Kilkkinen Annamari, Knekt Paul, Heliövaara Markku, Rissanen Harri, Marniemi Jukka, Hakulinen Timo, Aromaa Arpo
Department of Health and Functional Capacity, National Public Health Institute, Mannerheimintie 166, FI-00300 Helsinki, Finland.
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3274-8. doi: 10.1158/1055-9965.EPI-08-0199.
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.
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。