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血清维生素D浓度与结肠息肉的关联:一项利用韩国一家三级医院医疗筛查数据库的横断面研究。

The Association between Serum Vitamin D Concentration and Colon Polyp: A Cross-Sectional Study Using Health Care Screening Database in a Tertiary Hospital in Korea.

作者信息

Yoo Mun Young, Lee Jungkwon, Chung Ji In, Yeo Yohwan, Cho In Young

机构信息

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Fam Med. 2021 Jul;42(4):303-309. doi: 10.4082/kjfm.20.0181. Epub 2021 Jul 20.

Abstract

BACKGROUND

As indoor activity increases with modern lifestyles changes, reduced exposure to sunlight may lead to reduced vitamin D synthesis. Previous studies demonstrated that increased vitamin D level is associated with decreased risk of colon cancer; therefore, this study attempted to determine the association between vitamin D and colon polyps, which may be precancerous lesions, in participants who underwent colonoscopy exams.

METHODS

A total of 31,004 participants who underwent routine health checkups, including vitamin D level and colonoscopy, at Samsung Medical Center in South Korea from 2010 to 2018 were included in the study. Colorectal polyps were diagnosed through biopsy after performing colonoscopy exams. Participants were categorized into three groups according to level of vitamin D (deficient: <20 ng/mL), insufficient: 20≤ vitamin D <30 ng/mL, and sufficient: ≥30 ng/mL). We analyzed the presence of colorectal polyps according to vitamin D level, and performed multiple logistic regression analyses for the association between vitamin D level and colorectal polyps.

RESULTS

About 50% of participants had colorectal polyps (hyperplastic polyp, n=4,864; adenomatous polyp, n=10,470; adenocarcinoma, n=24). There were no significant associations between vitamin D categories and colorectal polyp and colorectal cancer. However, when further analyzing by type of polyp, the risk of hyperplastic polyps significantly decreased with increasing vitamin D levels (P for trend=0.006).

CONCLUSION

We did not find evidence for an association between vitamin D and overall colorectal polyps; however, we observed a trend for decreased odds of hyperplastic polyps with increased vitamin D levels in comparison to vitamin D deficient subjects.

摘要

背景

随着现代生活方式的改变,室内活动增加,阳光照射减少可能导致维生素D合成减少。先前的研究表明,维生素D水平升高与结肠癌风险降低有关;因此,本研究试图确定在接受结肠镜检查的参与者中,维生素D与可能为癌前病变的结肠息肉之间的关联。

方法

本研究纳入了2010年至2018年在韩国三星医疗中心接受包括维生素D水平和结肠镜检查在内的常规健康检查的31004名参与者。结肠镜检查后通过活检诊断大肠息肉。参与者根据维生素D水平分为三组(缺乏:<20 ng/mL)、不足:20≤维生素D<30 ng/mL和充足:≥30 ng/mL)。我们根据维生素D水平分析大肠息肉的存在情况,并对维生素D水平与大肠息肉之间的关联进行多因素逻辑回归分析。

结果

约50%的参与者患有大肠息肉(增生性息肉,n = 4864;腺瘤性息肉,n = 10470;腺癌,n = 24)。维生素D类别与大肠息肉和结直肠癌之间无显著关联。然而,按息肉类型进一步分析时,增生性息肉的风险随维生素D水平升高而显著降低(趋势P = 0.006)。

结论

我们没有发现维生素D与总体大肠息肉之间存在关联的证据;然而,与维生素D缺乏的受试者相比,我们观察到随着维生素D水平升高,增生性息肉的发生几率有降低的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b57/8321912/7c599b430e98/kjfm-20-0181f1.jpg

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