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血清维生素 D 浓度、维生素 D 相关多态性与结直肠癌风险。

Serum vitamin D concentration, vitamin D-related polymorphisms, and colorectal cancer risk.

机构信息

Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Int J Cancer. 2023 Jul 15;153(2):278-289. doi: 10.1002/ijc.34521. Epub 2023 Mar 29.

Abstract

Serum 25-hydroxyvitamin D (25(OH)D) has been demonstrated to be associated with risk of colorectal cancer (CRC). However, it remains unclear whether this association was modified by vitamin D-related polymorphisms. We evaluated association of serum 25(OH)D concentration with CRC risk among 403 170 participants from UK Biobank Project. Two variants of vitamin D binding protein (VDBP), rs4588 and rs7041, were included to estimate the binding affinity of 25(OH)D to VDBP, and three variants of vitamin D receptor (VDR), rs11568820, rs2228570 and rs1544410, which may influence VDR activity, were also investigated. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 4 957 677 person-years of follow-up, 5053 incident CRC cases were documented. Higher serum 25(OH)D concentrations were significantly associated with lower CRC incidence in a dose-response manner, with HR (95% CIs) being 0.94 (0.91-0.97) per 1 SD increment of serum 25(OH)D level (P  < .001). When separated by anatomic site, we observed a significant association between higher 25(OH)D and lower incidence of colon cancer (P  < .001), but not rectal cancer (P  = .880). The inverse associations between 25(OH)D level and CRC risk were demonstrated in almost all individuals carrying different GC or VDR genotypes, except for those with rs1544410 TT or rs4588 TT genotypes. There was no significant interaction between any single variant, or haplotypes of GC or VDR, and 25(OH)D level. Our findings suggest the potential benefits of maintaining adequate vitamin D for CRC prevention, particularly for tumors from colon.

摘要

血清 25-羟维生素 D(25(OH)D)已被证实与结直肠癌(CRC)的风险相关。然而,这种关联是否受到维生素 D 相关多态性的影响仍不清楚。我们评估了来自英国生物库项目的 403170 名参与者的血清 25(OH)D 浓度与 CRC 风险之间的关联。纳入了维生素 D 结合蛋白(VDBP)的两个变体 rs4588 和 rs7041,以估计 25(OH)D 与 VDBP 的结合亲和力,还研究了维生素 D 受体(VDR)的三个变体 rs11568820、rs2228570 和 rs1544410,它们可能影响 VDR 活性。多变量 Cox 比例风险回归用于估计风险比(HR)和 95%置信区间(CI)。在 4957677 人年的随访期间,记录了 5053 例 CRC 病例。血清 25(OH)D 浓度较高与 CRC 发病率呈剂量反应关系,每增加 1 SD 的血清 25(OH)D 水平,HR(95%CI)为 0.94(0.91-0.97)(P<.001)。按解剖部位划分时,我们观察到较高的 25(OH)D 与结肠癌发病率降低之间存在显著关联(P<.001),但与直肠癌无关(P=.880)。除了 rs1544410 TT 或 rs4588 TT 基因型外,在携带不同 GC 或 VDR 基因型的个体中,几乎都显示出 25(OH)D 水平与 CRC 风险之间的负相关关系。任何单个变体或 GC 或 VDR 的单倍型之间没有明显的相互作用,与 25(OH)D 水平之间没有明显的相互作用。我们的研究结果表明,维持足够的维生素 D 对预防 CRC 具有潜在益处,特别是对来自结肠的肿瘤。

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