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Zhao S, Qian F, Wan Z, Chen X, Pan A, Liu G. Vitamin D and major chronic diseases. Trends Endocrinol Metab 2024:S1043-2760(24)00112-7. [PMID: 38824035 DOI: 10.1016/j.tem.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 06/03/2024]
Abstract
Numerous observational studies have demonstrated a significant inverse association between vitamin D status and the risk of major chronic disease, including type 2 diabetes (T2D), cardiovascular disease (CVD), and cancer. However, findings from Mendelian randomization (MR) studies and randomized controlled trials (RCTs) suggest minimal or no benefit of increased vitamin D levels. We provide an overview of recent literature linking vitamin D to major chronic diseases. Because emerging evidence indicates a potential threshold effect of vitamin D, future well-designed studies focused on diverse populations with vitamin D deficiency or insufficiency are warranted for a more comprehensive understanding of the effect of maintaining sufficient vitamin D status on the prevention of major chronic diseases.
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Affiliation(s)
- Shiyu Zhao
- School of Public Health, and Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Frank Qian
- Section of Cardiovascular Medicine, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, and Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Gang Liu
- School of Public Health, and Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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2
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Voltan G, Cannito M, Ferrarese M, Ceccato F, Camozzi V. Vitamin D: An Overview of Gene Regulation, Ranging from Metabolism to Genomic Effects. Genes (Basel) 2023; 14:1691. [PMID: 37761831 PMCID: PMC10531002 DOI: 10.3390/genes14091691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Vitamin D is a pro-hormone characterized by an intricate metabolism and regulation. It is well known for its role in calcium and phosphate metabolism, and in bone health. However, several studies have assessed a huge number of extra-skeletal functions, ranging from cell proliferation in some oncogenic pathways to antioxidant and immunomodulatory functions. Vitamin D exerts its role by binding to VDRs (vitamin D receptors), which are located in many different tissues. Moreover, VDRs are able to bind hundreds of genomic loci, modulating the expression of various primary target genes. Interestingly, plenty of gene polymorphisms regarding VDRs are described, each one carrying a potential influence against gene expression, with relapses in several chronic diseases and metabolic complications. In this review, we provide an overview of the genetic aspects of vitamin D and VDR, emphasizing the gene regulation of vitamin D, and the genetic modulation of VDR target genes. In addition, we briefly summarize the rare genetic disease linked to vitamin D metabolism.
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Affiliation(s)
- Giacomo Voltan
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (G.V.); (M.C.); (M.F.); (V.C.)
- Endocrinology Unit, Padova University Hospital, Via Ospedale Civile 105, 35128 Padova, Italy
| | - Michele Cannito
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (G.V.); (M.C.); (M.F.); (V.C.)
- Endocrinology Unit, Padova University Hospital, Via Ospedale Civile 105, 35128 Padova, Italy
| | - Michela Ferrarese
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (G.V.); (M.C.); (M.F.); (V.C.)
- Endocrinology Unit, Padova University Hospital, Via Ospedale Civile 105, 35128 Padova, Italy
| | - Filippo Ceccato
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (G.V.); (M.C.); (M.F.); (V.C.)
- Endocrinology Unit, Padova University Hospital, Via Ospedale Civile 105, 35128 Padova, Italy
| | - Valentina Camozzi
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (G.V.); (M.C.); (M.F.); (V.C.)
- Endocrinology Unit, Padova University Hospital, Via Ospedale Civile 105, 35128 Padova, Italy
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3
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Feng C, Song X, Chalamaiah M, Ren X, Wang M, Xu B. Vitamin D Fortification and Its Effect on Athletes' Physical Improvement: A Mini Review. Foods 2023; 12:foods12020256. [PMID: 36673348 PMCID: PMC9857868 DOI: 10.3390/foods12020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status is a widespread problem regardless of age and sex, emphasizing the necessity of new food sources to improve vitamin D levels. Currently, approximately 60% of dietary vitamin D consumption occurs via fortified foods. Vitamin D insufficiency (50-90%) is widespread according to age and region, despite different levels of sunlight exposure. The food industry must identify more effective strategies to increase normal dietary vitamin D intake and improve overall health. Strategies for vitamin D fortification include bioaddition, wherein a vitamin D-rich food source is added to staple foods during processes. These bioadditive strategies expand the range of vitamin D-containing foods and appeal to different preferences, cultures, and economic statuses. In several countries, vitamin D deficiency places athletes at a high risk of disease susceptibility. Due to low sun exposure, athletes in countries with higher and lower levels of sunlight have similar risks of vitamin D deficiency. In this review, we summarize recent technical advances to promote vitamin D utilization by humans during sports activities and in relation to the normal practices of athletes.
