Ellingjord-Dale Merete, dos-Santos-Silva Isabel, Grotmol Tom, Sakhi Amrit Kaur, Hofvind Solveig, Qureshi Samera, Markussen Marianne Skov, Couto Elisabeth, Vos Linda, Ursin Giske
University of OsloOslo, Norway.
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2015 May 4;10(5):e0123754. doi: 10.1371/journal.pone.0123754. eCollection 2015.
The role of vitamin D in breast cancer etiology is unclear. There is some, but inconsistent, evidence that vitamin D is associated with both breast cancer risk and mammographic density (MD). We evaluated the associations of MD with month the mammogram was taken, and with vitamin D intake, in a population of women from Norway--a country with limited sunlight exposure for a large part of the year.
3114 women aged 50-69, who participated in the Norwegian Breast Cancer Screening Program (NBCSP) in 2004 or 2006/07, completed risk factor and food frequency (FFQ) questionnaires. Dietary and total (dietary plus supplements) vitamin D, calcium and energy intakes were estimated by the FFQ. Month when the mammogram was taken was recorded on the mammogram. Percent MD was assessed using a computer assisted method (Madena, University of Southern California) after digitization of the films. Linear regression models were used to investigate percent MD associations with month the mammogram was taken, and vitamin D and calcium intakes, adjusting for age, body mass index (BMI), study year, estrogen and progestin therapy (EPT), education, parity, calcium intakes and energy intakes.
There was no statistical significant association between the month the mammogram was taken and percent MD. Overall, there was no association between percent MD and quartiles of total or dietary vitamin D intakes, or of calcium intake. However, analysis restricted to women aged <55 years revealed a suggestive inverse association between total vitamin D intake and percent MD (p for trend = 0.03).
Overall, we found no strong evidence that month the mammogram was taken was associated with percent MD. We found no inverse association between vitamin D intake and percent MD overall, but observed a suggestive inverse association between dietary vitamin D and MD for women less than 55 years old.
维生素D在乳腺癌病因学中的作用尚不清楚。有一些但并不一致的证据表明,维生素D与乳腺癌风险及乳腺X线密度(MD)均有关联。我们在来自挪威的女性人群中评估了MD与乳腺X线检查月份以及维生素D摄入量之间的关联,挪威一年中大部分时间日照有限。
3114名年龄在50 - 69岁之间、于2004年或2006/07年参加挪威乳腺癌筛查项目(NBCSP)的女性完成了风险因素和食物频率(FFQ)问卷。通过FFQ估算饮食及总(饮食加补充剂)维生素D、钙和能量摄入量。乳腺X线检查的月份记录在乳腺X线片上。在对胶片进行数字化处理后,使用计算机辅助方法(南加州大学的Madena)评估MD百分比。采用线性回归模型研究MD百分比与乳腺X线检查月份、维生素D和钙摄入量之间的关联,并对年龄、体重指数(BMI)、研究年份、雌激素和孕激素治疗(EPT)、教育程度、产次、钙摄入量和能量摄入量进行校正。
乳腺X线检查月份与MD百分比之间无统计学显著关联。总体而言,MD百分比与总或饮食维生素D摄入量的四分位数以及钙摄入量之间均无关联。然而,对年龄小于55岁的女性进行的分析显示,总维生素D摄入量与MD百分比之间存在提示性的负相关(趋势p值 = 0.03)。
总体而言,我们没有发现有力证据表明乳腺X线检查月份与MD百分比有关联。我们未发现维生素D摄入量与总体MD百分比之间存在负相关,但观察到年龄小于55岁的女性饮食维生素D与MD之间存在提示性的负相关。