Fullmer Michell, Su Annelise, Bachrach Steven, Hossain Jobayer, Kecskemethy Heidi H
Nemours Center for Cancer and Blood Disorders, Nemours Children's Health, Wilmington, DE 19803, USA.
University of Richmond, Richmond, VA 23173, USA.
Cancers (Basel). 2022 May 12;14(10):2378. doi: 10.3390/cancers14102378.
Children with cancer have a greater risk for vitamin D concerns because of compromised health before diagnosis, the disease itself, and treatments for the cancer. This IRB-approved retrospective, matched case−control study of children with and without cancer included three race categories: black, other, and Caucasian. This is the first study to directly compare serum 25-hydroxy vitamin D (25(OH)D) levels and status in newly diagnosed pediatric cancer patients with age-, sex-, and race-matched cancer-free children from the same geographic region of the US, all of whom are free from other conditions that negatively impact 25(OH)D levels. Univariable and multivariable ordinal logistic regressions were performed. In the 544 children (mean age of 8.5 years, 53% female), there were 136 newly diagnosed children with cancer and 408 matched non-cancer controls. Serum 25(OH)D levels at cancer diagnosis were lower (22.4 ng/mL) than in controls (30.1 ng/mL; p < 0.0001). Differences persisted across race (p < 0.001) and age (p < 0.001), but not sex. Older children exhibited lower 25(OH)D levels. Only 18.4% of the children with cancer had sufficient levels. Black children with cancer had the greatest rate of deficiency (39%). Race differences were evident: children of color (other and black) displayed higher levels of insufficiency; black children were most deficient.
由于在诊断前健康状况不佳、疾病本身以及癌症治疗等原因，患癌儿童出现维生素D问题的风险更高。这项经机构审查委员会批准的回顾性配对病例对照研究纳入了患有和未患癌症的儿童，分为三个种族类别：黑人、其他种族和白种人。这是第一项直接比较新诊断的儿科癌症患者与来自美国同一地理区域、年龄、性别和种族匹配的无癌儿童的血清25-羟基维生素D（25(OH)D）水平和状态的研究，所有这些儿童均无其他对25(OH)D水平有负面影响的疾病。进行了单变量和多变量有序逻辑回归分析。在这544名儿童（平均年龄8.5岁，53%为女性）中，有136名新诊断为癌症的儿童和408名匹配的非癌症对照。癌症诊断时的血清25(OH)D水平（22.4 ng/mL）低于对照组（30.1 ng/mL；p < 0.0001）。种族（p < 0.001）和年龄（p < 0.001）方面的差异持续存在，但性别方面没有差异。年龄较大的儿童25(OH)D水平较低。只有18.4%的癌症儿童维生素D水平充足。患癌黑人儿童的缺乏率最高（39%）。种族差异明显：有色人种儿童（其他种族和黑人）的不足水平较高；黑人儿童缺乏情况最为严重。
