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血浆25-羟基维生素D和1,25-二羟基维生素D与卵巢癌发病风险

Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of incident ovarian cancer.

作者信息

Tworoger Shelley S, Lee I-Min, Buring Julie E, Rosner Bernard, Hollis Bruce W, Hankinson Susan E

机构信息

Channing Laboratory, Department of Medicine, Boston, MA 02115, USA.

出版信息

Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):783-8. doi: 10.1158/1055-9965.EPI-06-0981.

Abstract

Few modifiable factors are known to reduce ovarian cancer risk. Ecologic studies and experimental data suggest that vitamin D may reduce ovarian cancer risk. Therefore, we examined whether plasma concentrations of 25-hydroxyvitamin D (a measure of overall vitamin D status) and 1,25-dihydroxyvitamin D (biologically active form) were associated with risk of epithelial ovarian cancer in a nested-case control study using data from three prospective cohorts: the Nurses' Health Study (NHS), NHSII, and the Women's Health Study (WHS). The analysis had 224 cases (161 from NHS/NHSII and 63 from WHS) and 603 controls (matching ratio, 1:3 for NHS/NHSII and 1:2 for WHS). Women ranged in age from 34 to 73 years (mean, 56 years). We did not observe significant associations between 25-hydroxyvitamin D [top versus bottom quartile: relative risk (RR), 0.83; 95% confidence interval (95% CI), 0.49-1.39; P(trend) = 0.57] or 1,25-dihydroxyvitamin D levels (RR, 1.14; 95% CI, 0.70-1.85, P(trend) = 0.93) and ovarian cancer risk. Study-specific associations were not statistically significant and no statistical heterogeneity existed between studies (P = 0.66, 25-hydroxyvitamin D; P = 0.40, 1,25-dihydroxyvitamin D). However, there was a significant inverse association among overweight and obese women for 25-hydroxyvitamin D levels (RR, 0.39; 95% CI, 0.16-0.93; P(trend) = 0.04). Further, those with adequate (>or=32 ng/mL) versus inadequate 25-hydroxyvitamin D levels had a modestly decreased risk of serous ovarian cancer (RR, 0.64; 95% CI, 0.39-1.05). Overall, our results do not suggest that plasma vitamin D levels are associated with risk of ovarian cancer. However, we observed significant associations in some subgroups, which should be evaluated further in other studies because increasing vitamin D intake is an easy preventive measure to adopt.

摘要

已知很少有可改变的因素能降低卵巢癌风险。生态学研究和实验数据表明,维生素D可能降低卵巢癌风险。因此,我们在一项巢式病例对照研究中,利用来自三项前瞻性队列研究(护士健康研究(NHS)、NHSII和妇女健康研究(WHS))的数据,检验了血浆25-羟基维生素D(衡量总体维生素D状态)和1,25-二羟基维生素D(生物活性形式)的浓度与上皮性卵巢癌风险之间的关联。该分析纳入了224例病例(161例来自NHS/NHSII,63例来自WHS)和603例对照(匹配比例,NHS/NHSII为1:3,WHS为1:2)。女性年龄范围为34至73岁(平均56岁)。我们未观察到25-羟基维生素D(最高四分位数与最低四分位数相比:相对风险(RR)为0.83;95%置信区间(95%CI)为0.49 - 1.39;P趋势 = 0.57)或1,25-二羟基维生素D水平(RR为1.14;95%CI为0.70 - 1.85,P趋势 = 0.93)与卵巢癌风险之间存在显著关联。各研究特定的关联无统计学意义,且研究之间不存在统计学异质性(25-羟基维生素D,P = 0.66;1,25-二羟基维生素D,P = 0.40)。然而,在超重和肥胖女性中,25-羟基维生素D水平存在显著的负相关(RR为0.39;95%CI为0.16 - 0.93;P趋势 = 0.04)。此外,25-羟基维生素D水平充足(≥32 ng/mL)与不足的女性相比,浆液性卵巢癌风险适度降低(RR为0.64;95%CI为0.39 - 1.05)。总体而言,我们的结果并不表明血浆维生素D水平与卵巢癌风险相关。然而,我们在一些亚组中观察到了显著关联,由于增加维生素D摄入量是一种易于采取的预防措施,因此应在其他研究中进一步评估。

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