School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.
J Epidemiol. 2011;21(2):87-94. doi: 10.2188/jea.je20100088. Epub 2010 Dec 11.
Evidence for an association between vitamin D status and breast cancer is now more convincing, but is uncertain in subtropical areas like Taiwan. This hospital-based case-control study examined the relationship of breast cancer with vitamin D intake and sunlight exposure.
A total of 200 incident breast cancer cases in a Taipei hospital were matched with 200 controls by date of interview and menopausal status. Information on risk factors for breast cancer was collected in face-to-face interviews and assessed with reference to vitamin D intake (foods and nutrients) and sunlight exposure. Vitamin D intake was divided into quartiles, and threshold effect was evaluated by comparing Q2-Q4 with Q1.
After controlling for age, education, parity, hormone replacement therapy, body mass index (BMI), energy intake, menopausal status, and daily sunlight exposure, the risk of breast cancer in participants with a dietary vitamin D intake greater than 5 µg per day was significantly lower (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.24-0.97) than that of participants with an intake less than 2 µg per day. In analysis stratified by menopausal status and BMI, both dietary vitamin D and total vitamin D intakes were associated with a protective effect among premenopausal women. There was a significant linear trend for breast cancer risk and dietary vitamin D intake in premenopausal women (P = 0.02). In participants with a BMI lower than 24 kg/m(2) (ie, normal weight), dietary vitamin D intake was inversely related to breast cancer risk (P for trend = 0.002), and a threshold effect was apparent (Q2-Q4 vs Q1: OR, 0.46; 95% CI, 0.23-0.90).
Vitamin D had a protective effect against breast cancer in premenopausal women of normal weight in subtropical Taiwan, especially an intake greater than 5 µg per day.
维生素 D 状况与乳腺癌之间的关联证据现在更为确凿,但在台湾等亚热带地区仍不确定。本项基于医院的病例对照研究调查了乳腺癌与维生素 D 摄入和阳光暴露之间的关系。
在台北一家医院中选择了 200 例乳腺癌新发病例,并按访谈日期和绝经状态与 200 例对照相匹配。通过面对面访谈收集乳腺癌危险因素信息,并参考维生素 D 摄入(食物和营养素)和阳光暴露情况进行评估。维生素 D 摄入量分为四分位数,通过比较 Q2-Q4 与 Q1 来评估阈效应。
在校正年龄、教育程度、产次、激素替代疗法、体重指数(BMI)、能量摄入、绝经状态和每日阳光暴露后,每日膳食维生素 D 摄入量大于 5 µg 的参与者患乳腺癌的风险明显低于(比值比 [OR],0.48;95%置信区间 [CI],0.24-0.97)每日摄入量小于 2 µg 的参与者。按绝经状态和 BMI 分层分析时,膳食维生素 D 和总维生素 D 摄入量均与绝经前妇女的保护作用相关。在绝经前妇女中,乳腺癌风险与膳食维生素 D 摄入量之间存在显著线性趋势(P = 0.02)。在 BMI 低于 24 kg/m²(即正常体重)的参与者中,膳食维生素 D 摄入量与乳腺癌风险呈负相关(趋势 P 值=0.002),且存在阈效应(Q2-Q4 与 Q1:OR,0.46;95% CI,0.23-0.90)。
在亚热带台湾,正常体重的绝经前妇女中,维生素 D 对乳腺癌具有保护作用,尤其是摄入量大于 5 µg/d 时。