Bertone-Johnson Elizabeth R
Division of Biostatistics and Epidemiology, Department of Public Health, University of Massachusetts, Amherst, MA 01003-9304, USA.
Ann Epidemiol. 2009 Jul;19(7):462-7. doi: 10.1016/j.annepidem.2009.01.003. Epub 2009 Feb 20.
Though the relationship between vitamin D and breast cancer remains unclear, a growing body of evidence suggests that vitamin D may modestly reduce risk. A large number of in vitro studies indicate that vitamin D can inhibit cell proliferation and promote apoptosis and cell differentiation in breast tumor tissue. Results from analytic studies of sunlight exposure and dietary intake have been inconsistent but together generally support a modestly protective role of vitamin D, at least in some population subgroups. Studies using blood vitamin D metabolites to assess vitamin D status may be less prone to misclassification than those of diet and sunlight exposure. Overall, the two prospective and four case-control studies of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D tend to support a protective effect in older women. The relationship between common vitamin D receptor polymorphisms and risk remains unclear. Many questions about this relationship clearly remain, including the utility of assessing vitamin D through diet and sunlight exposure, the relationship between plasma metabolites, and the potential modifying effects of age, menopausal status and tumor characteristics. Given that vitamin D status is modifiable, additional prospective studies are necessary to determine if vitamin D may have important potential for breast cancer prevention.
尽管维生素D与乳腺癌之间的关系仍不明确，但越来越多的证据表明维生素D可能会适度降低风险。大量的体外研究表明，维生素D可以抑制乳腺肿瘤组织中的细胞增殖，促进细胞凋亡和细胞分化。关于阳光照射和饮食摄入的分析研究结果并不一致，但总体上普遍支持维生素D至少在某些人群亚组中具有适度的保护作用。与饮食和阳光照射的研究相比，使用血液维生素D代谢物来评估维生素D状态的研究可能不太容易出现错误分类。总体而言，两项关于25-羟基维生素D和1,25-二羟基维生素D的前瞻性研究以及四项病例对照研究倾向于支持其对老年女性的保护作用。常见维生素D受体多态性与风险之间的关系仍不明确。关于这种关系显然仍有许多问题，包括通过饮食和阳光照射评估维生素D的效用、血浆代谢物之间的关系以及年龄、绝经状态和肿瘤特征的潜在调节作用。鉴于维生素D状态是可以改变的，有必要进行更多的前瞻性研究，以确定维生素D是否对乳腺癌预防具有重要的潜在作用。
