence over a multi-year period (median: 3.9 years) was compared according to 25(OH)D concentration. Kaplan-Meier plots were developed and the association between 25(OH)D and cancer risk was examined with multivariate Cox regression using multiple 25(OH)D measurements and spline functions. The study included all invasive cancers excluding skin cancer. Results Age-adjusted cancer incidence across the combined cohort (N = 2,304) was 840 cases per 100,000 person-years (1,020 per 100,000 person-years in the Lappe cohort and 722 per 100,000 person-years in the GrassrootsHealth cohort). Incidence was lower at higher concentrations of 25(OH)D. Women with 25(OH)D concentrations ≥40 ng/ml had a 67% lower risk of cancer than women with concentrations <20 ng/ml (HR = 0.33, 95% CI = 0.12–0.90). Conclusions 25(OH)D concentrations ≥40 ng/ml were associated with substantial reduction in risk of all invasive cancers combined.
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Affiliation(s)
| | - Carole Baggerly
- GrassrootsHealth, Encinitas, California, United States of America
| | | | - Leo L. Baggerly
- GrassrootsHealth, Encinitas, California, United States of America
| | - Cedric F. Garland
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Edward D. Gorham
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Joan M. Lappe
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
| | - Robert P. Heaney
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
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25
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Dairy Product, Calcium Intake and Lung Cancer Risk: A Systematic Review with Meta-Analysis. Sci Rep 2016; 6:20624. [PMID: 26877260 PMCID: PMC4753428 DOI: 10.1038/srep20624] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/08/2016] [Indexed: 12/23/2022] Open
Abstract
The effects of dairy products on human health have been studied for years. However, the relationship between dairy products as well as calcium intake and the risk of lung cancer is still inconclusive. A total of 32 studies regarding this association were identified from the PubMed and Web of Science databases through April 1, 2015, including 12 cohort studies and 20 case-control studies. After pooling the results of individual studies, the summary RRs (relative risks) of lung cancer for the highest versus lowest intake were 1.05 (95%CI: 0.84–1.31) and 1.08 (95%CI: 0.80–1.46) for total dairy products and milk, respectively. The results on the consumption of cheese, yogurt and low-fat milk were also negative, and the RRs for total and dietary calcium intakes were 0.99 (95%CI: 0.70–1.38) and 0.85 (95%CI: 0.63–1.13), respectively. After stratifying by potential confounders, the results remained consistent in most subgroup analyses. Our study indicates that intake of dairy products or calcium was not statistically associated with the risk of lung cancer. This negative finding provides a conclusive answer to the disease association issue based on current evidence, and suggests that further efforts should be made to find other nutritional risk factors for lung cancer.
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26
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Vitamin D deficiency in patients admitted to the general ward with breast, lung, and colorectal cancer in Buenos Aires, Argentina. Arch Osteoporos 2016; 11:4. [PMID: 26732091 DOI: 10.1007/s11657-015-0256-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/14/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED A high prevalence of hypovitaminosis D has been reported in cancer patients. Low levels of 25-(OH)-vitamin D were found in 158 of 162 (97.5%) inpatients with breast, lung, and colorectal cancer under active treatment, with severe deficiency (<20 ng/ml) in 77.2% and mild deficiency (20-30 ng/ml) in 20.4%. PURPOSE A high prevalence of vitamin D deficiency has been reported in cancer patients. Nevertheless, vitamin D serum levels have been checked in few patients. Information about the frequency of hypovitaminosis D in cancer patients in Argentina is unknown. The aim of the study was to assess the frequency of vitamin D deficiency in patients with breast, lung, and colorectal cancer. METHODS A prospective observational study was designed for cancer patients admitted to the general ward in 2014. The patients included had breast, lung, and colorectal cancer. All of them were under active treatment. The serum level of 25-(OH)-vitamin D [25-(OH)-D] was measured and categorized as sufficiency (>30 ng/ml), mild deficiency (20-30 ng/ml), and severe deficiency (<20 ng/ml). RESULTS A total of 162 patients were included, 98.2% were in stages III-IV. Median level of 25-(OH)-D was 15.3 ng/ml (range 4.1-103.6 ng/ml). Serum levels <30 ng/ml were found in 158 (97.5%) patients, severe deficiency in 125 cases (77.2%) and mild deficiency in 33 cases (20.4%). In patients under chemo/hormone therapy, the median level was 15.3 ng/ml (range 4.1-103.6 ng/ml) and in those under concurrent therapy was 17.1 ng/ml (range 7.4-58.5 ng/ml); p = 0.1944. There were no statistical differences in severe or mild deficiency of vitamin D among breast, lung, and colorectal cancer patients. CONCLUSION The study found a high prevalence of vitamin D deficiency in hospitalized cancer patients under active treatment. Many authors have recommended dosing vitamin D levels in this population; normalizing serum levels is difficult.
