Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, The Netherlands.
Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, The Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Nutrition. 2019 Oct;66:166-172. doi: 10.1016/j.nut.2019.05.008. Epub 2019 May 29.
Vitamin deficiencies may reflect less-than-optimal health in select populations. The aim of this study was to determine whether vitamin D supplementation (VDs) after malnutrition may be adversely related to cancer diagnoses in a selected group of patients with alcoholic Wernicke-Korsakoff syndrome (WKS).
This was a retrospective cohort study of all patients admitted to Slingedael Korsakoff Center, from 1996 to 2018. The patients were subdivided into three predefined groups depending on differences in VDs: "early" supplementation, which started during or before the previous hospital admission, before the transfer to our center; "late" supplementation, which started later in our center; and "no" VDs received. Data collection involved patients' ages, sex, body mass index, skin type, baseline serum 25-hydroxyvitamin D concentrations if available, doses of cholecalciferol (vitamin D) supplementation, other vitamins, sun exposure, malnutrition, alcohol use, smoking, cognitive diagnoses, somatic comorbidity, cancer diagnoses, cause of death, and length of stay in Slingedael. New tumors (dependent variable) may have been diagnosed during VDs (exposed cases) or before the start of VDs, if any (unexposed cases).
New cancers were diagnosed in 87 of 389 (22.4%) patients after median 3 y of follow-up (interquartile range, 1.1‒5.8 y). In logistic regression analysis, age, smoking, and length of stay in log (y) showed odds ratios of 1.021, 2.74, and 1.68, respectively. The temporal relationship of VDs and cancer diagnosis was significant in VDs that started in the year leading up to the diagnosis (Wilcoxon signed-ranks test of positive ranks corresponding with supplementation and negative ranks corresponding with non-supplementation: Z score 2.54; P = 0.011).
VDs was time-related to cancer diagnosis in a cohort of patients with alcoholic WKS. The study may suggest the proliferation of cancer as an adverse effect of VDs, particularly in malnourished patients.
维生素缺乏可能反映出特定人群的健康状况不佳。本研究旨在确定营养不良后补充维生素 D（VDs）是否与酒精性 Wernicke-Korsakoff 综合征（WKS）患者中选定人群的癌症诊断有关。
这是一项回顾性队列研究，纳入了 1996 年至 2018 年期间入住 Slingedael Korsakoff 中心的所有患者。根据 VDs 的差异，患者被分为三个预设组：“早期”补充，即在之前的住院期间或之前开始，在转入我们中心之前；“晚期”补充，即在我们中心开始；以及“未”补充 VDs。数据收集包括患者的年龄、性别、体重指数、皮肤类型、如果有基线血清 25-羟维生素 D 浓度、胆钙化醇（维生素 D）补充剂量、其他维生素、阳光暴露、营养不良、酒精使用、吸烟、认知诊断、躯体合并症、癌症诊断、死亡原因和在 Slingedael 的住院时间。新肿瘤（因变量）可能在 VDs 期间（暴露病例）或 VDs 开始之前（未暴露病例）诊断。
中位随访 3 年后（1.1‒5.8 年），389 例患者中有 87 例（22.4%）诊断出新发癌症。在逻辑回归分析中，年龄、吸烟和住院时间（以 log(y) 表示）的比值比分别为 1.021、2.74 和 1.68。VDs 与癌症诊断的时间关系在诊断前一年开始的 VDs 中具有统计学意义（补充的正秩和非补充的负秩的 Wilcoxon 符号秩检验：Z 分数 2.54；P=0.011）。
在酒精性 WKS 患者队列中，VDs 与癌症诊断呈时间相关。该研究可能表明，VDs 作为一种不良影响，特别是在营养不良的患者中，可能会促进癌症的增殖。
