Bidgoli Sepideh Arbabi, Azarshab Hamid
Department of Toxicology and Pharmacology, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch (IAUPS), Tehran, Iran E-mail :
Asian Pac J Cancer Prev. 2014;15(8):3391-6. doi: 10.7314/apjcp.2014.15.8.3391.
Vitamin D has been suggested as one of the critical factors for female reproductive health with protective activities against different cancers but there are conflicting facts regarding its role on breast cancer without any clear data on premenopausal cases. This study aimed to evaluate the role of vitamin D from dietary sources and sunlight exposure on the incidence of premenopausal breast cancer.
We conducted a case control study on 60 newly diagnosed premenopausal breast cancer patients and 116 normal women who lived in Sabzevar and surrounding villages in Razavi, Khorasan, a rural and conservative area of Iran.
The mean concentrations of 25-OH vitamin D in cases and controls were 15.2 ± 8.15 vs 15.5 ± 7/45 ng/ml, both well below normal values elsewhere. In fact 50% of analyzed individuals showed very severe or severe vitamin D deficiency and the rest (25%) were detected in suboptimal levels. Although the lack of vitamin D and calcium supplementation increased slightly the risk of premenopausal breast cancer (p=0.009, OR=1.115, CI 95%=1.049-1.187), higher prevalence of weekly egg consumption (86.66% vs 96.55%, p=0.023, OR=0.232, CI 95% 0.065-0.806) showed a slight protective role. The last but the most important risk factor was lack of sunlight exposure because the breast cancer patients had total body coverage from sun (p=0.007, OR=10.131, CI 98% 0.314-78.102).
This study pointed out the role of vitamin D and other possible risk factors on the development and growth of breast tumors in this special geographical region. Although this study has revealed the interactions between hormonal and environmental factors in this province of Iran, understanding the deficiency pattern and its contribution to other lifestyle factors elsewhere is also necessary.
维生素D被认为是女性生殖健康的关键因素之一,对不同癌症具有保护作用,但关于其在乳腺癌中的作用存在相互矛盾的观点,且尚无关于绝经前病例的明确数据。本研究旨在评估饮食来源的维生素D和阳光照射对绝经前乳腺癌发病率的作用。
我们对60例新诊断的绝经前乳腺癌患者和116名正常女性进行了病例对照研究,这些女性居住在伊朗拉扎维霍拉桑省萨卜泽瓦尔及其周边村庄,该地区为农村且较为保守。
病例组和对照组中25-羟维生素D的平均浓度分别为15.2±8.15 ng/ml和15.5±7.45 ng/ml,均远低于其他地区的正常值。事实上,50%的分析对象显示出非常严重或严重的维生素D缺乏,其余25%处于次优水平。虽然缺乏维生素D和钙补充剂会略微增加绝经前乳腺癌的风险(p=0.009,OR=1.115,95%CI=1.049-1.187),但每周食用鸡蛋的较高比例(86.66%对96.55%,p=0.023,OR=0.232,95%CI 0.065-0.806)显示出轻微的保护作用。最后但也是最重要的风险因素是缺乏阳光照射,因为乳腺癌患者全身都被衣物覆盖以避免阳光照射(p=0.007,OR=10.131,98%CI 0.314-78.102)。
本研究指出了维生素D和其他可能的风险因素在这一特殊地理区域乳腺肿瘤发生和发展中的作用。虽然本研究揭示了伊朗该省激素和环境因素之间的相互作用,但了解其他地区的缺乏模式及其对其他生活方式因素的影响也很有必要。