Bhatti Parveen, Doody David R, Mckean-Cowdin Roberta, Mueller Beth A
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA.
Int J Cancer. 2015 May 15;136(10):2481-5. doi: 10.1002/ijc.29291. Epub 2014 Nov 9.
Vitamin D deficiency among pregnant women is common. Compelling animal evidence suggests carcinogenic effects of vitamin D deficiency on the brains of offspring; however, the impact of circulating vitamin D [25(OH)D] on childhood brain tumor (CBT) risk has not been previously evaluated. Using linked birth-cancer registry data in Washington State, 247 CBT cases (<15 years at diagnosis; born 1991 or later) were identified. A total of 247 birth year-, sex- and race-matched controls were selected from the remaining birth certificates. Liquid chromatography-tandem mass spectrometry was used to measure circulating levels of vitamin D3 [25(OH)D3] in neonatal dried blood spots. Overall, no significant associations were observed. However, when stratified by median birth weight (3,458 g), there was evidence of increasing risk of CBT with increasing 25(OH)D3 among children in the higher birth weight category. Compared to the lowest quartile (2.8-7.7 ng/mL), odds ratios (ORs) and 95% confidence intervals (CIs) for the second (7.7-<11.0 ng/mL), third (11.0-<14.7 ng/mL) and fourth (14.7-37.0) quartiles of 25(OH)D3 were 1.7 (1.0-3.3), 2.4 (1.2-4.8) and 2.6 (1.2-5.6), respectively. Among children in the lower birth weight category, there was suggestive evidence of a protective effect: ORs and 95% CIs for the second, third and fourth quartiles were 0.9 (0.4-1.9), 0.7 (0.3-1.4) and 0.6 (0.3-1.3), respectively. Any associations of neonatal vitamin D with CBT may be birth weight-specific, suggesting the possible involvement of insulin-like growth factor 1, circulating levels of which have been associated with vitamin D and accelerated fetal growth.
孕妇维生素D缺乏情况很常见。有力的动物证据表明,维生素D缺乏对后代大脑有致癌作用;然而,循环维生素D[25(OH)D]对儿童脑肿瘤(CBT)风险的影响此前尚未得到评估。利用华盛顿州的出生-癌症登记关联数据,确定了247例CBT病例(诊断时年龄<15岁;1991年或之后出生)。从其余出生证明中选取了247例与出生年份、性别和种族匹配的对照。采用液相色谱-串联质谱法测定新生儿干血斑中维生素D3[25(OH)D3]的循环水平。总体而言,未观察到显著关联。然而,按出生体重中位数(3458克)分层时,有证据表明出生体重较高类别的儿童中,CBT风险随25(OH)D3水平升高而增加。与最低四分位数(2.8 - 7.7纳克/毫升)相比,25(OH)D3第二(7.7 - <11.0纳克/毫升)、第三(11.0 - <14.7纳克/毫升)和第四(14.7 - 37.0)四分位数的比值比(OR)和95%置信区间(CI)分别为1.7(1.0 - 3.3)、2.4(1.2 - 4.8)和2.6(1.2 - 5.6)。在出生体重较低类别的儿童中,有提示性证据表明存在保护作用:第二、第三和第四四分位数的OR和95%CI分别为0.9(0.4 - 1.9)、0.7(0.3 - 1.4)和0.6(0.3 - 1.3)。新生儿维生素D与CBT的任何关联可能具有出生体重特异性,这表明胰岛素样生长因子1可能参与其中,其循环水平与维生素D及胎儿生长加速有关。