血清 25-羟维生素 D 浓度与 2 型糖尿病成人结直肠癌发病率的关系。
Serum 25-hydroxyvitamin D concentrations and colorectal cancer incidence in adults with type 2 diabetes.
机构信息
Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China.
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
出版信息
Br J Cancer. 2023 Aug;129(3):486-491. doi: 10.1038/s41416-023-02323-w. Epub 2023 Jun 19.
BACKGROUND
To examine the association of serum 25-hydroxyvitamin D (25[OH]D) with colorectal cancer (CRC) risk in adults with type 2 diabetes (T2D).
METHODS
Using UK Biobank data, this study included 18,453 adults with T2D. Serum 25(OH)D concentrations were determined by the chemiluminescent immunoassay method. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC outcomes.
RESULTS
During a median follow-up of 8.8 years, there were 284 incident CRC cases. Compared with adults with serum 25(OH)D concentrations <25.0 nmol/L, the adjusted HRs (95% CIs) for lower to higher serum 25(OH)D concentrations (25.0 to <50.0, 50.0 to <75.0, and ≥75.0 nmol/L) were 0.61 (0.46-0.82), 0.50 (0.34-0.74), and 0.53 (0.30-0.94), respectively (P = 0.001). The risk of CRC decreased by 19.0% for per 1-SD increment in serum 25(OH)D concentrations. A nonlinear association of serum 25(OH)D concentrations with CRC risk was observed using a restricted cubic spline analysis (P nonlinearity = 0.002).
CONCLUSIONS
Higher serum 25(OH)D concentrations were significantly and nonlinearly associated with a lower risk of CRC. These findings highlight the potential benefits of maintaining adequate vitamin D levels in CRC prevention among adults with T2D.
背景
本研究旨在探讨 2 型糖尿病（T2D）患者血清 25-羟维生素 D（25[OH]D）水平与结直肠癌（CRC）风险的相关性。
方法
本研究利用英国生物库（UK Biobank）的数据，纳入了 18453 例 T2D 患者。采用化学发光免疫分析法测定血清 25（OH）D 浓度。采用 Cox 比例风险模型计算 CRC 结局的风险比（HR）和 95%置信区间（CI）。
结果
在中位随访 8.8 年期间，共发生 284 例 CRC 事件。与血清 25（OH）D 浓度<25.0 nmol/L 的患者相比，血清 25（OH）D 浓度较低（25.0<50.0、50.0<75.0 和≥75.0 nmol/L）至较高水平的患者调整后 HR（95%CI）分别为 0.61（0.460.82）、0.50（0.340.74）和 0.53（0.30~0.94）（P=0.001）。血清 25（OH）D 浓度每增加 1 个标准差，CRC 风险降低 19.0%。限制性立方样条分析（P 非线性=0.002）显示，血清 25（OH）D 浓度与 CRC 风险之间存在非线性关联。
结论
较高的血清 25（OH）D 浓度与 CRC 风险呈显著且非线性负相关。这些发现提示，在 T2D 患者中，维持足够的维生素 D 水平可能有助于预防 CRC。
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