Neuhouser Marian L, Sorensen Bess, Hollis Bruce W, Ambs Anita, Ulrich Cornelia M, McTiernan Anne, Bernstein Leslie, Wayne Sharon, Gilliland Frank, Baumgartner Kathy, Baumgartner Richard, Ballard-Barbash Rachel
Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Am J Clin Nutr. 2008 Jul;88(1):133-9. doi: 10.1093/ajcn/88.1.133.
Little is known about vitamin D status in breast cancer survivors. This issue is important because vitamin D influences pathways related to carcinogenesis.
The objective of this report was to describe and understand vitamin D status in a breast cancer survivor cohort.
Data are from the Health, Eating, Activity, and Lifestyle study. With the use of a cross-sectional design, we examined serum concentrations of 25-hydroxyvitamin D [25(OH)D] in 790 breast cancer survivors from western Washington state, New Mexico, and Los Angeles County. Cancer treatment data were obtained from Surveillance, Epidemiology, and End Results registries and medical records. Fasting blood, anthropometry, and lifestyle habits were collected after diagnosis and treatment. We examined distributions of 25(OH)D by race-ethnicity, season, geography, and clinical characteristics. Multivariate regression tested associations between 25(OH)D and stage of disease.
Five hundred ninety-seven (75.6%) of the women had low serum 25(OH)D, suggesting vitamin D insufficiency or frank deficiency. The overall mean (+/-SD) was 24.8 +/- 10.4 ng/mL, but it was lower for African Americans (18.1 +/- 8.7 ng/mL) and Hispanics (22.1 +/- 9.2 ng/mL). Women with localized (n = 424) or regional (n = 182) breast cancer had lower serum 25(OH)D than did women with in situ disease (n = 184) (P = 0.05 and P = 0.03, respectively). Multivariate regression models controlled for age, body mass index (in kg/m(2)), race-ethnicity, geography, season, physical activity, diet, and cancer treatments showed that stage of disease independently predicted serum 25(OH)D (P = 0.02).
In these breast cancer survivors, the prevalence of vitamin D insufficiency was high. Clinicians might consider monitoring vitamin D status in breast cancer patients, together with appropriate treatments, if necessary.
乳腺癌幸存者的维生素D状况鲜为人知。这个问题很重要，因为维生素D会影响与致癌作用相关的途径。
本报告的目的是描述并了解一组乳腺癌幸存者的维生素D状况。
数据来自健康、饮食、活动和生活方式研究。采用横断面设计，我们检测了来自华盛顿州西部、新墨西哥州和洛杉矶县的790名乳腺癌幸存者的血清25-羟基维生素D [25(OH)D] 浓度。癌症治疗数据来自监测、流行病学和最终结果登记处以及医疗记录。在诊断和治疗后收集空腹血液、人体测量数据和生活习惯信息。我们按种族、季节、地理位置和临床特征检查了25(OH)D的分布情况。多变量回归分析检验了25(OH)D与疾病分期之间的关联。
597名（75.6%）女性血清25(OH)D水平较低，表明存在维生素D不足或明显缺乏。总体平均水平（±标准差）为24.8±10.4 ng/mL，但非裔美国人（18.1±8.7 ng/mL）和西班牙裔（22.1±9.2 ng/mL）的水平更低。患有局限性（n = 424）或区域性（n = 182）乳腺癌的女性血清25(OH)D水平低于原位癌女性（n = 184）（分别为P = 0.05和P = 0.03）。控制了年龄、体重指数（kg/m²）、种族、地理位置、季节、体育活动、饮食和癌症治疗的多变量回归模型显示，疾病分期可独立预测血清25(OH)D水平（P = 0.02）。
在这些乳腺癌幸存者中，维生素D不足的患病率很高。临床医生在必要时可能需要考虑监测乳腺癌患者的维生素D状况并给予适当治疗。