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Affiliation(s)
- Cong Feng
- Department of Physical Education, Jiangsu University, Zhenjiang 212013, China
| | - Xinjie Song
- School of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou 310023, China
- Correspondence:
| | - Meram Chalamaiah
- Department of Agricultural, Food and Nutritional Science (AFNS), 4-10 Ag/For Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Xiaofeng Ren
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Mingxing Wang
- Department of Business Administration, School of Business, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Baoguo Xu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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4
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Hernández-Alonso P, Boughanem H, Canudas S, Becerra-Tomás N, Fernández de la Puente M, Babio N, Macias-Gonzalez M, Salas-Salvadó J. Circulating vitamin D levels and colorectal cancer risk: A meta-analysis and systematic review of case-control and prospective cohort studies. Crit Rev Food Sci Nutr 2023; 63:1-17. [PMID: 34224246 DOI: 10.1080/10408398.2021.1939649] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The associations between circulating vitamin D concentrations and total and site-specific colorectal cancer (CRC) incidence have been examined in several epidemiological studies with overall inconclusive findings. The aim of this systematic review and meta-analysis of both case-control and prospective cohort studies was to evaluate the association between CRC and circulating levels of vitamin D. The main exposure and outcome were circulating total 25(OH)D and CRC, respectively, in the overall population (i.e., all subjects). Two reviewers, working independently, screened all the literature available to identify studies that met the inclusion criteria (e.g., case-control or prospective cohort studies, published in English, and excluding non-original papers). Data were pooled by the generic inverse variance method using a random or fixed effect model, as approriate. Heterogeneity was identified using the Cochran's Q-test and quantified by the I2 statistic. Results were stratified by study design, sex, and metabolite of vitamin D. Sensitivity and subgroup analyses were also performed. A total of 28 original studies were included for the quantitative meta-analysis. Meta-analyses comparing the highest vs lowest categories, showed a 39% lower risk between levels of total 25(OH)D and CRC risk (OR (95% CI): 0.61 (0.52; 0.71); 11 studies) in case-control studies; whereas a 20% reduced CRC risk in prospective cohort studies (HR (95% CI): 0.80 (0.66; 0.97); 6 studies). Results in women mirrored main results, whereas results in men were non-significant in both analyses. Our findings support an inverse association between circulating vitamin D levels and CRC risk.
