Husain Nazik Elmalaika, Suliman Ahmed A, Abdelrahman Ismail, Bedri Shahinaz A, Musa Rasha M, Osman Hind E, Mustafa Ayda H, Gafer Nahla, Farah Ehab, Satir Ali Abdel, Ahmed Mohamed H, Osman Mugtaba, Agaimy Abbas
Department of Pathology, Omdurman Islamic University, Omdurman, Sudan.
Department of Pathology, National Ribat University, Sudan.
J Family Med Prim Care. 2019 May;8(5):1706-1714. doi: 10.4103/jfmpc.jfmpc_197_19.
The role of vitamin D in the development, progression, and prognosis of breast cancer, though widely studied worldwide, has been inconclusive. This study intended to assess the role of some factors (including serum vitamin D level, sun-exposed area, dietary factors, and physical activity) as predictors of the development of invasive breast cancer (IBC) among Sudanese women.
A case-control study was conducted on 200 Sudanese women (100 with newly diagnosed IBC and 100 matched healthy females). Serum 25-hydroxyvitamin D was measured through a competitive electrochemiluminescence immunoassay. Matching analysis was adopted by R version 3.4.1 making use of the "MatchIt" package for calculating propensity scores to build a confounder-adjusted, multiple generalized, linear logistic regression model.
Participants' age ranged from 28 to 85 years with a mean [±standard deviation (SD)] of 48.10 (±12.11) years. The mean (±SD) serum vitamin D level was 12.97 (±8.60) and 13.79 (±6.79) ng/mL in breast cancer and noncancer Sudanese women, respectively [P = 0.013; odds ratio (OR) 0.862; 95% confidence interval (CI) 0.766-0.969; β = 0.149)]. Sun-exposed area ( = 0.038; OR 0.013; 95% CI 0.000-0.782; β = 4.339) is significantly and negatively associated with breast cancer development. While moderate physical activity ( = 0.0008; OR 2625.430; 95% CI 26.647-258673.001; β = 7.873) is significantly and positively associated with IBC risk. Occasional consumption of milk, dairy products, eggs, and fish reduces the risk of developing IBC by 78.1%, 75.0%, 78.4%, and 76.4%, respectively.
The higher the plasma vitamin D level by one unit, the lower the risk of breast cancer by 13.84%. Sedentary lifestyle, reduced sun-exposed skin area, and low serum vitamin D levels can be considered as predictors of IBC. Encouraging moderate physical activity and consumption of certain foods may, in part, decrease the precipitating risks of breast cancer. More studies and research are needed to confirm these findings.
维生素D在乳腺癌的发生、发展及预后中的作用，尽管在全球范围内已得到广泛研究，但尚无定论。本研究旨在评估一些因素（包括血清维生素D水平、阳光暴露面积、饮食因素和身体活动）作为苏丹女性浸润性乳腺癌（IBC）发生预测指标的作用。
对200名苏丹女性进行了一项病例对照研究（100名新诊断为IBC的患者和100名匹配的健康女性）。通过竞争性电化学发光免疫分析法测定血清25-羟维生素D。使用R 3.4.1版本并借助“MatchIt”软件包进行匹配分析，以计算倾向得分，从而构建一个经混杂因素调整的多重广义线性逻辑回归模型。
参与者年龄在28至85岁之间，平均[±标准差（SD）]为48.10（±12.11）岁。乳腺癌苏丹女性和非癌症苏丹女性的血清维生素D平均（±SD）水平分别为12.97（±8.60）和13.79（±6.79）ng/mL[P = 0.013；比值比（OR）0.862；95%置信区间（CI）0.766 - 0.969；β = 0.149]。阳光暴露面积（P = 0.038；OR 0.013；95% CI 0.000 - 0.782；β = 4.339）与乳腺癌发生呈显著负相关。而适度身体活动（P = 0.0008；OR 2625.430；95% CI 26.647 - 258673.001；β = 7.873）与IBC风险呈显著正相关。偶尔食用牛奶、乳制品、鸡蛋和鱼类分别使患IBC的风险降低78.1%、75.0%、78.4%和76.4%。
血浆维生素D水平每升高一个单位，患乳腺癌的风险就降低13.84%。久坐的生活方式、阳光暴露皮肤面积减少和血清维生素D水平低可被视为IBC的预测指标。鼓励适度身体活动和食用某些食物可能在一定程度上降低乳腺癌的诱发风险。需要更多的研究来证实这些发现。
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