Wimalawansa Sunil J
CardioMetabolic & Endocrine Institute, North Brunswick, NJ, USA.
Nutrients. 2025 Jul 16;17(14):2333. doi: 10.3390/nu17142333.
: Adequate vitamin D levels are essential for various physiological functions, including cell growth, immune modulation, metabolic regulation, DNA repair, and overall health span. Despite its proven cost-effectiveness, widespread deficiency persists due to inadequate supplementation and limited sunlight exposure. : This systematic review (SR) examines the relationship between vitamin D and the reduction of cancer risk and mortality, and the mechanisms involved in cancer prevention. This SR followed the PRISMA and PICOS guidelines and synthesized evidence from relevant studies. : Beyond genomic actions via calcitriol [1,25(OH)D]-receptor interactions, vitamin D exerts cancer-protective effects through mitigating inflammation, autocrine, paracrine, and membrane signaling. The findings reveal a strong inverse relationship between serum 25(OH)D levels and the incidence, metastasis, and mortality of several cancer types, including colon, gastric, rectal, breast, endometrial, bladder, esophageal, gallbladder, ovarian, pancreatic, renal, vulvar cancers, and both Hodgkin's and non-Hodgkin's lymphomas. While 25(OH)D levels of around 20 ng/mL suffice for musculoskeletal health, maintaining levels above 40 ng/mL (100 nmol/L: range, 40-80 ng/mL) significantly lowers cancer risks and mortality. : While many observational studies support vitamin D's protective role in incidents and deaths from cancer, some recent mega-RCTs have failed to demonstrate this. The latter is primarily due to critical study design flaws, like recruiting vitamin D sufficient subjects, inadequate dosing, short durations, and biased designs in nutrient supplementation studies. Consequently, conclusions from these cannot be relied upon. Well-designed, adequately powered clinical trials using appropriate methodologies, sufficient vitamin D doses, and extended durations consistently demonstrate that proper supplementation significantly reduces cancer risk and markedly lowers cancer mortality.
充足的维生素D水平对于多种生理功能至关重要，包括细胞生长、免疫调节、代谢调控、DNA修复以及整体健康寿命。尽管已证实其具有成本效益，但由于补充不足和阳光照射有限，维生素D普遍缺乏的情况仍然存在。：本系统评价（SR）研究了维生素D与降低癌症风险和死亡率之间的关系，以及癌症预防所涉及的机制。该SR遵循PRISMA和PICOS指南，并综合了相关研究的证据。：除了通过骨化三醇[1,25(OH)D] - 受体相互作用产生的基因组作用外，维生素D还通过减轻炎症、自分泌、旁分泌和膜信号传导发挥癌症保护作用。研究结果显示，血清25(OH)D水平与几种癌症类型的发病率、转移和死亡率之间存在强烈的负相关，这些癌症类型包括结肠癌、胃癌、直肠癌、乳腺癌、子宫内膜癌、膀胱癌、食管癌、胆囊癌、卵巢癌、胰腺癌、肾癌、外阴癌以及霍奇金淋巴瘤和非霍奇金淋巴瘤。虽然约20 ng/mL的25(OH)D水平足以维持骨骼肌肉健康，但将水平维持在40 ng/mL以上（100 nmol/L：范围为40 - 80 ng/mL）可显著降低癌症风险和死亡率。：虽然许多观察性研究支持维生素D在癌症发病和死亡中的保护作用，但最近一些大型随机对照试验（RCT）未能证明这一点。后者主要是由于关键的研究设计缺陷，如招募维生素D充足的受试者、剂量不足、持续时间短以及营养补充研究中的设计偏差。因此，这些研究的结论不可靠。使用适当方法、足够维生素D剂量和延长持续时间的精心设计、有足够效力的临床试验一致表明，适当补充可显著降低癌症风险并显著降低癌症死亡率。
