Department of Internal Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, New York, NY 11206, USA.
Department of Gastroenterology and Hepatology, New York University School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, New York, NY 11206, USA.
Nutrients. 2018 May 16;10(5):629. doi: 10.3390/nu10050629.
: Low circulating vitamin D levels are associated with gastric adenocarcinoma, but whether vitamin D levels are associated with premalignant gastric mucosal changes is unknown. Here, we determined associations between vitamin D levels and gastric incomplete intestinal metaplasia, a known gastric adenocarcinoma risk factor. : This was a retrospective, unmatched, case-control study comparing serum 25-hydroxyvitamin D levels among subjects with gastric incomplete intestinal metaplasia (cases; = 103) and those without gastric incomplete intestinal metaplasia (controls; = 216). The 25-hydroxyvitamin D levels were categorized as normal (30–100 ng/dL), vitamin D insufficiency (VDi; 20–29 ng/dL), and vitamin D deficiency (VDd; <20 ng/dL). Using multivariable logistic regression, odds ratios (ORs) were calculated and adjusted to age, gender, ethnicity, body mass index, history of hypertension or diabetes mellitus, and timing of vitamin D collection to assess associations between 25-hydroxyvitamin D levels and gastric incomplete intestinal metaplasia. Results: A majority of case subjects were male, Hispanic, and did not have hypertension or diabetes mellitus. The average serum 25-hydroxyvitamin D level was significantly lower in the intestinal metaplasia group than the control group (19.7 ng/dL vs. 34.7 ng/dL; < 0.001). Hypovitaminosis D was more common in subjects with incomplete intestinal metaplasia in a multivariable regression model (OR 54.1, 95% CI 21.8–134.3; < 0.001). VDd (OR 129.0, 95% CI 43.7–381.2; < 0.001) and VDi (OR 31.0, 95% CI 11.9–80.3; < 0.001) were more common in patients with incomplete intestinal metaplasia than healthy subjects, with VDd slightly more prevalent than VDi (OR 4.0, 95% CI 1.7–9.6; < 0.001). : Vitamin D deficiency and insufficiency are more common in patients with gastric incomplete intestinal metaplasia than healthy subjects and may play a role in the development of premalignant phenotypes related to gastric adenocarcinoma.
血清 25-羟维生素 D 水平与不完全性胃肠上皮内瘤变的关系：一项病例对照研究
循环中维生素 D 水平较低与胃腺癌相关，但维生素 D 水平是否与癌前胃黏膜变化相关尚不清楚。在这里，我们确定了维生素 D 水平与不完全性胃肠上皮内瘤变（已知的胃腺癌危险因素）之间的关系。
这是一项回顾性、非匹配的病例对照研究，比较了不完全性胃肠上皮内瘤变患者（病例；n=103）和无不完全性胃肠上皮内瘤变患者（对照；n=216）的血清 25-羟维生素 D 水平。25-羟维生素 D 水平分为正常（30-100ng/dL）、维生素 D 不足（20-29ng/dL）和维生素 D 缺乏（<20ng/dL）。使用多变量逻辑回归计算比值比（OR），并根据年龄、性别、种族、体重指数、高血压或糖尿病病史以及维生素 D 采集时间进行调整，以评估 25-羟维生素 D 水平与不完全性胃肠上皮内瘤变之间的关系。
大多数病例组患者为男性、西班牙裔，且无高血压或糖尿病。肠上皮内瘤变组的血清 25-羟维生素 D 水平明显低于对照组（19.7ng/dL 比 34.7ng/dL；<0.001）。在多变量回归模型中，不完全性肠上皮内瘤变患者的维生素 D 缺乏症更为常见（OR 54.1，95%CI 21.8-134.3；<0.001）。维生素 D 缺乏（OR 129.0，95%CI 43.7-381.2；<0.001）和维生素 D 不足（OR 31.0，95%CI 11.9-80.3；<0.001）在不完全性肠上皮内瘤变患者中更为常见，且维生素 D 缺乏症比维生素 D 不足症更为常见（OR 4.0，95%CI 1.7-9.6；<0.001）。
与健康受试者相比，不完全性胃肠上皮内瘤变患者的维生素 D 缺乏症和不足症更为常见，这可能与胃腺癌相关的癌前表型的发生有关。
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