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de Jonge EAL, Kiefte-de Jong JC, Campos-Obando N, Booij L, Franco OH, Hofman A, Uitterlinden AG, Rivadeneira F, Zillikens MC. Dietary vitamin A intake and bone health in the elderly: the Rotterdam Study. Eur J Clin Nutr 2015; 69:1360-8. [PMID: 26373964 DOI: 10.1038/ejcn.2015.154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 07/07/2015] [Accepted: 08/03/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES High vitamin A intake may be associated with a decreased bone mineral density (BMD) and increased risk of fractures. Our objectives were to study whether dietary intake of vitamin A (total, retinol or beta-carotene) is associated with BMD and fracture risk and if associations are modified by body mass index (BMI) and vitamin D. SUBJECTS/METHODS Participants were aged 55 years and older (n=5288) from the Rotterdam Study, a population-based prospective cohort. Baseline vitamin A and D intake was measured by a food frequency questionnaire. BMD was measured by dual-energy X-ray absorptiometry at four visits between baseline (1989-1993) and 2004. Serum vitamin D was assessed in a subgroup (n=3161). Fracture incidence data were derived from medical records with a mean follow-up time of 13.9 years. RESULTS Median intake of vitamin A ranged from 684 retinol equivalents (REs)/day (quintile 1) to 2000 REs/day (quintile 5). After adjustment for confounders related to lifestyle and socioeconomic status, BMD was significantly higher in subjects in the highest quintile of total vitamin A (mean difference in BMD (95% confidence interval (CI))=11.53 (0.37-22.7) mg/cm(2)) and retinol intake (mean difference in BMD (95% CI)=12.57 (1.10-24.05) mg/cm(2)) than in the middle quintile. Additional adjustment for BMI diluted these associations. Fracture risk was reduced in these subjects. Significant interaction was present between intake of retinol and overweight (BMI >25 kg/m(2)) in relation to fractures (P for interaction =0.05), but not BMD. Stratified analysis showed that these favourable associations with fracture risk were only present in overweight subjects (BMI >25 kg/m(2)). No effect modification by vitamin D intake or serum levels was observed. CONCLUSIONS Our results suggest a plausible favourable relation between high vitamin A intake from the diet and fracture risk in overweight subjects, whereas the association between vitamin A and BMD is mainly explained by BMI.
