Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4B402, Seattle, WA 98109-1024, USA.
Cancer Causes Control. 2012 Sep;23(9):1557-65. doi: 10.1007/s10552-012-0033-8. Epub 2012 Jul 25.
Excess vitamin A may interrupt vitamin D-mediated transcription of target genes. This study investigated whether serum 25-hydroxyvitamin D [25(OH)D] concentrations were associated with lung cancer mortality, and whether this association varied by excess circulating vitamin A and vitamin A/β-carotene supplement use.
We analyzed 16,693 men and women in the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. Lung cancer mortality (n = 258, 104 were former smokers and 23 were never smokers) were identified through National Death Index as of 2006. Serum 25(OH)D was measured by a radioimmunoassay. Vitamin A biomarkers including serum retinol, β-carotene, and retinyl esters were measured by HPLC. Supplement use for the past month was obtained by self-report. Multivariate-adjusted hazard ratios (HR) were estimated by Cox proportional hazard models.
There was no association of serum 25(OH)D with overall lung cancer mortality. Among nonsmokers, ≥44 vs. <44 nmol/L of serum 25(OH)D was associated with a decreased risk (HR = 0.53, 95 % CI = 0.31-0.92, former/never smokers and HR = 0.31, 95 % CI = 0.13-0.77, distant-former [quit ≥20 years]/never smokers). The associations were not observed among participants with excess circulating vitamin A (serum retinyl esters ≥7.0 μg/dL or the ratio of retinyl esters to retinol ≥0.08) or vitamin A/β-carotene supplement users. However, statistical evidence to support effect modification of vitamin A was less clear.
Serum 25(OH)D concentrations were inversely associated with lung cancer mortality in nonsmokers. The beneficial association was diminished among those with excess circulating vitamin A or vitamin A/β-carotene supplement users.
过量的维生素 A 可能会干扰维生素 D 介导的靶基因转录。本研究旨在探讨血清 25-羟维生素 D [25(OH)D]浓度与肺癌死亡率之间的关系，以及这种关系是否因循环中过量的维生素 A 和维生素 A/β-胡萝卜素补充剂的使用而有所不同。
我们分析了 1988 年至 1994 年参加第三次全国健康和营养调查（NHANES III）的 16693 名男性和女性。截至 2006 年，通过国家死亡指数确定了 258 名肺癌死亡者（104 名为曾经吸烟者，23 名为从不吸烟者）。通过放射免疫法测量血清 25(OH)D。通过高效液相色谱法测量血清视黄醇、β-胡萝卜素和视黄酯等维生素 A 生物标志物。通过自我报告获得过去一个月的补充剂使用情况。使用 Cox 比例风险模型估计多变量调整后的风险比（HR）。
血清 25(OH)D 与总体肺癌死亡率之间无关联。在不吸烟者中，血清 25(OH)D 浓度≥44 vs. <44 nmol/L 与肺癌死亡率降低相关（HR=0.53，95%CI=0.31-0.92，曾经/从不吸烟者和 HR=0.31，95%CI=0.13-0.77，远处-曾经[戒烟≥20 年]/从不吸烟者）。在循环中维生素 A 过量（血清视黄酯≥7.0 μg/dL 或视黄酯/视黄醇比值≥0.08）或维生素 A/β-胡萝卜素补充剂使用者中未观察到这些关联。然而，支持维生素 A 效应修饰的统计学证据不太明确。
血清 25(OH)D 浓度与不吸烟者的肺癌死亡率呈负相关。在循环中维生素 A 过量或维生素 A/β-胡萝卜素补充剂使用者中，这种有益的关联减弱。