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Affiliation(s)
- Pablo Hernández-Alonso
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Hatim Boughanem
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Silvia Canudas
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences. Food Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, Spain
| | - Nerea Becerra-Tomás
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.,MRC Centre for Environment and Health, Department of Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, UK
| | - María Fernández de la Puente
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Manuel Macias-Gonzalez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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5
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Visvanathan K, Mondul AM, Zeleniuch-Jacquotte A, Wang M, Gail MH, Yaun SS, Weinstein SJ, McCullough ML, Eliassen AH, Cook NR, Agnoli C, Almquist M, Black A, Buring JE, Chen C, Chen Y, Clendenen T, Dossus L, Fedirko V, Gierach GL, Giovannucci EL, Goodman GE, Goodman MT, Guénel P, Hallmans G, Hankinson SE, Horst RL, Hou T, Huang WY, Jones ME, Joshu CE, Kaaks R, Krogh V, Kühn T, Kvaskoff M, Lee IM, Mahamat-Saleh Y, Malm J, Manjer J, Maskarinec G, Millen AE, Mukhtar TK, Neuhouser ML, Robsahm TE, Schoemaker MJ, Sieri S, Sund M, Swerdlow AJ, Thomson CA, Ursin G, Wactawski-Wende J, Wang Y, Wilkens LR, Wu Y, Zoltick E, Willett WC, Smith-Warner SA, Ziegler RG. Circulating vitamin D and breast cancer risk: an international pooling project of 17 cohorts. Eur J Epidemiol 2023; 38:11-29. [PMID: 36593337 PMCID: PMC10039648 DOI: 10.1007/s10654-022-00921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/21/2022] [Indexed: 01/04/2023]
Abstract
Laboratory and animal research support a protective role for vitamin D in breast carcinogenesis, but epidemiologic studies have been inconclusive. To examine comprehensively the relationship of circulating 25-hydroxyvitamin D [25(OH)D] to subsequent breast cancer incidence, we harmonized and pooled participant-level data from 10 U.S. and 7 European prospective cohorts. Included were 10,484 invasive breast cancer cases and 12,953 matched controls. Median age (interdecile range) was 57 (42-68) years at blood collection and 63 (49-75) years at breast cancer diagnosis. Prediagnostic circulating 25(OH)D was either newly measured using a widely accepted immunoassay and laboratory or, if previously measured by the cohort, calibrated to this assay to permit using a common metric. Study-specific relative risks (RRs) for season-standardized 25(OH)D concentrations were estimated by conditional logistic regression and combined by random-effects models. Circulating 25(OH)D increased from a median of 22.6 nmol/L in consortium-wide decile 1 to 93.2 nmol/L in decile 10. Breast cancer risk in each decile was not statistically significantly different from risk in decile 5 in models adjusted for breast cancer risk factors, and no trend was apparent (P-trend = 0.64). Compared to women with sufficient 25(OH)D based on Institute of Medicine guidelines (50- < 62.5 nmol/L), RRs were not statistically significantly different at either low concentrations (< 20 nmol/L, 3% of controls) or high concentrations (100- < 125 nmol/L, 3% of controls; ≥ 125 nmol/L, 0.7% of controls). RR per 25 nmol/L increase in 25(OH)D was 0.99 [95% confidence intervaI (CI) 0.95-1.03]. Associations remained null across subgroups, including those defined by body mass index, physical activity, latitude, and season of blood collection. Although none of the associations by tumor characteristics reached statistical significance, suggestive inverse associations were seen for distant and triple negative tumors. Circulating 25(OH)D, comparably measured in 17 international cohorts and season-standardized, was not related to subsequent incidence of invasive breast cancer over a broad range in vitamin D status.
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Affiliation(s)
- Kala Visvanathan
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shiaw-Shyuan Yaun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy R Cook
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Martin Almquist
- Department of Surgery, Skane University Hospital, Lund, Sweden
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Tess Clendenen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gary E Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marc T Goodman
- Cancer Prevention and Control Research Program, Cedars Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Tao Hou
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Corrine E Joshu
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Marina Kvaskoff
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yahya Mahamat-Saleh
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jonas Manjer
- Department of Surgery, Skane University Hospital, Lund University, Malmö, Sweden
| | - Gertraud Maskarinec