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Affiliation(s)
- E A L de Jonge
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands.,Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands.,Department of Global Public Health, Leiden University College, The Hague, The Netherlands
| | - N Campos-Obando
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - L Booij
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - O H Franco
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - A Hofman
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands.,Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - F Rivadeneira
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - M C Zillikens
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
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Chen GC, Zhang ZL, Wan Z, Wang L, Weber P, Eggersdorfer M, Qin LQ, Zhang W. Circulating 25-hydroxyvitamin D and risk of lung cancer: a dose-response meta-analysis. Cancer Causes Control 2015; 26:1719-28. [PMID: 26358829 DOI: 10.1007/s10552-015-0665-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mounting experimental evidence supports a protective effect of high 25-hydroxyvitamin D (25[OH]D), a good indicator of vitamin D status, on risk of various cancers including lung cancer. However, prospective observational studies examining the 25(OH)D-lung cancer association reported inconsistent findings. A dose-response meta-analysis was carried out to elucidate the subject. METHODS Potentially eligible studies were identified by searching PubMed and EMBASE databases, and by carefully reviewing the bibliographies of retrieved publications. The summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random-effects model. RESULTS Thirteen reports from ten prospective studies were included, totaling 2,227 lung cancer events. Results of the meta-analysis showed a significant 5% (RR 0.95, 95% CI 0.91-0.99) reduction in the risk of lung cancer for each 10 nmol/L increment in 25(OH)D concentrations. This inverse association was not significantly modified by area, study duration, sex, methods for 25(OH)D measurement, baseline 25(OH)D levels, or quality score of included studies. There was evidence of a nonlinear relationship between 25(OH)D and risk of lung cancer (p-nonlinearity = 0.02), with the greatest reductions in risk observed at 25(OH)D of nearly 53 nmol/L, and remained protective until approximately 90 nmol/L. Further increases showed no significant association with cancer risk, but scanty data were included in the analyses of high-level 25(OH)D. There was no evidence of publication bias. CONCLUSION This dose-response meta-analysis of prospective studies suggests that 25(OH)D may be associated with reduced risk of lung cancer, in particular among subjects with vitamin D deficiencies.
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Affiliation(s)
- Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Zeng-Li Zhang
- Department of Labor Hygiene and Environmental Health, School of Public Health, Soochow University, Suzhou, China
| | - Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Ling Wang
- Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Peter Weber
- DSM Nutritional Products Ltd., Human Nutrition and Health, Kaiseraugst, Switzerland
| | - Manfred Eggersdorfer
- DSM Nutritional Products Ltd., Human Nutrition and Health, Kaiseraugst, Switzerland
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Renai Road, Suzhou, 215123, China.
| | - Weiguo Zhang
- DSM Nutritional Products Ltd., Human Nutrition and Health, No. 9 Dongdaqiao Road, Beijing, 100020, China.
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Mazzilli SA, Hershberger PA, Reid ME, Bogner PN, Atwood K, Trump DL, Johnson CS. Vitamin D Repletion Reduces the Progression of Premalignant Squamous Lesions in the NTCU Lung Squamous Cell Carcinoma Mouse Model. Cancer Prev Res (Phila) 2015; 8:895-904. [PMID: 26276745 DOI: 10.1158/1940-6207.capr-14-0403] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 07/20/2015] [Indexed: 12/14/2022]
Abstract
The chemopreventive actions of vitamin D were examined in the N-nitroso-tris-chloroethylurea (NTCU) mouse model, a progressive model of lung squamous cell carcinoma (SCC). SWR/J mice were fed a deficient diet (D) containing no vitamin D3, a sufficient diet (S) containing 2,000 IU/kg vitamin D3, or the same diets in combination with the active metabolite of vitamin D, calcitriol (C; 80 μg/kg, weekly). The percentage (%) of the mucosal surface of large airways occupied by dysplastic lesions was determined in mice after treatment with a total dose of 15 or 25 μmol NTCU (N). After treatment with 15 μmol NTCU, the percentages of the surface of large airways containing high-grade dysplastic (HGD) lesions were vitamin D-deficient + NTCU (DN), 22.7% [P < 0.05 compared with vitamin D-sufficient +NTCU (SN)]; DN + C, 12.3%; SN, 8.7%; and SN + C, 6.6%. The extent of HGD increased with NTCU dose in the DN group. Proliferation, assessed by Ki-67 labeling, increased upon NTCU treatment. The highest Ki-67 labeling index was seen in the DN group. As compared with SN mice, DN mice exhibited a three-fold increase (P < 0.005) in circulating white blood cells (WBC), a 20% (P < 0.05) increase in IL6 levels, and a four-fold (P < 0.005) increase in WBC in bronchial lavages. Thus, vitamin D repletion reduces the progression of premalignant lesions, proliferation, and inflammation, and may thereby suppress development of lung SCC. Further investigations of the chemopreventive effects of vitamin D in lung SCC are warranted.
