Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo 105-8461, Japan.
Department of Surgery, International University of Health and Welfare Hospital, Narita-shi 286-0048, Japan.
Nutrients. 2024 Mar 22;16(7):921. doi: 10.3390/nu16070921.
A meta-analysis suggested that marine -3 polyunsaturated fatty acids (PUFAs), e.g., eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), might reduce cancer mortality. However, a randomized clinical trial of marine -3 PUFA and vitamin D supplementation failed to verify this benefit. This study aimed to investigate the potential interaction between vitamin D supplementation and serum EPA and DHA levels. This post hoc analysis of the AMATERASU trial (UMIN000001977), a randomized controlled trial (RCT), included 302 patients with digestive tract cancers divided into two subgroups stratified by median serum levels of EPA + DHA into higher and lower halves. The 5-year relapse-free survival (RFS) rate was significantly higher in the higher half (80.9%) than the lower half (67.8%; hazard ratio (HR), 2.15; 95% CI, 1.29-3.59). In the patients in the lower EPA + DHA group, the 5-year RFS was significantly higher in the vitamin D (74.9%) than the placebo group (49.9%; HR, 0.43; 95% CI, 0.24-0.78). Conversely, vitamin D had no effect in the higher half, suggesting that vitamin D supplementation only had a significant interactive effect on RFS in the lower half ( for interaction = 0.03). These results suggest that vitamin D supplementation may reduce the risk of relapse or death by interacting with marine -3 PUFAs.
一项荟萃分析表明，海洋ω-3 多不饱和脂肪酸（PUFA），如二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），可能降低癌症死亡率。然而，一项海洋ω-3 PUFA 和维生素 D 补充剂的随机临床试验未能证实这一益处。本研究旨在探讨维生素 D 补充剂与血清 EPA 和 DHA 水平之间的潜在相互作用。这项 AMATERASU 试验（UMIN000001977）的事后分析，是一项随机对照试验（RCT），纳入了 302 例消化道癌症患者，根据血清 EPA+DHA 的中位数水平将其分为两个亚组，分为上下两半。上半部分（80.9%）的 5 年无复发生存率（RFS）明显高于下半部分（67.8%；危险比（HR），2.15；95%置信区间，1.29-3.59）。在 EPA+DHA 较低的患者中，维生素 D 组（74.9%）的 5 年 RFS 明显高于安慰剂组（49.9%；HR，0.43；95%置信区间，0.24-0.78）。相反，维生素 D 在较高半部分没有效果，这表明维生素 D 补充剂仅在较低半部分对 RFS 有显著的交互作用（交互作用=0.03）。这些结果表明，维生素 D 补充剂可能通过与海洋 ω-3 PUFAs 相互作用，降低癌症复发或死亡的风险。