- Cancer Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Toqir K Mukhtar
- Department of Primary Care and Public Health, Imperial College, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Trude E Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Sabina Sieri
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona and University of Arizona Cancer Center, Tucson, AZ, USA
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Yujie Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emilie Zoltick
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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6
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Weinstein SJ, Mondul AM, Layne TM, Yu K, Huang J, Stolzenberg-Solomon RZ, Ziegler RG, Purdue MP, Huang WY, Abnet CC, Freedman ND, Albanes D. Prediagnostic Serum Vitamin D, Vitamin D Binding Protein Isoforms, and Cancer Survival. JNCI Cancer Spectr 2022; 6:pkac019. [PMID: 35603848 PMCID: PMC8982405 DOI: 10.1093/jncics/pkac019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 01/07/2022] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Higher circulating vitamin D has been associated with improved overall cancer survival, but data for organ-specific cancers are mixed. METHODS We examined the association between prediagnostic serum 25-hydroxyvitamin D [25(OH)D], the recognized biomarker of vitamin D status, and cancer survival in 4038 men and women diagnosed with 1 of 11 malignancies during 22 years of follow-up (median = 15.6 years) within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Multivariable-adjusted proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations between baseline 25(OH)D concentration and subsequent cancer survival; we also stratified on the common vitamin D binding protein isoforms (Gc1f, Gc1s, and Gc2) defined by two single-nucleotide polymorphisms (rs7041 and rs4588) in the vitamin D binding protein gene GC. All P values were 2-sided. RESULTS Higher 25(OH)D concentrations were associated with greater overall cancer survival (HR for cancer mortality = 0.83, 95% CI = 0.70 to 0.98 for highest vs lowest quintile; Ptrend = .05) and lung cancer survival (HR = 0.63, 95% CI = 0.44 to 0.90; Ptrend = .03). These associations were limited to cases expressing the Gc2 isoform (HR = 0.38 for Gc2-2, 95% CI = 0.14 to 1.05 for highest vs lowest quintile; Ptrend = .02; and HR = 0.30 for Gc1-2/Gc2-2 combined, 95% CI = 0.16 to 0.56; Ptrend < .001 for overall and lung cancer, respectively). CONCLUSIONS Higher circulating 25(OH)D was associated with improved overall and lung cancer survival. As this was especially evident among cases with the genetically determined Gc2 isoform of vitamin D binding protein, such individuals may gain a cancer survival advantage by maintaining higher 25(OH)D blood concentrations.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tracy M Layne
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Johnson CR, Dudenkov DV, Mara KC, Fischer PR, Maxson JA, Thacher TD. Serum 25-Hydroxyvitamin D and Subsequent Cancer Incidence and Mortality: A Population-Based Retrospective Cohort Study. Mayo Clin Proc 2021; 96:2157-2167. [PMID: 34353470 PMCID: PMC8359728 DOI: 10.1016/j.mayocp.2020.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/27/2020] [Accepted: 12/22/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the relationship between 25-hydroxyvitamin D (25[OH]D) values and subsequent cancer incidence and mortality. PATIENTS AND METHODS We identified all adult patients living in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2011, who had at least 1 25(OH)D measurement and no prior diagnosis of cancer. Cancer outcomes were retrieved starting 30 days after 25(OH)D measurement and until patients' final clinical visit as an Olmsted County resident; December 31, 2014; or death. Cox proportional hazards regression was used to analyze data. RESULTS A total of 8700 individuals had a 25(OH)D measurement and no history of cancer, with a mean ± SD 25(OH)D value of 29.7±12.8 ng/mL (to convert to nmol/L, multiply by 2.496). The mean ± SD age was 51.5±16.4 years, and most were women (78.1%; n=6796) and White (85.7%; n=7460). A total of 761 individuals developed cancer (skin cancer, n=360; nonskin cancer, n=401) during a median follow-up of 4.6 (interquartile range, 3.4-6.1) years. Compared with participants with 25(OH)D values of 20 to 50 ng/mL (reference group), those with 25(OH)D values less than 12 ng/mL had a greater nonskin cancer incidence (hazard ratio [HR], 1.56; 95% CI, 1.03 to 2.36; P=.04) after adjustment. There was no association between 25(OH)D values and total cancer or skin cancer incidence. Compared with individuals from the reference group, 25(OH)D levels less than 12 ng/mL (HR, 2.35; 95% CI, 1.01 to 5.48; P=.047) and 12 to 19 ng/mL (HR, 2.10; 95% CI, 1.05 to 4.22; P=.04) were associated with increased cancer mortality. CONCLUSION Low 25(OH)D levels were associated with increased risk for incident nonskin cancer and cancer-related mortality.