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Affiliation(s)
- Sarah A Mazzilli
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, New York.
| | - Pamela A Hershberger
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, New York
| | - Mary E Reid
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Paul N Bogner
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York
| | - Kristopher Atwood
- Department of Biostatistics, Roswell Park Cancer Institute, Buffalo New York
| | | | - Candace S Johnson
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, New York
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Chen G, Wang J, Hong X, Chai Z, Li Q. Dietary vitamin E intake could reduce the risk of lung cancer: evidence from a meta-analysis. Int J Clin Exp Med 2015; 8:6631-6637. [PMID: 26131295 PMCID: PMC4483938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Quantification of the association between the intake of vitamin E and risk of lung cancer is still conflicting. Thus, we conducted a meta-analysis to summarize the evidence from epidemiological studies of vitamin E intake with the risk of lung cancer. METHODS Pertinent studies were identified by a search in PubMed and Web of Knowledge up to October 2014. Random-effect model was used to combine study-specific results. Publication bias was estimated using Egger's regression asymmetry test. RESULTS Ten articles reporting 11 studies (10 prospective studies and 1 case-control studies) involving 4434 lung cancer cases were used in this meta-analysis. The combined relative risk (RR) of lung cancer associated with vitamin E intake was 0.858 (95% CI=0.742-0.991) overall, significant protective associations were also found in America population (RR=0.862, 95% CI=0.715-0.996) and prospective studies (RR=0.913, 95% CI=0.827-0.996). No publication bias was found. CONCLUSIONS Our analysis indicated that vitamin E intake might decrease the risk of lung cancer, especially in America.
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Affiliation(s)
- Guohan Chen
- Department of Thoracic Surgery, East Hospital, Tongji University School of Medicine 150 Jimo Road, Shanghai 200120, China
| | - Jinyi Wang
- Department of Thoracic Surgery, East Hospital, Tongji University School of Medicine 150 Jimo Road, Shanghai 200120, China
| | - Xuan Hong
- Department of Thoracic Surgery, East Hospital, Tongji University School of Medicine 150 Jimo Road, Shanghai 200120, China
| | - Zhengjun Chai
- Department of Thoracic Surgery, East Hospital, Tongji University School of Medicine 150 Jimo Road, Shanghai 200120, China
| | - Qinchuan Li
- Department of Thoracic Surgery, East Hospital, Tongji University School of Medicine 150 Jimo Road, Shanghai 200120, China
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Schmutz EA, Zimmermann MB, Rohrmann S. The inverse association between serum 25-hydroxyvitamin D and mortality may be modified by vitamin A status and use of vitamin A supplements. Eur J Nutr 2015; 55:393-402. [PMID: 25701092 DOI: 10.1007/s00394-015-0860-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 02/09/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Low serum 25-hydroxyvitamin D [25(OH)D] levels have been associated with higher risk of many diseases that affect mortality, including cardiovascular disease (CVD) and cancer. The inverse association between serum 25(OH)D and mortality may be modified by excess circulating vitamin A, due to interactions of vitamin A at the level of the vitamin D nuclear receptor. In this prospective cohort study, we investigated whether the association of 25(OH)D with all-cause, cancer, and CVD mortality was modified by circulating vitamin A or preformed vitamin A intake from supplements. METHODS We analyzed 15,998 adults in the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. Mortality data for all-cause (n = 3890), cancer (n = 844), and CVD mortality (n = 1715) were assessed through December 2006. Serum 25(OH)D was measured using a radioimmunoassay kit, vitamin A biomarkers were measured by HPLC, and information on supplement use was obtained by self-report. Multivariable hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were estimated by proportional hazards regression. RESULTS Serum 25(OH)D was significantly inversely associated with all-cause mortality (HR 0.93, 95% CI 0.89, 0.97, per 10 ng/mL increase) and also with CVD mortality and mortality due to non-cancer/non-cardiovascular causes, but not with cancer mortality. The observed inverse associations remained statistically significant only among participants with serum retinyl esters <7.0 μg/dL. High intake (>5000 IU/day) of preformed vitamin A from supplements attenuated the inverse association of 25(OH)D with overall mortality. The observed interactions were not statistically significant. CONCLUSIONS 25(OH)D was inversely associated with overall mortality, CVD mortality, and mortality due to non-cancer/non-CVD causes, but not with cancer mortality. A possible interaction between vitamin A exposure and 25(OH)D concentration appears to be associated with an attenuation of the inverse association between risk of death and quartile of 25(OH)D concentration.
