Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China.
Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Clin Nutr. 2019 Oct;38(5):2381-2388. doi: 10.1016/j.clnu.2018.10.019. Epub 2018 Nov 5.
BACKGROUND & AIMS: Evidence from epidemiologic studies on the association of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with the incident risk of cancer has been inconsistent. We aimed to investigate the prospective relationship of baseline plasma 25(OH)D concentrations with the risk of cancer, and to examine possible effect modifiers.
We employed a nested case-control study design, including 231 patients with incident cancer during a median 4.5 years of follow up, and 231 matched controls from the China Stroke Primary Prevention Trial (CSPPT).
The prevalence of plasma 25(OH)D <15, <20 and <30 ng/mL was 23.6%, 47.4% and 85.5%, respectively. Overall, there was an inverse relation between risk of cancer and plasma 25(OH)D. The Odds ratios (95% CI) for participants in the second (15.1 to <20.6 ng/mL), third (20.6 to <26.4 ng/mL) and fourth quartiles (≥26.4 ng/mL) were 0.45 (95% CI: 0.25-0.80), 0.53 (95% CI: 0.27-1.06) and 0.55 (95% CI: 0.27-1.10), respectively, compared with those in quartile 1. Conversely, low 25(OH)D (<15.1 ng/mL) concentrations were associated with increased risk of cancer (OR, 2.08; 95% CI: 1.20-3.59) compared to higher concentrations. These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified, including plasma vitamin E concentrations and alcohol intake.
Low plasma 25(OH)D concentrations (<15.1 ng/mL) were associated with increased total cancer risk among Chinese hypertensive adults, compared to higher 25(OH)D concentrations. This finding and the possible effect modifiers warrant additional investigation.
流行病学研究中关于循环 25-羟维生素 D [25(OH)D] 浓度与癌症发病风险的关联证据并不一致。本研究旨在探讨基线血浆 25(OH)D 浓度与癌症风险的前瞻性关系，并检验可能的效应修饰因素。
我们采用巢式病例对照研究设计，包括中位随访 4.5 年内 231 例新发癌症患者和来自中国脑卒中一级预防试验（CSPPT）的 231 名匹配对照者。
血浆 25(OH)D <15、<20 和 <30ng/mL 的患病率分别为 23.6%、47.4%和 85.5%。总体而言，癌症风险与血浆 25(OH)D 呈负相关。第 2（15.1<20.6ng/mL）、第 3（20.6<26.4ng/mL）和第 4 四分位组（≥26.4ng/mL）参与者的比值比（95%可信区间）分别为 0.45（95%可信区间：0.250.80）、0.53（95%可信区间：0.271.06）和 0.55（95%可信区间：0.271.10），而第 1 四分位组的比值比为 1。相反，与较高浓度相比，低浓度 25(OH)D（<15.1ng/mL）与癌症风险增加相关（OR，2.08；95%CI：1.203.59）。这些关联在各种癌症亚型中均一致。确定了几个潜在的效应修饰因素，包括血浆维生素 E 浓度和饮酒量。
与较高的 25(OH)D 浓度相比，中国高血压成年人中较低的血浆 25(OH)D 浓度（<15.1ng/mL）与总癌症风险增加相关。这一发现和可能的效应修饰因素值得进一步研究。