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Affiliation(s)
- Casey R Johnson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
| | | | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Philip R Fischer
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Julie A Maxson
- Department of Family Medicine, Mayo Clinic, Rochester, MN
| | - Tom D Thacher
- Department of Family Medicine, Mayo Clinic, Rochester, MN
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8
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Campolina-Silva GH, Barata MC, Werneck-Gomes H, Maria BT, Mahecha GAB, Belleannée C, Oliveira CA. Altered expression of the vitamin D metabolizing enzymes CYP27B1 and CYP24A1 under the context of prostate aging and pathologies. J Steroid Biochem Mol Biol 2021; 209:105832. [PMID: 33596463 DOI: 10.1016/j.jsbmb.2021.105832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 12/20/2022]
Abstract
Low circulating levels of vitamin D are common at older ages and have been linked to an increased risk of prostate disease, including cancer. However, it has not yet been determined whether aging affects the ability of prostate cells to locally metabolize vitamin D into its active metabolite calcitriol and thus mediate the vitamin D signaling in autocrine and paracrine ways. By using a suitable rat model to interrogate spontaneous prostatic modifications over the course of aging, here we showed that both CYP27B1 and CYP24A1 enzymes, which are key players respectively involved with calcitriol synthesis and deactivation, were highly expressed in the prostate epithelium. Furthermore, as the animals aged, a drastic reduction of CYP27B1 levels was detected in total protein extracts and especially in epithelial areas of lesions, including tumors. On the other hand, CYP24A1 expression significantly increased with aging and remained elevated even in altered epithelia. Such intricate unbalance in regard to vitamin D metabolizing enzymes was strongly associated with reduced bioavailability of calcitriol in the senile prostate, which in addition to decreased expression of the vitamin D receptor, further limits the protective actions mediated by vitamin D signaling. This evidence was corroborated by the increased proliferative activity exactly at sites of lesions where the factors implicated with calcitriol synthesis and responsiveness had its expression inhibited. Taken together, our results emphasize a set of modifications over the course of aging with a high potential to hamper vitamin D signaling on the prostate. These findings highlight a crosstalk between vitamin D, aging, and prostate carcinogenesis, offering new potential targets in the prevention of malignancies and other aging-related disorders arising in the gland.
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Affiliation(s)
| | - Maria Clara Barata
- Department of Morphology, Universidade Federal De Minas Gerais, Cx. Postal 486, CEP 31.270-901, Belo Horizonte, MG, Brazil
| | - Hipácia Werneck-Gomes
- Department of Morphology, Universidade Federal De Minas Gerais, Cx. Postal 486, CEP 31.270-901, Belo Horizonte, MG, Brazil
| | - Bruna Toledo Maria
- Department of Morphology, Universidade Federal De Minas Gerais, Cx. Postal 486, CEP 31.270-901, Belo Horizonte, MG, Brazil
| | | | - Clémence Belleannée
- Faculty of Medicine, Department of Obstetrics, Gynecology and Reproduction, Université Laval, CHU De Québec Research Center (CHUL), Quebec City, QC, Canada
| | - Cleida Aparecida Oliveira
- Department of Morphology, Universidade Federal De Minas Gerais, Cx. Postal 486, CEP 31.270-901, Belo Horizonte, MG, Brazil.
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9
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Sun K, Zuo M, Zhang Q, Wang K, Huang D, Zhang H. Anti-Tumor Effect of Vitamin D Combined with Calcium on Lung Cancer: A Systematic Review and Meta-Analysis. Nutr Cancer 2020; 73:2633-2642. [PMID: 33225749 DOI: 10.1080/01635581.2020.1850812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although many studies have demonstrated the impact of vitamin D and calcium on lung cancer, it remains the discrepancy for the effect of vitamin D and calcium on lung cancer. In this study, we aimed to verify the roles of vitamin D and calcium in the incidence and prognosis of lung cancer. A systematic literature search was performed by February 29, 2020. The relative risks (RRs) and hazard ratio (HRs) were pooled to evaluate the risk for the incidence and mortality of lung cancer. A total of 58,625 lung cancer cases from 40 studies were included. The risk (RR: 0.915, 95% Cl: 0.849-0.986) and mortality (RR: 0.718, 95% Cl: 0.530-0.973) of lung cancer were significantly decreased due to high circulating 25(OH)D level. Although the separate intake of vitamin D (RR: 0.909, 95% Cl: 0.801-1.031) and calcium (RR: 0.890, 95% Cl: 0.741-1.070) did not exhibit a protective effect on lung cancer, the combination supplement of vitamin D and calcium significantly decreased the incidence of lung cancer (RR: 0.811, 95% Cl: 0.659-0.999). High level of serum 25(OH)D could play the preventive role in lung cancer. Furthermore, vitamin D could be supplemented together with calcium against lung cancer.