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Affiliation(s)
- Einat Avital Schmutz
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael Bruce Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Department of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
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Cheng TYD, Goodman GE, Thornquist MD, Barnett MJ, Beresford SAA, LaCroix AZ, Zheng Y, Neuhouser ML. Estimated intake of vitamin D and its interaction with vitamin A on lung cancer risk among smokers. Int J Cancer 2014; 135:2135-45. [PMID: 24622914 PMCID: PMC4293152 DOI: 10.1002/ijc.28846] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/17/2014] [Indexed: 11/11/2022]
Abstract
Data are very limited on vitamin D and lung cancer prevention in high-risk populations. The authors investigated whether estimated vitamin D intake was associated with lung cancer risk and whether effect modification by vitamin A existed among current/former heavy smokers and workers with occupational exposure to asbestos. A case-cohort study selected 749 incident lung cancers and 679 noncases from the Carotene and Retinol Efficacy Trial (CARET), 1988-2005. The active intervention was supplementation of 30 mg β-carotene + 25,000 IU retinyl palmitate/day. Baseline total intake including both diet (from food frequency questionnaire) and personal supplements (from brand names linked to the labeled potencies) was assessed. Hazard ratios (HRs) were estimated by Cox proportional hazard models. No significant association of total vitamin D intake with lung cancer was observed overall. However, total vitamin D intake ≥600 versus <200 IU/day was associated with a lower risk of non-small cell lung cancer among former smokers [HR = 0.36, 95% confidence interval (CI) = 0.13-0.96]. Total vitamin D intake ≥400 versus <400 IU/day was associated with a lower risk of total lung cancer among participants who received the CARET active intervention (HR = 0.56, 95% CI = 0.32-0.99) and among those who had total vitamin A intake ≥1,500 µg/day retinol activity equivalent (RAE; HR = 0.46, 95% CI = 0.23-0.91). The beneficial associations were attenuated among those who did not receive the CARET active intervention or who had total vitamin A intake <1,500 µg/day RAE (p-interaction = 0.02 for current smokers). Our observation suggests that vitamin A may assist vitamin D in preventing lung cancer among smokers.
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Affiliation(s)
- Ting-Yuan David Cheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Gary E. Goodman
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Mark D. Thornquist
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Matt J. Barnett
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Shirley A. A. Beresford
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Andrea Z. LaCroix
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Yingye Zheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Marian L. Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
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Shin DY, Kim S, Park S, Koh JS, Kim CH, Baek H, Yang SH, Na II. Serum 25-hydroxyvitamin D levels correlate with EGFR mutational status in pulmonary adenocarcinoma. Endocr Relat Cancer 2014; 21:715-21. [PMID: 25030993 DOI: 10.1530/erc-14-0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
There have been several epidemiological studies of the association between 25-hydroxyvitamin D (25(OH)D) level and lung cancer risk. We explored the potential association between serum 25(OH)D levels and mutations in epidermal growth factor receptor (EGFR) in patients with pulmonary adenocarcinoma. We analyzed clinical data from 135 patients whose serum 25(OH)D levels were measured and EGFR mutational status was tested at the time of diagnosis. The relationship between 25(OH)D and clinical factors such as EGFR mutational status and sex was examined. The median serum 25(OH)D level in patients with pulmonary adenocarcinoma was 16.8 ng/ml (range: 3.0-84.3 ng/ml). The level of 25(OH)D was lower in female patients than in male patients (P=0.03). Interestingly, 25(OH)D levels of patients with EGFR-mutated tumors were low compared with those with wild-type tumors (median 18.2 vs 14.7 ng/ml, P=0.011). After a dose-response relationship between EGFR mutations and 25(OH)D levels (as a continuous variable) was observed (OR=0.96, P=0.036), we categorized 25(OH)D levels as low (≤16.8 ng/ml) and high (>16.8 ng/ml). Multivariate analysis revealed the association between low 25(OH)D levels and a high incidence of EGFR mutations (adjusted OR=2.42, 95% CI: 1.11-5.26, P=0.026). The results from this study indicate that low 25(OH)D levels are associated with EGFR mutations in pulmonary adenocarcinoma.
