Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
Cancer Epidemiol Biomarkers Prev. 2020 Jun;29(6):1135-1144. doi: 10.1158/1055-9965.EPI-19-1522. Epub 2020 Apr 3.
Vitamin D status may be an important determinant of health-related quality of life of colorectal cancer survivors. The current study investigated longitudinal associations between serum 25-hydroxyvitamin D (25OHD) concentrations and quality of life in stage I-III colorectal cancer survivors up to 2 years after treatment.
Patients with colorectal cancer ( = 261) were included upon diagnosis. Home visits (including blood sampling) were performed at diagnosis and at 6 weeks, 6 months, 1 year, and 2 years after treatment. Serum 25OHD concentrations were measured using LC/MS-MS and adjusted for season. Validated questionnaires were used to assess global quality of life and cognitive functioning (EORTC-QLQ-C30), fatigue (EORTC-QLQ-C30 and Checklist Individual Strength, CIS), and depression and anxiety (Hospital Anxiety and Depression Scale). Statistical analyses were performed using linear mixed models and adjusted for sex, age, time since diagnosis, therapy, comorbidities, physical activity, and body mass index.
At diagnosis, 45% of patients were vitamin D deficient (<50 nmol/L). After treatment, 25OHD concentrations increased on average with 3.1 nmol/L every 6 months. In confounder-adjusted models, 20 nmol/L increments in 25OHD were longitudinally associated with increased global quality of life [β 2.9; 95% confidence interval (CI), 1.5-4.3] and reduced fatigue (EORTC-QLQ-C30 subscale: β -3.5; 95% CI, -5.3 to -1.8 and CIS: β -2.8; 95% CI, -4.7 to -0.9). Observed associations were present both within and between individuals over time.
Higher concentrations of 25OHD were longitudinally associated with better global quality of life and less fatigue in colorectal cancer survivors.
This study suggests that higher 25OHD concentrations may be beneficial for colorectal cancer survivors. Future intervention studies are needed to corroborate these findings.
维生素 D 状况可能是影响结直肠癌幸存者健康相关生活质量的一个重要决定因素。本研究旨在调查在治疗后 2 年内,Ⅰ-Ⅲ期结直肠癌幸存者血清 25-羟维生素 D(25OHD)浓度与生活质量之间的纵向关联。
在诊断时纳入结直肠癌患者(n=261)。在诊断时、治疗后 6 周、6 个月、1 年和 2 年时进行上门访视(包括采血)。使用 LC/MS-MS 测量血清 25OHD 浓度,并按季节进行调整。使用经过验证的问卷评估总体生活质量和认知功能(EORTC-QLQ-C30)、疲劳(EORTC-QLQ-C30 和 Checklist Individual Strength,CIS)以及抑郁和焦虑(医院焦虑和抑郁量表)。使用线性混合模型进行统计分析,并根据性别、年龄、诊断后时间、治疗、合并症、身体活动和体重指数进行调整。
在诊断时,45%的患者维生素 D 缺乏(<50 nmol/L)。治疗后,25OHD 浓度平均每 6 个月增加 3.1 nmol/L。在混杂因素调整模型中,25OHD 增加 20 nmol/L 与总体生活质量的提高呈纵向相关[β 2.9;95%置信区间(CI),1.5-4.3],与疲劳的减轻呈纵向相关(EORTC-QLQ-C30 子量表:β -3.5;95% CI,-5.3 至-1.8 和 CIS:β -2.8;95% CI,-4.7 至-0.9)。观察到的关联在个体内部和个体之间随时间变化而存在。
25OHD 浓度较高与结直肠癌幸存者的总体生活质量较高和疲劳减轻呈纵向相关。
本研究表明,较高的 25OHD 浓度可能对结直肠癌幸存者有益。需要进一步的干预研究来证实这些发现。