Feng Qianqian, Zhang Han, Dong Zhengqin, Zhou Yang, Ma Jingping
Department of Respiratory Medicine, The Second Clinical Medical College, Yangtze University, Jingzhou, Hubei, China.
Medicine (Baltimore). 2017 Nov;96(45):e8613. doi: 10.1097/MD.0000000000008613.
Lower serum level of 25-hydroxyvitamin D is associated with several negative outcomes. However, previous studies have indicated that 25-hydroxyvitamin D is associated with lung cancer risk and survival, but presented controversial results.PubMed and Embase databases were searched update to August 2017 to identify and quantify the potential association between 25-hydroxyvitamin D and lung cancer risk and survival.Seventeen eligible studies involving a total of 138,858 participants with 4368 incident cases were included in this meta-analysis. Our results showed statistically significant association between 25-hydroxyvitamin D and lung cancer risk and mortality. However, circulating 25-hydroxyvitamin D was not associated with overall lung cancer survival. Furthermore, compared with the lowest circulating 25-hydroxyvitamin D, the highest circulating 25-hydroxyvitamin D is significantly decreased risk of lung cancer risk in male and female. In addition, the highest circulating 25-hydroxyvitamin D was significantly associated with a lower risk in Caucasian and Asian. We also obtained the best fit at an inflection point of 10 nmol/L in piecewise regression analysis, increasing 10 nmol/L dose of circulating 25-hydroxyvitamin D was associated with an 8% reduction in the risk of lung cancer risk and an 7% reduction in the risk of lung cancer mortality. Subgroup meta-analyses in study quality, number of participants, and number of cases showed consistent with the primary findings.The highest circulating 25-hydroxyvitamin D was associated with decreased lung cancer risk and mortality but not overall survival.
血清25-羟维生素D水平较低与多种不良后果相关。然而,先前的研究表明,25-羟维生素D与肺癌风险及生存率有关,但结果存在争议。检索了截至2017年8月的PubMed和Embase数据库,以识别并量化25-羟维生素D与肺癌风险及生存率之间的潜在关联。本荟萃分析纳入了17项符合条件的研究,共涉及138,858名参与者,其中有4368例新发病例。我们的结果显示,25-羟维生素D与肺癌风险及死亡率之间存在统计学上的显著关联。然而,循环中的25-羟维生素D与肺癌总体生存率无关。此外,与循环中25-羟维生素D水平最低者相比,最高者在男性和女性中均显著降低了肺癌风险。另外,循环中25-羟维生素D水平最高者在白种人和亚洲人中与较低风险显著相关。在分段回归分析中,我们还在10 nmol/L的拐点处获得了最佳拟合,循环25-羟维生素D剂量每增加10 nmol/L,肺癌风险降低8%,肺癌死亡率风险降低7%。在研究质量、参与者数量和病例数量方面的亚组荟萃分析结果与主要发现一致。循环中25-羟维生素D水平最高者与肺癌风险和死亡率降低相关,但与总体生存率无关。