代谢综合征相关因素与维生素D对前列腺癌风险的相互作用。
Interaction of factors related to the metabolic syndrome and vitamin D on risk of prostate cancer.
作者信息
Tuohimaa Pentti, Tenkanen Leena, Syvälä Heimo, Lumme Sonja, Hakulinen Timo, Dillner Joakim, Hakama Matti
机构信息
Medical School, University of Tampere, Department of Clinical Chemistry, Tampere University Hospital, Finland.
出版信息
Cancer Epidemiol Biomarkers Prev. 2007 Feb;16(2):302-7. doi: 10.1158/1055-9965.EPI-06-0777.
BACKGROUND
Factors related to the metabolic syndrome and low levels of vitamin D have been implicated as risk factors for prostate cancer. Insofar, no studies have assessed their joint effects on prostate cancer risk.
METHODS
We studied (a) the associations of vitamin D with the metabolic syndrome factors body mass index, systolic and diastolic blood pressure, and high-density lipoprotein cholesterol (HDL-C) and (b) the prostate cancer risk associated with these factors and especially their joint effects with vitamin D on risk of prostate cancer. We did a longitudinal nested case-control study on 132 prostate cancer cases and 456 matched controls from a cohort of 18,939 Finnish middle-aged men from the Helsinki Heart Study. The odds ratios (OR) of prostate cancer were assessed via conditional logistic regression analysis.
RESULTS
Apart from HDL-C, there was no linear association between the metabolic syndrome factors and vitamin D levels. In univariate analysis, men in the highest quartiles of body mass index (>28 kg/m(2)) and systolic blood pressure (>150 mmHg) showed a modest increase in risks of prostate cancer, with ORs of 1.37 (P = 0.16) and 1.53 (P = 0.05) when compared with the three lower quartiles, but low HDL-C entailed no prostate cancer risk. However, with all three factors present, the OR was 3.36 (P = 0.02), and jointly with low vitamin D (<or=40 nmol/L), the OR was 8.03 (P = 0.005) compared with those with no metabolic syndrome factors and intermediate levels of vitamin D. There was an interaction between vitamin D and the metabolic syndrome factors so that a clustering of these factors entailed high risk of prostate cancer but only if vitamin D level was low (<or=40 nmol/L). If it was at intermediate levels, the metabolic syndrome factors entailed no prostate cancer risk.
CONCLUSIONS
We conclude that the prostate cancer risk associated with factors related to the metabolic syndrome is strongly conditioned by levels of vitamin D.
背景
与代谢综合征及低水平维生素D相关的因素已被认为是前列腺癌的危险因素。到目前为止，尚无研究评估它们对前列腺癌风险的联合影响。
方法
我们研究了（a）维生素D与代谢综合征因素体重指数、收缩压和舒张压以及高密度脂蛋白胆固醇（HDL-C）之间的关联，以及（b）与这些因素相关的前列腺癌风险，特别是它们与维生素D对前列腺癌风险的联合影响。我们对来自赫尔辛基心脏研究的18939名芬兰中年男性队列中的132例前列腺癌病例和456例匹配对照进行了纵向巢式病例对照研究。通过条件逻辑回归分析评估前列腺癌的比值比（OR）。
结果
除HDL-C外，代谢综合征因素与维生素D水平之间无线性关联。在单变量分析中，体重指数最高四分位数（>28kg/m²）和收缩压最高四分位数（>150mmHg）的男性前列腺癌风险略有增加，与三个较低四分位数相比，OR分别为1.37（P = 0.16）和1.53（P = 0.05），但低HDL-C并未带来前列腺癌风险。然而，当所有三个因素都存在时，OR为3.36（P = 0.02），与无代谢综合征因素且维生素D水平中等的人相比，与低维生素D（≤40nmol/L）共同存在时，OR为8.03（P = 0.005）。维生素D与代谢综合征因素之间存在相互作用，因此这些因素的聚集会带来高前列腺癌风险，但前提是维生素D水平较低（≤40nmol/L）。如果处于中等水平，代谢综合征因素不会带来前列腺癌风险。
结论
我们得出结论，与代谢综合征相关因素相关的前列腺癌风险受维生素D水平的强烈制约。
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