Department of Gynecological Radiation Oncology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China.
Department of Dermatology and Venereology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China.
BMJ Open. 2022 Aug 26;12(8):e052442. doi: 10.1136/bmjopen-2021-052442.
To evaluate the association of serum vitamin D levels and dietary intake with melanoma risk and prognostic factors.
Two independent investigators systematically searched PubMed, Embase and ISI Web of Knowledge (Thomson Scientific Technical Support, New York) databases for eligible studies published between January 1992 and September 2020 using the following combinations of search terms: (vitamin D, or 25-hydroxyvitamin D) AND (melanoma, malignant melanoma, cutaneous melanoma, or cutaneous malignant melanoma). Articles not written in English but with English titles and abstracts were also checked. We obtained the full text of all potentially eligible articles, and reference lists of all studies retrieved at the first stage were also checked to identify other eligible papers. Review articles not reporting original data were excluded, but their reference lists were inspected.
Six studies including 212 723 cases reported the association between dietary intake of 25(OH) D serum levels and melanoma risk. The total relative risk for the comparison between the highest and lowest quantiles of the distribution of vitamin D intake was 1.10 (95% CI 0.96 to 1.26) with =56%. Another six studies including 12 297 cases evaluated the association between serum vitamin D levels and melanoma risk. The total relative risk for the comparison of serum vitamin D levels between the highest and lowest quantiles was 1.12 (95% CI 0.53 to 2.35) with =91%. Four studies with 2105 cases investigated the association between serum 25(OH)D (nmol/L) and Breslow thickness, three of which found an inverse association between serum 25(OH)D (nmol/L) and melanoma thickness.
Vitamin D intake and serum 25(OH)D levels were not closely related with melanoma risk, but an inverse association between serum 25(OH)D levels with melanoma thickness was discovered. As the positive correlation between melanoma thickness and melanoma mortality has been recognised, hence it is concluded that a moderate dietary vitamin D supplement to avoid the serum 25(OH)D deficient might be beneficial to the long-term survival of patients with melanoma.
评估血清维生素 D 水平和饮食摄入与黑色素瘤风险及预后因素的相关性。
两名独立调查员使用以下搜索词组合，系统地在 PubMed、Embase 和 ISI Web of Knowledge（汤森路透科技支持，纽约）数据库中搜索 1992 年 1 月至 2020 年 9 月发表的合格研究：（维生素 D 或 25-羟维生素 D）和（黑色素瘤、恶性黑色素瘤、皮肤黑色素瘤或皮肤恶性黑色素瘤）。还检查了标题和摘要为英文但全文为其他语言的文章。我们获取了所有潜在合格文章的全文，并检查了第一阶段检索到的所有研究的参考文献列表，以确定其他合格的论文。排除了未报告原始数据的综述文章，但检查了它们的参考文献列表。
六项研究共纳入 212723 例病例，报告了血清 25(OH)D 水平与黑色素瘤风险之间的饮食摄入关系。最高和最低维生素 D 摄入量分布定量之间的总相对风险比为 1.10（95%CI 0.96 至 1.26）， =56%。另外六项研究共纳入 12297 例病例，评估了血清维生素 D 水平与黑色素瘤风险之间的关系。最高和最低血清维生素 D 水平定量之间的总相对风险比为 1.12（95%CI 0.53 至 2.35）， =91%。四项研究共纳入 2105 例病例，探讨了血清 25(OH)D（nmol/L）与 Breslow 厚度之间的关系，其中三项研究发现血清 25(OH)D（nmol/L）与黑色素瘤厚度之间呈负相关。
维生素 D 摄入和血清 25(OH)D 水平与黑色素瘤风险没有密切关系，但发现血清 25(OH)D 水平与黑色素瘤厚度之间存在负相关。由于已经认识到黑色素瘤厚度与黑色素瘤死亡率之间的正相关关系，因此得出结论，适度补充维生素 D 以避免血清 25(OH)D 缺乏可能有利于黑色素瘤患者的长期生存。