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Affiliation(s)
- Kang Sun
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Minghao Zuo
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Qin Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Keyi Wang
- Central Laboratory, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dongdong Huang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honghe Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
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Mäkitaipale J, Sankari S, Sievänen H, Laitinen-Vapaavuori O. The relationship between serum 25-hydroxyvitamin D and parathyroid hormone concentration in assessing vitamin D deficiency in pet rabbits. BMC Vet Res 2020; 16:403. [PMID: 33109180 DOI: 10.1186/s12917-020-02599-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/30/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin D deficiency and related metabolic bone diseases in pet rabbits have been intermittently debated. In human research, the parathyroid hormone concentration in relation to the 25-hydroxyvitamin D concentration is used to determine vitamin D deficiency. Thus, this study aimed to identify the breakpoint in the 25-hydroxyvitamin D concentration indicating a significant change in the parathyroid hormone concentration in 139 pet rabbits. An enzyme immunoassay kit was used for 25-hydroxyvitamin D analysis and the intact parathyroid hormone (PTH 1-84) immunoradiometric assay kit for parathyroid hormone analysis. The mid-tibial cortical bone density was measured using peripheral quantitative computed tomography. A segmented linear regression analysis was performed, with the 25-hydroxyvitamin D concentration as the independent variable, and parathyroid hormone, ionised calcium, total calcium, inorganic phosphorus concentrations and the mid-tibial cortical density as the dependent variables. RESULTS The breakpoint for the parathyroid hormone concentration occurred at a 25(OH)D concentration of 17 ng/mL, whereas the cortical bone density breakpoint occurred at a 25-hydroxyvitamin D concentration of 19 ng/mL. No breakpoints were found for ionised calcium, total calcium or phosphorus. CONCLUSIONS These results suggest that a serum 25-hydroxyvitamin D concentration of 17 ng/mL serves as the threshold for vitamin D deficiency in rabbits. Nearly one-third of the rabbits had a serum 25-hydroxyvitamin D concentration below this threshold. Concerns persist regarding the high prevalence of vitamin D deficiency in pet rabbits and the possible health consequences caused by a chronic vitamin D deficiency, including the risk for metabolic bone diseases.
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Affiliation(s)
- J Mäkitaipale
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014, Helsinki, Finland.
| | - S Sankari
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014, Helsinki, Finland
| | - H Sievänen
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland
| | - O Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014, Helsinki, Finland
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Costales-Carrera A, Fernández-Barral A, Bustamante-Madrid P, Domínguez O, Guerra-Pastrián L, Cantero R, del Peso L, Burgos A, Barbáchano A, Muñoz A. Comparative Study of Organoids from Patient-Derived Normal and Tumor Colon and Rectal Tissue. Cancers (Basel) 2020; 12:cancers12082302. [PMID: 32824266 PMCID: PMC7465167 DOI: 10.3390/cancers12082302] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022] Open
Abstract
Colon and rectal tumors, often referred to as colorectal cancer, show different gene expression patterns in studies that analyze whole tissue biopsies containing a mix of tumor and non-tumor cells. To better characterize colon and rectal tumors, we investigated the gene expression profile of organoids generated from endoscopic biopsies of rectal tumors and adjacent normal colon and rectum mucosa from therapy-naive rectal cancer patients. We also studied the effect of vitamin D on these organoid types. Gene profiling was performed by RNA-sequencing. Organoids from a normal colon and rectum had a shared gene expression profile that profoundly differed from that of rectal tumor organoids. We identified a group of genes of the biosynthetic machinery as rectal tumor organoid-specific, including those encoding the RNA polymerase II subunits POLR2H and POLR2J. The active vitamin D metabolite 1α,25-dihydroxyvitamin D3/calcitriol upregulated stemness-related genes (LGR5, LRIG1, SMOC2, and MSI1) in normal rectum organoids, while it downregulated differentiation marker genes (TFF2 and MUC2). Normal colon and rectum organoids share similar gene expression patterns and respond similarly to calcitriol. Rectal tumor organoids display distinct and heterogeneous gene expression profiles, with differences with respect to those of colon tumor organoids, and respond differently to calcitriol than normal rectum organoids.
