Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-530 Kraków, Poland.
Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, 31-501 Kraków, Poland.
Nutrients. 2022 Jun 29;14(13):2712. doi: 10.3390/nu14132712.
Gastric cancer is a malignant neoplasm of the gastrointestinal tract, with one of the standard treatment methods remaining gastrectomy. The authors conducted a systemic review of the Medline and Embase databases concerning the serum vitamin D level in post-gastrectomy gastric cancer patients, regarding all articles published until 22 May 2022 according to the PRISMA guidelines. 18 studies with a total number of 908 gastric cancer survivors were included in the analysis. The initial rate of vitamin D deficiency in gastric cancer patients undergoing gastrectomy appears to be similar to the global population deficiency. In post-gastrectomy survivors, the level of 25(OH)D may remain stable or decrease, while the level of 1, 25(OH)D remains normal. Supplementation with vitamin D results in an improvement in its serum concentration and positively affects bone mineral density, which is gradually reduced in post-gastrectomy survivors. Combining vitamin D supplementation with calcium and bisphosphonates enables us to obtain better results than vitamin D and calcium only. The type of surgery influences the level of serum vitamin D and its metabolites, with total or partial gastrectomy and maintenance of the duodenal food passage remaining the most important factors. There is a strong need for randomized, controlled trials that would investigate this matter in the future.
胃癌是一种胃肠道的恶性肿瘤,其标准治疗方法之一仍然是胃切除术。作者按照 PRISMA 指南,对截至 2022 年 5 月 22 日在 Medline 和 Embase 数据库中关于胃切除术后胃癌患者血清维生素 D 水平的所有文章进行了系统性回顾。分析中纳入了 18 项研究,共纳入了 908 例胃癌幸存者。胃切除术后胃癌患者维生素 D 缺乏的初始发生率似乎与全球人群的缺乏率相似。在胃切除术后幸存者中,25(OH)D 水平可能保持稳定或下降,而 1,25(OH)D 水平保持正常。补充维生素 D 可提高其血清浓度,并对骨密度产生积极影响,而骨密度在胃切除术后幸存者中逐渐降低。维生素 D 补充与钙和双膦酸盐联合使用可使我们获得比单独使用维生素 D 和钙更好的效果。手术类型会影响血清维生素 D 及其代谢物的水平,全胃或部分胃切除术以及保持十二指肠食物通道仍然是最重要的因素。未来需要进行随机对照试验对此进行研究。