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维生素 D 缺乏在癌症患者中普遍存在,并与晚期疾病相关:社区肿瘤学经验。

Vitamin D deficiency is widespread in cancer patients and correlates with advanced stage disease: a community oncology experience.

机构信息

The Commonwealth Medical College, Scranton, Pennsylvania 18510, USA.

出版信息

Nutr Cancer. 2012;64(4):521-5. doi: 10.1080/01635581.2012.661515. Epub 2012 Mar 27.

DOI:10.1080/01635581.2012.661515
PMID:22452722
Abstract

The purpose of this study was to correlate serum vitamin D levels with potential clinical variables and to determine the extent of vitamin D deficiency in a large, outpatient oncology practice. One hundred ninety-five consecutive patients referred for consultation at a community radiation oncology center from October 8, 2008 to March 17, 2010 had vitamin D levels ordered. Patients who were deficient in vitamin D were treated with replacement therapy. Demographic and medical data were collected prospectively and subsequently analyzed. Pretreatment baseline patient and tumor characteristics were evaluated with respect to vitamin D concentrations. One hundred and sixty patients were analyzed. A total of 74% of patients had 25-hydroxyvitamin D concentrations considered either deficient (<20 ng/mL) or suboptimal (20-30 ng/mL). Replacement therapy raised serum vitamin D levels by an average of 15 ng/mL (95% CI = 11-18, P < 0.01). Lower than median serum vitamin D levels were associated with stage III disease in univariate analysis [OR = 2.6 (95% CI = 1.1-6.2), p = 0.04] as well as multivariate analysis adjusted for age, sex, body mass index, and season of draw [OR = 3.3 (95% CI = 1.1-9.7), P = 0.03]. Three-quarters of patients in our series had suboptimal or deficient circulating concentrations of 25-hydroxyvitamin D. Low serum vitamin D levels, independent of age, sex, and body mass index, predicted advanced stage disease.

摘要

本研究旨在将血清维生素 D 水平与潜在的临床变量相关联,并确定在大型门诊肿瘤学实践中维生素 D 缺乏的程度。2008 年 10 月 8 日至 2010 年 3 月 17 日,连续有 195 例患者在社区放射肿瘤中心就诊时被要求检测维生素 D 水平。维生素 D 缺乏的患者接受了替代治疗。前瞻性收集了人口统计学和医学数据,并随后进行了分析。根据维生素 D 浓度评估了治疗前基线患者和肿瘤特征。对 160 例患者进行了分析。74%的患者 25-羟维生素 D 浓度被认为不足(<20ng/ml)或不足(20-30ng/ml)。替代疗法使血清维生素 D 水平平均升高 15ng/ml(95%置信区间=11-18,P<0.01)。在单变量分析中,低于中位数的血清维生素 D 水平与 III 期疾病相关[OR=2.6(95%置信区间=1.1-6.2),p=0.04],以及调整年龄、性别、体重指数和采血季节的多变量分析[OR=3.3(95%置信区间=1.1-9.7),P=0.03]。我们系列中的 3/4 的患者存在 25-羟维生素 D 循环浓度不足或缺乏。低血清维生素 D 水平,与年龄、性别和体重指数无关,预测晚期疾病。

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