Mohr Sharif B, Gorham Edward D, Kim June, Hofflich Heather, Cuomo Raphael E, Garland Cedric F
Department of Family and Preventive Medicine 0620, University of California, San Diego, La Jolla CA 92093, USA.
Department of Medicine, Internal Medical Group, University of California, San Diego, La Jolla CA 92093, USA.
J Steroid Biochem Mol Biol. 2015 Apr;148:239-44. doi: 10.1016/j.jsbmb.2014.12.010. Epub 2014 Dec 19.
To determine whether a higher serum 25-hydroxyvitamin D [25(OH)D] concentration at diagnosis is associated with longer survival of colorectal cancer patients.
A meta-analysis was performed of studies of the relationship between 25(OH)D and mortality of patients with colorectal cancer. A random-effects model was used to calculate a pooled hazards ratio. Homogeneity was evaluated through a DerSimonian-Laird test.
Higher serum concentrations of 25(OH)D were associated with lower mortality in patients with colorectal cancer. Patients in the highest quintile of 25(OH)D had 37% lower mortality from colorectal cancer compared to those in the lowest quintile of 25(OH)D (pooled odds ratio=0.63, p<0.0001). Dose-response curves showed lower hazard ratios for mortality with higher serum 25(OH)D through at least 40ng/ml. There were no exceptions.
Higher serum 25(OH)D was associated with lower mortality of patients with colorectal cancer. These results suggest that colorectal cancer patients with deficient levels of serum 25(OH)D should have their levels restored to a normal range (30-80ng/ml). This could be done with regular testing of serum 25(OH)D to be confident that an adequate serum level is being maintained. Additional studies would be worthwhile to evaluate confounding or the possibility of reverse causation.
确定诊断时较高的血清25-羟维生素D[25(OH)D]浓度是否与结直肠癌患者的更长生存期相关。
对25(OH)D与结直肠癌患者死亡率之间关系的研究进行荟萃分析。采用随机效应模型计算合并风险比。通过DerSimonian-Laird检验评估同质性。
较高的血清25(OH)D浓度与结直肠癌患者较低的死亡率相关。25(OH)D最高五分位数的患者与最低五分位数的患者相比，结直肠癌死亡率低37%（合并优势比=0.63，p<0.0001）。剂量反应曲线显示，血清25(OH)D水平至少达到40ng/ml时，死亡率的风险比更低。无一例外。
较高的血清25(OH)D与结直肠癌患者较低的死亡率相关。这些结果表明，血清25(OH)D水平不足的结直肠癌患者应将其水平恢复到正常范围（30-80ng/ml）。这可以通过定期检测血清25(OH)D来确保维持足够的血清水平。评估混杂因素或反向因果关系的可能性的进一步研究将是有价值的。
