Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Eur J Cancer. 2023 Sep;191:113241. doi: 10.1016/j.ejca.2023.113241. Epub 2023 Jul 17.
Although the associations of serum 25-hydroxyvitamin D (25(OH)D) levels and vitamin D supplementation with total cancer mortality are well-known, evidence regarding the association of 25(OH)D and cancer site-specific mortality is predominantly limited to common cancer types, and most studies on vitamin D supplementation use have limitations on sample size and the adjustment of important confounding factors.
We used cause-specific Cox regression models adjusted for 48 covariates to assess the associations of vitamin D deficiency, insufficiency, and vitamin D supplementation use with mortality from any cancer and 18 specific cancers in 411,436 United Kingdom Biobank participants, aged 40-69 years.
The majority of the study population had either vitamin D deficiency (21.1%) or insufficiency (34.4%). Furthermore, 4.1% and 20.3% of the participants regularly took vitamin D or multivitamin supplements, respectively. During a median follow-up of 12.7 years, vitamin D deficiency was associated with significantly increased mortality from total cancer and four specific cancers: stomach (hazard ratio, 95% confidence interval: 1.42, 1.05-1.92), colorectal (1.27, 1.07-1.50), lung (1.24, 1.10-1.40), and prostate (1.36, 1.06-1.75). Vitamin D insufficiency was associated with increased colorectal (1.14, 1.00-1.30) and lung cancer mortality (1.19, 1.08-1.32). Compared to non-users, vitamin D use was associated with lower lung cancer (0.75, 0.60-0.95) and total cancer mortality. Multivitamin use was associated with lower mortality from melanoma (0.64, 0.43-0.97).
Vitamin D deficiency and insufficiency were associated with increased mortality from multiple common cancers. The potential to reduce cancer mortality by vitamin D supplementation in populations with low 25(OH)D levels should be further explored.
尽管血清 25-羟维生素 D（25（OH）D）水平与维生素 D 补充剂与全因癌症死亡率的关联已为人熟知，但与 25（OH）D 和癌症部位特异性死亡率相关的证据主要局限于常见癌症类型，并且大多数关于维生素 D 补充剂的研究在样本量和重要混杂因素的调整方面存在局限性。
我们使用基于 48 个协变量的特定原因 Cox 回归模型来评估维生素 D 缺乏、不足和维生素 D 补充剂使用与 411436 名英国生物库参与者中任何癌症和 18 种特定癌症的死亡率之间的关联，这些参与者年龄在 40-69 岁之间。
研究人群中大多数人存在维生素 D 缺乏（21.1%）或不足（34.4%）。此外，4.1%和 20.3%的参与者分别定期服用维生素 D 或多种维生素补充剂。在中位随访 12.7 年期间，维生素 D 缺乏与全因癌症和四种特定癌症的死亡率显著增加相关：胃癌（危险比，95%置信区间：1.42，1.05-1.92）、结直肠癌（1.27，1.07-1.50）、肺癌（1.24，1.10-1.40）和前列腺癌（1.36，1.06-1.75）。维生素 D 不足与结直肠癌（1.14，1.00-1.30）和肺癌死亡率增加相关（1.19，1.08-1.32）。与非使用者相比，维生素 D 使用与肺癌（0.75，0.60-0.95）和全因癌症死亡率降低相关。多种维生素使用与黑色素瘤死亡率降低相关（0.64，0.43-0.97）。
维生素 D 缺乏和不足与多种常见癌症的死亡率增加相关。应进一步探讨在 25（OH）D 水平较低的人群中通过维生素 D 补充来降低癌症死亡率的可能性。