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Affiliation(s)
- Dong-Yeop Shin
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Soyeun Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sunhoo Park
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Jae Soo Koh
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Cheol Hyeon Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - HeeJong Baek
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sung Hyun Yang
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Im Il Na
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Lerchbaum E. Vitamin D and menopause—A narrative review. Maturitas 2014; 79:3-7. [DOI: 10.1016/j.maturitas.2014.06.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 06/05/2014] [Indexed: 01/23/2023]
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Association between vitamin C intake and lung cancer: a dose-response meta-analysis. Sci Rep 2014; 4:6161. [PMID: 25145261 PMCID: PMC5381428 DOI: 10.1038/srep06161] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/25/2014] [Indexed: 02/07/2023] Open
Abstract
Epidemiological studies evaluating the association between the intake of vitamin C and lung cancer risk have produced inconsistent results. We conducted a meta-analysis to assess the association between them. Pertinent studies were identified by a search of PubMed, Web of Knowledge and Wan Fang Med Online through December of 2013. Random-effect model was used to combine the data for analysis. Publication bias was estimated using Begg's funnel plot and Egger's regression asymmetry test. Eighteen articles reporting 21 studies involving 8938 lung cancer cases were included in this meta-analysis. Pooled results suggested that highest vitamin C intake level versus lowest level was significantly associated with the risk of lung cancer [summary relative risk (RR) = 0.829, 95%CI = 0.734–0.937, I2 = 57.8%], especially in the United States and in prospective studies. A linear dose-response relationship was found, with the risk of lung cancer decreasing by 7% for every 100 mg/day increase in the intake of vitamin C [summary RR = 0.93, 95%CI = 0.88–0.98]. No publication bias was found. Our analysis suggested that the higher intake of vitamin C might have a protective effect against lung cancer, especially in the United States, although this conclusion needs to be confirmed.
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Bendik I, Friedel A, Roos FF, Weber P, Eggersdorfer M. Vitamin D: a critical and essential micronutrient for human health. Front Physiol 2014; 5:248. [PMID: 25071593 PMCID: PMC4092358 DOI: 10.3389/fphys.2014.00248] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 06/14/2014] [Indexed: 12/11/2022] Open
Abstract
Vitamin D is a micronutrient that is needed for optimal health throughout the whole life. Vitamin D3 (cholecalciferol) can be either synthesized in the human skin upon exposure to the UV light of the sun, or it is obtained from the diet. If the photoconversion in the skin due to reduced sun exposure (e.g., in wintertime) is insufficient, intake of adequate vitamin D from the diet is essential to health. Severe vitamin D deficiency can lead to a multitude of avoidable illnesses; among them are well-known bone diseases like osteoporosis, a number of autoimmune diseases, many different cancers, and some cardiovascular diseases like hypertension are being discussed. Vitamin D is found naturally in only very few foods. Foods containing vitamin D include some fatty fish, fish liver oils, and eggs from hens that have been fed vitamin D and some fortified foods in countries with respective regulations. Based on geographic location or food availability adequate vitamin D intake might not be sufficient on a global scale. The International Osteoporosis Foundation (IOF) has collected the 25-hydroxy-vitamin D plasma levels in populations of different countries using published data and developed a global vitamin D map. This map illustrates the parts of the world, where vitamin D did not reach adequate 25-hydroxyvitamin D plasma levels: 6.7% of the papers report 25-hydroxyvitamin D plasma levels below 25 nmol/L, which indicates vitamin D deficiency, 37.3% are below 50 nmol/Land only 11.9% found 25-hydroxyvitamin D plasma levels above 75 nmol/L target as suggested by vitamin D experts. The vitamin D map is adding further evidence to the vitamin D insufficiency pandemic debate, which is also an issue in the developed world. Besides malnutrition, a condition where the diet does not match to provide the adequate levels of nutrients including micronutrients for growth and maintenance, we obviously have a situation where enough nutrients were consumed, but lacked to reach sufficient vitamin D micronutrient levels. The latter situation is known as hidden hunger. The inadequate vitamin D status impacts on health care costs, which in turn could result in significant savings, if corrected. Since little is known about the effects on the molecular level that accompany the pandemic like epigenetic imprinting, the insufficiency-triggered gene regulations or the genetic background influence on the body to maintain metabolic resilience, future research will be needed. The nutrition community is highly interested in the molecular mechanism that underlies the vitamin D insufficiency caused effect. In recent years, novel large scale technologies have become available that allow the simultaneous acquisition of transcriptome, epigenome, proteome, or metabolome data in cells of organs. These important methods are now used for nutritional approaches summarized in emerging scientific fields of nutrigenomics, nutrigenetics, or nutriepigenetics. It is believed that with the help of these novel concepts further understanding can be generated to develop future sustainable nutrition solutions to safeguard nutrition security.
