National Cancer Institute, Bethesda, Maryland 20852, USA.
Am J Epidemiol. 2010 Jul 1;172(1):94-106. doi: 10.1093/aje/kwq121. Epub 2010 Jun 18.
Upper gastrointestinal (GI) cancers of the stomach and esophagus have high incidence and mortality worldwide, but they are uncommon in Western countries. Little information exists on the association between vitamin D and risk of upper GI cancers. This study examined the association between circulating 25-hydroxyvitamin D (25(OH)D) and upper GI cancer risk in the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Concentrations of 25(OH)D were measured from 1,065 upper GI cancer cases and 1,066 age-, sex-, race-, and season-of blood draw-matched controls from 8 prospective cohort studies. In multivariate-adjusted models, circulating 25(OH)D concentration was not significantly associated with upper GI cancer risk. Subgroup analysis by race showed that among Asians, but not Caucasians, lower concentrations of 25(OH)D (<25 nmol/L) were associated with a statistically significant decreased risk of upper GI cancer (reference: 50-<75 nmol/L) (odds ratio = 0.53, 95% confidence interval: 0.31, 0.91; P trend = 0.003). Never smokers with concentrations of <25 nmol/L showed a lower risk of upper GI cancers (odds ratio = 0.55, 95% confidence interval: 0.31, 0.96). Subgroup analyses by alcohol consumption produced opposing trends. Results do not support the hypothesis that interventions aimed at increasing vitamin D status would lead to a lower risk of these highly fatal cancers.
上消化道(GI)癌症包括胃癌和食管癌,在全球范围内发病率和死亡率都很高,但在西方国家并不常见。关于维生素 D 与上消化道癌症风险之间的关系,相关信息有限。本研究在癌症罕见病例协作组维生素 D 汇总研究中,调查了循环 25-羟维生素 D(25(OH)D)与上消化道癌症风险之间的关系。该研究从 8 项前瞻性队列研究中,选取了 1065 例上消化道癌症病例和 1066 名年龄、性别、种族和采血季节相匹配的对照者,检测了他们的 25(OH)D 浓度。在多变量调整模型中,循环 25(OH)D 浓度与上消化道癌症风险无显著相关性。按种族进行的亚组分析显示,在亚洲人群中,而非在白种人群中,25(OH)D 浓度较低(<25 nmol/L)与上消化道癌症风险显著降低相关(参考:50-<75 nmol/L)(比值比=0.53,95%置信区间:0.31,0.91;P 趋势=0.003)。浓度<25 nmol/L 的从不吸烟者上消化道癌症风险较低(比值比=0.55,95%置信区间:0.31,0.96)。按饮酒量进行的亚组分析得出了相反的趋势。结果不支持干预措施旨在提高维生素 D 状态会降低这些高致命性癌症风险的假设。