Department Epidemiology, Maastricht University, Maastricht, the Netherlands.
Department Epidemiology, Maastricht University, Maastricht, the Netherlands.
Clin Nutr. 2023 Aug;42(8):1462-1474. doi: 10.1016/j.clnu.2023.05.010. Epub 2023 May 22.
BACKGROUND & AIMS: Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus, thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk.
Individual dietary data were pooled from ten cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose-response relationships (Model 1) were examined using a nonparametric test for trend.
In total, 1994 cases and 518,002 non-cases were included in the analyses. The present study showed no significant associations between individual nutrient intake and BC risk. A significant decreased BC risk was observed for high vitamin D intake with moderate calcium and low phosphorus intake (Model 2: HR: 0.77, 95% CI: 0.59-1.00). No significant dose-response analyses were observed.
The present study showed a decreased BC risk for high dietary vitamin D intake in combination with low calcium intake and moderate phosphorus intake. The study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.
饮食可能在膀胱癌（BC）的病因学中起重要作用。维生素 D 参与多种生物学功能，具有预防 BC 发展的潜力。此外，维生素 D 还影响钙和磷的吸收，从而可能间接影响 BC 的风险。本研究旨在探讨维生素 D 摄入与 BC 风险之间的关系。
个体饮食数据来自 10 项队列研究进行了汇总。食物摄入量转换为每日维生素 D、钙和磷的摄入量。使用 Cox 回归模型获得了多变量危险比（HR）及其相应的 95%置信区间（CI）的汇总结果。分析调整了性别、年龄和吸烟状况（模型 1），并进一步调整了水果、蔬菜和肉类等食物组（模型 2）。使用非参数趋势检验检查了剂量-反应关系（模型 1）。
总共纳入了 1994 例病例和 518002 例非病例进行分析。本研究表明，个体营养素摄入与 BC 风险之间没有显著关联。对于高维生素 D 摄入、中钙摄入和低磷摄入的组合，观察到 BC 风险显著降低（模型 2：HR：0.77，95%CI：0.59-1.00）。未观察到显著的剂量-反应分析。
本研究表明，高膳食维生素 D 摄入与低钙摄入和中磷摄入相结合可降低 BC 风险。该研究强调了在评估风险时检查营养素与互补营养素协同作用的重要性。未来的研究应着眼于更广泛的营养背景和营养模式中的营养素。
