Redaniel Maria Theresa, Gardner Michael P, Martin Richard M, Jeffreys Mona
School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK,
Cancer Causes Control. 2014 Feb;25(2):267-71. doi: 10.1007/s10552-013-0328-4. Epub 2013 Dec 15.
There is inconclusive evidence on whether vitamin D therapy reduces cancer risk. We investigated the effect of vitamin D (±calcium) supplementation on the risk of breast, ovarian, uterine, colorectal, and lung cancer in women.
We conducted a case-control study using the UK Clinical Practice Research Datalink (CPRD); cases were women aged ≥55 years with a first diagnosis of either breast, colorectal, lung, ovarian, or uterine cancer between 2002 and 2009, with at least 5 years of CPRD follow-up prior to the date of diagnosis, and controls were women without cancer, frequency-matched to cases by year of birth, date of study entry, length of follow-up, and general practice. The association of vitamin D supplementation with the odds of developing each cancer was determined using multivariable logistic regression, controlling for body mass index, smoking, alcohol, and deprivation.
Ninety-seven percent of women took vitamin D with a calcium supplement. Exposure to three or more prescriptions of vitamin D was associated with a 17 % reduced odds (95 % CI 0.71-0.97) of breast cancer versus 1-2 prescriptions, but this effect disappeared when omitting women first exposed within a year of diagnosis (OR 1.0, 95 % CI 0.82-1.23). Having more than 10 prescriptions of vitamin D was associated with a 17 % lower odds (95 % CI 0.65-1.06) of colorectal cancer, but the estimates are imprecise. There was little evidence of associations of supplements with lung or gynecological cancers.
We found little evidence that vitamin D (largely with calcium) supplementation is associated with decreased breast, lung, ovarian, and uterine cancer risk. There is a possible protective association between having more than 10 prescriptions of vitamin D supplements and colorectal cancer, but it requires further investigation.
关于维生素D疗法是否能降低癌症风险,证据尚无定论。我们研究了补充维生素D(±钙)对女性患乳腺癌、卵巢癌、子宫癌、结直肠癌和肺癌风险的影响。
我们利用英国临床实践研究数据链(CPRD)进行了一项病例对照研究;病例为2002年至2009年间首次诊断为乳腺癌、结直肠癌、肺癌、卵巢癌或子宫癌且年龄≥55岁的女性,在诊断日期前至少有5年的CPRD随访记录,对照为无癌症的女性,根据出生年份、研究入组日期、随访时长和全科医疗与病例进行频数匹配。使用多变量逻辑回归确定补充维生素D与患每种癌症几率之间的关联,并对体重指数、吸烟、饮酒和贫困状况进行控制。
97%的女性服用了含钙剂的维生素D。与开具1 - 2次维生素D处方相比,开具3次或更多次维生素D处方与乳腺癌几率降低17%相关(95%置信区间0.71 - 0.97),但在排除诊断后一年内首次暴露的女性后,这种效应消失(比值比1.0,95%置信区间0.82 - 1.23)。开具超过10次维生素D处方与结直肠癌几率降低17%相关(95%置信区间0.65 - 1.06),但估计值不精确。几乎没有证据表明补充剂与肺癌或妇科癌症有关联。
我们几乎没有发现证据表明补充维生素D(主要是含钙剂)与降低乳腺癌、肺癌、卵巢癌和子宫癌风险有关。开具超过10次维生素D补充剂处方与结直肠癌之间可能存在保护关联,但需要进一步研究。