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Affiliation(s)
- Igor Bendik
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Angelika Friedel
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Franz F Roos
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Peter Weber
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Manfred Eggersdorfer
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
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Cheng TYD, Millen AE, Wactawski-Wende J, Beresford SAA, LaCroix AZ, Zheng Y, Goodman GE, Thornquist MD, Neuhouser ML. Vitamin D intake determines vitamin d status of postmenopausal women, particularly those with limited sun exposure. J Nutr 2014; 144:681-9. [PMID: 24598886 PMCID: PMC3985825 DOI: 10.3945/jn.113.183541] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Few detailed data are available on the wide range of determinants of vitamin D status among postmenopausal women, and it is also unclear whether there may be undiscovered determinants. The objective of this study was to comprehensively evaluate determinants of serum 25-hydroxyvitamin D [25(OH)D] concentrations in a large cohort of postmenopausal women. Data from a subset of the Women's Health Initiative Observational Study were analyzed (50-79 y; n = 3345). Information on diet, lifestyle behaviors, secondhand smoke, use of dietary supplements and medication, chronic diseases, and anthropometry was collected at baseline (1993-1998) and on sun exposure at year 4 follow-up. Linear regression was performed to estimate regression coefficients (β). Significant determinants were total vitamin D intake (food plus supplements per 100 IU/d, β = 2.08), years of supplemental vitamin D use (β = 0.15), total fat intake (grams per day, β = -0.03), smoking status (β = -2.64, current vs. never), regional solar irradiance (β = 6.26, 475-500 vs. 300-325 Langleys), daylight time spent outdoors in summer (β = 5.15, >2 h vs. <30 min/d), recreational physical activity (metabolic equivalent task per hour per week, β = 0.13), waist circumference (centimeters, β = -0.26), and race/ethnicity (β = -11.94, black vs. white). Total vitamin D intake (partial R(2) = 0.09) explained the most variance in serum 25(OH)D concentrations (total R(2) = 0.29). The association between total vitamin D intake and serum 25(OH)D concentrations was stronger among participants who spent less rather than more daylight time outdoors in summer (P-interaction = 0.026). History and medications for hypertension, hyperlipidemia, and type 2 diabetes and secondhand smoke exposure were not associated with serum 25(OH)D. In conclusion, dietary factors and sun exposure remain important determinants of vitamin D status in postmenopausal women. Vitamin D intake should be emphasized for those with limited sun exposure.
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Affiliation(s)
- Ting-Yuan David Cheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Departments of Epidemiology and,To whom correspondence should be addressed. E-mail:
| | - Amy E. Millen
- Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY; and
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY; and
| | - Shirley A. A. Beresford
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Departments of Epidemiology and
| | - Andrea Z. LaCroix
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Departments of Epidemiology and
| | - Yingye Zheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Biostatistics, University of Washington, Seattle, WA
| | - Gary E. Goodman
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mark D. Thornquist
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Biostatistics, University of Washington, Seattle, WA
| | - Marian L. Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA,Departments of Epidemiology and
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