Raimondi Sara, Johansson Harriet, Maisonneuve Patrick, Gandini Sara
Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
Carcinogenesis. 2009 Jul;30(7):1170-80. doi: 10.1093/carcin/bgp103. Epub 2009 Apr 29.
It was suggested that vitamin D levels influence cancer development. The vitamin D receptor (VDR) is a crucial mediator for the cellular effects of vitamin D. Results from previous studies on the association of VDR polymorphisms with different cancer types are somewhat contradictory, and the role of VDR in the etiology of cancer is still equivocal. We therefore performed a meta-analysis on the association between the two most studied VDR polymorphisms (FokI and BsmI) and any cancer site. Up to January 2009, we identified 67 independent studies. We used random-effects models to provide summary odds ratio (SOR) for VDR polymorphisms and cancer. We tested homogeneity of effects across studies and publication bias and explored between-study heterogeneity. When comparing FokI ff with FF carriers, we found a significant increase in skin cancer [SOR; 95% confidence intervals (CIs): 1.30; 1.04-1.61] and breast cancer (SOR; 95%CI: 1.14; 1.03-1.27) risk. For the same genotype comparison, we found a significantly higher risk of cancer when we pooled estimates from cancer sites possibly associated with vitamin D levels (prostate, breast, skin, ovary, non-Hodgkin lymphoma and colorectal). A significant reduction in prostate cancer risk was observed for carriers of BsmI Bb compared with bb genotype (SOR; 95%CI: 0.83; 0.69-0.99). In Caucasian populations, both Bb and BB carriers had a significant reduced risk of cancer at any site. In conclusion, this meta-analysis showed that VDR FokI and BsmI polymorphisms might modulate the risk of cancer of breast, skin and prostate and possibly affect cancer risk at any site in Caucasians.
有人提出维生素D水平会影响癌症的发展。维生素D受体（VDR）是维生素D细胞效应的关键介质。先前关于VDR基因多态性与不同癌症类型关联的研究结果有些相互矛盾，VDR在癌症病因学中的作用仍不明确。因此，我们对研究最多的两种VDR基因多态性（FokI和BsmI）与任何癌症部位之间的关联进行了荟萃分析。截至2009年1月，我们确定了67项独立研究。我们使用随机效应模型来提供VDR基因多态性与癌症的汇总比值比（SOR）。我们检验了各研究间效应的同质性和发表偏倚，并探讨了研究间的异质性。当比较FokI ff与FF携带者时，我们发现皮肤癌[SOR；95%置信区间（CI）：1.30；1.04 - 1.61]和乳腺癌（SOR；95%CI：1.14；1.03 - 1.27）风险显著增加。对于相同的基因型比较，当我们汇总可能与维生素D水平相关的癌症部位（前列腺、乳腺、皮肤、卵巢、非霍奇金淋巴瘤和结肠直肠癌）的估计值时，发现患癌风险显著更高。与bb基因型相比，BsmI Bb携带者的前列腺癌风险显著降低（SOR；95%CI：0.83；0.69 - 0.99）。在白种人群中，Bb和BB携带者在任何部位患癌的风险均显著降低。总之，这项荟萃分析表明，VDR FokI和BsmI基因多态性可能会调节乳腺癌、皮肤癌和前列腺癌的风险，并可能影响白种人在任何部位患癌的风险。
