Cheng Ting-Yuan David, Song Xiaoling, Beresford Shirley A A, Ho Gloria Y F, Johnson Karen C, Datta Mridul, Chlebowski Rowan T, Wactawski-Wende Jean, Qi Lihong, Neuhouser Marian L
Department of Epidemiology, University of Florida, 2004 Mowry Road, 4th Floor, RM4213, P. O. Box 100231, Gainesville, FL, 32610, USA.
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Cancer Causes Control. 2017 Oct;28(10):1053-1063. doi: 10.1007/s10552-017-0956-1. Epub 2017 Sep 12.
Vitamin D has been implicated in lowering lung cancer risk, but serological data on the association among never-smoking women are limited. We report results examining the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with lung cancer risk among female never smokers. We also examined whether the association was modified by vitamin D supplementation and serum vitamin A concentrations.
In the Women's Health Initiative, including the calcium/vitamin D (CaD) Trial, we selected 298 incident cases [191 non-small cell lung cancer (NSCLC) including 170 adenocarcinoma] and 298 matched controls of never smokers. Baseline serum 25(OH)D was assayed by a chemiluminescent method. Logistic regression was used to estimate odds ratios (ORs) for quartiles and predefined clinical cutoffs of serum 25(OH)D concentrations.
Comparing quartiles 4 versus 1 of serum 25(OH)D concentrations, ORs were 1.06 [95% confidence interval (CI) 0.61-1.84] for all lung cancer, 0.94 (95% CI 0.52-1.69) for NSCLC, and 0.91 (95% CI 0.49-1.68) for adenocarcinoma. Comparing serum 25(OH)D ≥ 75 (high) versus <30 nmol/L (deficient), ORs were 0.76 (95% CI 0.31-1.84) for all lung cancer, 0.71 (95% CI 0.27-1.86) for NSCLC, and 0.81 (95% CI 0.31-2.14) for adenocarcinoma. There is suggestive evidence that CaD supplementation (1 g calcium + 400 IU D/day) and a high level of circulating vitamin A may modify the associations of 25(OH)D with lung cancer overall and subtypes (p interaction <0.10).
In this group of never-smoking postmenopausal women, the results did not support the hypothesis of an association between serum 25(OH)D and lung cancer risk.
维生素D被认为与降低肺癌风险有关，但关于从不吸烟女性中这种关联的血清学数据有限。我们报告了关于血清25-羟基维生素D[25(OH)D]浓度与从不吸烟女性肺癌风险之间关联的研究结果。我们还研究了这种关联是否会因维生素D补充剂和血清维生素A浓度而改变。
在女性健康倡议（包括钙/维生素D[CaD]试验）中，我们选取了298例新发病例[191例非小细胞肺癌（NSCLC），包括170例腺癌]以及298例匹配的从不吸烟对照。采用化学发光法检测基线血清25(OH)D。使用逻辑回归来估计血清25(OH)D浓度四分位数和预定义临床临界值的比值比（OR）。
比较血清25(OH)D浓度的第4四分位数与第1四分位数，所有肺癌的OR为1.06[95%置信区间（CI）0.61 - 1.84]，NSCLC为0.94（95%CI 0.52 - 1.69），腺癌为0.91（95%CI 0.49 - 1.68）。比较血清25(OH)D≥75（高）与<30 nmol/L（缺乏），所有肺癌的OR为0.76（95%CI 0.31 - 1.84），NSCLC为0.71（95%CI 0.27 - 1.86），腺癌为0.81（95%CI 0.31 - 2.14）。有提示性证据表明，补充CaD（1克钙 + 400国际单位维生素D/天）和高水平的循环维生素A可能会改变25(OH)D与总体肺癌及各亚型之间的关联（p交互作用<0.10）。
在这组从不吸烟的绝经后女性中，结果不支持血清25(OH)D与肺癌风险之间存在关联的假设。
