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维生素D状态与肺癌风险:芬兰的一项队列研究

Vitamin D status and the risk of lung cancer: a cohort study in Finland.

作者信息

Kilkkinen Annamari, Knekt Paul, Heliövaara Markku, Rissanen Harri, Marniemi Jukka, Hakulinen Timo, Aromaa Arpo

机构信息

Department of Health and Functional Capacity, National Public Health Institute, Mannerheimintie 166, FI-00300 Helsinki, Finland.

出版信息

Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3274-8. doi: 10.1158/1055-9965.EPI-08-0199.

Abstract

Experimental data support the suppressing effect of vitamin D on lung carcinogenesis, but epidemiologic evidence is limited. The aim of the present study was to evaluate whether serum 25-hydroxyvitamin D [25(OH)D] level is associated with the risk of lung cancer in a prospective cohort study in Finland. 25(OH)D levels were measured by RIA from serum collected at baseline (1978--1980) from 6,937 men and women. During a maximum follow-up of 24 years, 122 lung cancers were identified. After adjustment for potential confounders, no overall significant association between vitamin D and lung cancer risk was observed [relative risk (RR) for the highest versus lowest tertile, 0.72; 95% confidence interval (95% CI), 0.43-1.19; Ptrend = 0.22]. There was a statistically significant interaction between vitamin D and sex (P = 0.02) and age (P = 0.02): serum 25(OH)D level was inversely associated with lung cancer incidence for women (RR, 0.16; 95% CI, 0.04-0.59; Ptrend < 0.001) and younger participants (RR, 0.34; 95% CI, 0.13-0.90; Ptrend = 0.04) but not for men (RR, 1.03; 95% CI, 0.59-1.82; Ptrend = 0.81) or older individuals (RR, 0.92; 95% CI, 0.50-1.70; Ptrend = 0.79). In conclusion, although there was no overall association between vitamin D and lung cancer risk, women and young participants with a higher level of vitamin D were observed to have a lower lung cancer risk. Although experimental data support the suppressing effect of vitamin D on the development of lung cancer, large epidemiologic studies from different populations with repeated measurements of vitamin D are warranted to confirm this finding.

摘要

实验数据支持维生素D对肺癌发生的抑制作用,但流行病学证据有限。本研究的目的是在芬兰的一项前瞻性队列研究中评估血清25-羟基维生素D[25(OH)D]水平是否与肺癌风险相关。通过放射免疫分析法(RIA)测定了1978 - 1980年基线时收集的6937名男性和女性血清中的25(OH)D水平。在最长24年的随访期间,共确诊122例肺癌。在对潜在混杂因素进行调整后,未观察到维生素D与肺癌风险之间存在总体显著关联[最高三分位数与最低三分位数相比的相对风险(RR)为0.72;95%置信区间(95%CI)为0.43 - 1.19;P趋势 = 0.22]。维生素D与性别(P = 0.02)和年龄(P = 0.02)之间存在统计学显著的交互作用:血清25(OH)D水平与女性(RR为0.16;95%CI为0.04 - 0.59;P趋势 < 0.001)和年轻参与者(RR为0.34;95%CI为0.13 - 0.90;P趋势 = 0.04)的肺癌发病率呈负相关,但与男性(RR为1.03;95%CI为0.59 - 1.82;P趋势 = 0.81)或老年个体(RR为0.92;95%CI为0.50 - 1.70;P趋势 = 0.79)无关。总之,虽然维生素D与肺癌风险之间没有总体关联,但观察到维生素D水平较高的女性和年轻参与者患肺癌的风险较低。尽管实验数据支持维生素D对肺癌发展的抑制作用,但仍需要来自不同人群的大规模流行病学研究,并重复测量维生素D来证实这一发现。

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