Piper Marina R, Freedman D Michal, Robien Kim, Kopp William, Rager Helen, Horst Ronald L, Stolzenberg-Solomon Rachael Z
From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH).
Am J Clin Nutr. 2015 Jun;101(6):1206-15. doi: 10.3945/ajcn.114.096016. Epub 2015 Apr 22.
Vitamin D-binding protein (DBP) is the primary carrier of 25-hydroxyvitamin D [25(OH)D] in the circulation. One prospective study in male smokers found a protective association between DBP and pancreatic cancer, particularly among men with higher 25(OH)D concentrations.
The objective was to examine the association between DBP and pancreatic cancer risk in an American population.
We conducted a nested case-control study in the Prostate, Lung, Colorectal, and Ovarian Cancer screening trial cohort of men and women aged 55-74 y at baseline. Between 1993 and 2010, 295 incident pancreatic adenocarcinoma cases were reported (follow-up to 15.1 y). Two controls (n = 590) were matched to each case by age, race, sex, and month of blood draw. We calculated smoking- and diabetes-adjusted ORs and 95% CIs with the use of conditional logistic regression.
DBP concentration was not significantly associated with pancreatic cancer overall [highest (≥7149.4 nmol/L) vs. lowest (<3670.4 nmol/L) quintile; OR: 1.75; 95% CI: 0.91, 3.37; P-trend = 0.25]. For serum 25(OH)D compared with the referent (50 to <75 nmol/L), individuals in the highest group had a significantly higher risk (≥100 nmol/L; OR: 3.23; 95% CI: 1.24, 8.44), whereas those in the lowest group had no significant association (<25 nmol/L; OR: 2.50; 95% CI: 0.92, 6.81). Further adjustment for DBP did not alter this association.
Our results do not support the hypothesis that serum DBP or 25(OH)D plays a protective role in pancreatic cancer. This trial was registered at clinicaltrials.gov as NCT00339495.
维生素D结合蛋白（DBP）是循环中25-羟基维生素D[25(OH)D]的主要载体。一项针对男性吸烟者的前瞻性研究发现，DBP与胰腺癌之间存在保护性关联，尤其是在25(OH)D浓度较高的男性中。
目的是研究美国人群中DBP与胰腺癌风险之间的关联。
我们在前列腺、肺、结肠直肠和卵巢癌筛查试验队列中进行了一项巢式病例对照研究，该队列中的男性和女性基线年龄为55-74岁。1993年至2010年期间，报告了295例胰腺癌新发病例（随访15.1年）。根据年龄、种族、性别和采血月份，为每个病例匹配两名对照（n = 590）。我们使用条件逻辑回归计算了调整吸烟和糖尿病因素后的比值比（OR）和95%可信区间（CI）。
总体而言，DBP浓度与胰腺癌无显著关联[最高（≥7149.4 nmol/L）与最低（<3670.4 nmol/L）五分位数相比；OR：1.75；95%CI：0.91，3.37；P趋势 = 0.25]。与参考组（50至<75 nmol/L）相比，血清25(OH)D最高组（≥100 nmol/L）的个体风险显著更高（OR：3.23；95%CI：1.24，8.44），而最低组（<25 nmol/L）则无显著关联（OR：2.50；95%CI：0.92，6.81）。进一步调整DBP后，这种关联未改变。
我们的结果不支持血清DBP或25(OH)D在胰腺癌中起保护作用的假设。该试验在clinicaltrials.gov上注册，注册号为NCT00339495。
