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血清 25-羟维生素 D 与代谢综合征患者中 16 种癌症的发病率、癌症死亡率和全因死亡率的关系:一项前瞻性队列研究。

Association of serum 25-hydroxyvitamin D with the incidence of 16 cancers, cancer mortality, and all-cause mortality among individuals with metabolic syndrome: a prospective cohort study.

机构信息

Rehabilitation and Nursing School, Hangzhou Vocational & Technical College, Hangzhou, 310018, Zhejiang, China.

School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.

出版信息

Eur J Nutr. 2023 Sep;62(6):2581-2592. doi: 10.1007/s00394-023-03169-x. Epub 2023 May 20.

DOI:10.1007/s00394-023-03169-x
PMID:37209191
Abstract

PURPOSE

The relationship between vitamin D levels and cancer incidence and mortality in individuals with metabolic syndrome (MetS) remains poorly explored. Herein, we aimed to determine the association between 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of 16 cancer incidence types and cancer/all-cause mortality in patients with MetS.

METHODS

We enrolled 97,621 participants with MetS at recruitment from the UK Biobank cohort. The exposure factor was baseline serum 25(OH)D concentrations. The associations were examined using Cox proportional hazards models, which were displayed as hazard ratios (HRs) with 95% confidence intervals (CIs).

RESULTS

Over a median follow-up period of 10.92 years for cancer incidence outcomes, 12,137 new cancer cases were recorded. We observed that 25(OH)D concentrations were inversely related to the risk of colon, lung, and kidney cancer, and HRs (95% CI) for 25(OH)D ≥ 75.0 vs. < 25.0 nmol/L were 0.67 (0.45-0.98), 0.64 (0.45-0.91), and 0.54 (0.31-0.95), respectively. The fully adjusted model revealed a null correlation between 25(OH)D and the incidence of stomach, rectum, liver, pancreas, breast, ovary, bladder, brain, multiple myeloma, leukemia, non-Hodgkin lymphoma, esophagus, and corpus uteri cancer. Over a median follow-up period of 12.72 years for mortality outcomes, 8286 fatalities (including 3210 cancer mortalities) were documented. An "L-shaped" nonlinear dose-response correlation was detected between 25(OH)D and cancer/all-cause mortality; the respective HRs (95% CI) were 0.75 (0.64-0.89) and 0.65 (0.58-0.72).

CONCLUSION

These findings emphasize the importance of 25(OH)D in cancer prevention and longevity promotion among patients with MetS.

摘要

目的

维生素 D 水平与代谢综合征(MetS)个体的癌症发病率和死亡率之间的关系尚未得到充分探索。在此,我们旨在确定 25-羟维生素 D [25(OH)D] 浓度与 MetS 患者 16 种癌症发病类型和癌症/全因死亡率风险之间的关系。

方法

我们从英国生物库队列中招募了 97621 名患有 MetS 的参与者。暴露因素为基线血清 25(OH)D 浓度。使用 Cox 比例风险模型检查关联,其以危险比(HR)和 95%置信区间(CI)显示。

结果

在癌症发病结果的中位随访期为 10.92 年期间,记录了 12137 例新的癌症病例。我们观察到,25(OH)D 浓度与结肠癌、肺癌和肾癌风险呈负相关,25(OH)D≥75.0 与 <25.0 nmol/L 的 HR(95%CI)分别为 0.67(0.45-0.98)、0.64(0.45-0.91)和 0.54(0.31-0.95)。完全调整模型显示,25(OH)D 与胃癌、直肠癌、肝癌、胰腺癌、乳腺癌、卵巢癌、膀胱癌、脑癌、多发性骨髓瘤、白血病、非霍奇金淋巴瘤、食管癌和子宫体癌的发病率之间没有相关性。在死亡率结果的中位随访期为 12.72 年期间,记录了 8286 例死亡(包括 3210 例癌症死亡)。25(OH)D 与癌症/全因死亡率之间存在“L 形”非线性剂量反应关系;相应的 HR(95%CI)分别为 0.75(0.64-0.89)和 0.65(0.58-0.72)。

结论

这些发现强调了 25(OH)D 在预防 MetS 患者癌症和促进长寿方面的重要性。

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