Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Division of Gastroenterology and Hepatology, 1st Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Basic and Translational Research Unit, Special Unit for Biomedical Research and Education, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Pharmacol Ther. 2022 Sep;237:108252. doi: 10.1016/j.pharmthera.2022.108252. Epub 2022 Aug 1.
Colorectal cancer (CRC) is the third most common cancer in both sexes and the second in terms of mortality. Apart from genetic predisposition, dietary and lifestyle factors have been implicated in the development of CRC. Several studies suggested that vitamin D (VitD) might be a promising strategy in CRC prevention, while other studies did not confirm this finding. The aim of our study was to examine the role of Vit-D supplementation in the prevention of colorectal neoplasms (CRC and polyps). We conducted a systematic search in Pubmed, Embase and Web of Science databases for Randomized Controlled Trials (RCTs) examining the incidence of colorectal neoplasms in patients taking Vit-D supplementation compared to placebo. We synthetized results using Risk Ratio along with 95% Confidence Intervals (CIs). Nine RCTs (N = 71,386) were included. Non-significant correlations were observed between Vit-D supplementation and CRC incidence (RR:1.06, p = 0.52). Similarly, non-significant associations were observed between the use of Vit-D supplements and colorectal adenoma incidence (RR:1.00, p = 0.91). Advanced adenomas (OR:1.05, p = 0.63) and serrated polyps (RR:1.03, p = 0.63) were also not significantly inversely associated with Vit-D supplementation. Our study shows that Vit-D does not seem to have a role in the chemoprevention of colorectal neoplasms. However, additional well-designed studies are needed in order to draw safe conclusions. A potentially beneficial role of Vit-D supplementation in CRC primary prevention in individuals with severe vitamin D deficiency as well in the primary prevention of early-onset CRC, requires further investigation.
结直肠癌（CRC）是男女两性中最常见的癌症之一，也是死亡率第二高的癌症。除了遗传易感性外，饮食和生活方式因素也与 CRC 的发生有关。一些研究表明，维生素 D（VitD）可能是 CRC 预防的一种有前途的策略，而其他研究则没有证实这一发现。我们的研究旨在研究 Vit-D 补充剂在预防结直肠肿瘤（CRC 和息肉）中的作用。我们在 Pubmed、Embase 和 Web of Science 数据库中进行了系统检索，以寻找比较 Vit-D 补充剂与安慰剂组患者结直肠肿瘤发生率的随机对照试验（RCT）。我们使用风险比（RR）和 95%置信区间（CI）综合了结果。共纳入了 9 项 RCT（N = 71386）。Vit-D 补充与 CRC 发生率之间无显著相关性（RR：1.06，p = 0.52）。同样，Vit-D 补充剂的使用与结直肠腺瘤发生率之间也无显著相关性（RR：1.00，p = 0.91）。高级别腺瘤（OR：1.05，p = 0.63）和锯齿状息肉（RR：1.03，p = 0.63）也与 Vit-D 补充无显著负相关。我们的研究表明，Vit-D 似乎在结直肠肿瘤的化学预防中不起作用。然而，需要进一步进行设计良好的研究以得出安全的结论。Vit-D 补充在严重维生素 D 缺乏症患者中的 CRC 一级预防以及在早发性 CRC 的一级预防中的潜在有益作用需要进一步研究。