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Affiliation(s)
- Alba Costales-Carrera
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Centro de Investigaciones Biomédicas en Red-Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Asunción Fernández-Barral
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Centro de Investigaciones Biomédicas en Red-Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Pilar Bustamante-Madrid
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Centro de Investigaciones Biomédicas en Red-Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Orlando Domínguez
- Unidad de Genómica, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain;
| | - Laura Guerra-Pastrián
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Departamento de Patología, Hospital Universitario La Paz, 28029 Madrid, Spain
| | - Ramón Cantero
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Unidad Colorrectal, Departamento de Cirugía, Hospital Universitario La Paz, 28029 Madrid, Spain
| | - Luis del Peso
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Centro de Investigaciones Biomédicas en Red-Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Aurora Burgos
- Unidad de Endoscopia, Departamento de Digestivo, Hospital Universitario La Paz, 28029 Madrid, Spain;
| | - Antonio Barbáchano
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Centro de Investigaciones Biomédicas en Red-Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Alberto Muñoz
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), 28029 Madrid, Spain; (A.C.-C.); (A.F.-B.); (P.B.-M.); (L.d.P.); (A.B.)
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (L.G.-P.); (R.C.)
- Centro de Investigaciones Biomédicas en Red-Cáncer (CIBERONC), 28029 Madrid, Spain
- Correspondence:
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12
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Wu G, Xue M, Zhao Y, Han Y, Zhang S, Zhang J, Li C, Xu J. Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose-response meta-analysis. Biosci Rep 2020; 40:BSR20201008. [PMID: 32686830 PMCID: PMC7391129 DOI: 10.1042/bsr20201008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/18/2020] [Accepted: 07/17/2020] [Indexed: 12/14/2022] Open
Abstract
Epidemiological studies have suggested inconclusive associations between 25-hydroxyvitamin D (25(OH)D) and survival in patients with colorectal cancer (CRC). The aim of the present study was to quantitatively assess these associations. PubMed, EMBASE, and Web of Science databases were systematically searched for eligible studies. Subgroup analyses based on study geographic location, publication year, length of follow-up time, sample size, and stage were conducted to explore the potential sources of heterogeneity. Dose-response relationships and pooled hazard ratios (HR) for overall and CRC-specific survival comparing the highest versus the lowest categories of circulating 25(OH)D concentrations were assessed. Overall, 17 original studies with a total of 17,770 CRC patients were included. Pooled HR (95% confidence intervals) comparing highest versus lowest categories were 0.64 (0.55-0.72) and 0.65 (0.56-0.73) for overall and CRC-specific survival, respectively. Studies conducted in the U.S.A., with median follow-up time ≥ 8 years, larger sample size, and including stage I-III patients showed a more prominent association between 25(OH)D concentrations and overall survival. The dose-response analysis showed that the risk of all-cause mortality was reduced by 7% (HR = 0.93; 95% CI: 0.90, 0.95), and the risk of CRC-specific mortality was reduced by 12% (HR = 0.88; 95% CI: 0.84, 0.93) for each 20 nmol/l increment of 25(OH)D concentration. This meta-analysis provides evidences that a higher 25(OH)D concentration is associated with lower overall mortality and CRC-specific mortality.
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Affiliation(s)
- Guanghai Wu
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Mei Xue
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, P.R. China
| | - Yongjie Zhao
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Youkui Han
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Shuai Zhang
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Judong Zhang
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Chao Li
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
| | - Jing Xu
- Department of General Surgery, Tianjin Union Medical Center, Jieyuan Road 190, Hongqiao District, Tianjin, 300121, P.R. China
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Huang D, Lei S, Wu Y, Weng M, Zhou Y, Xu J, Xia D, Xu E, Lai M, Zhang H. Additively protective effects of vitamin D and calcium against colorectal adenoma incidence, malignant transformation and progression: A systematic review and meta-analysis. Clin Nutr 2019; 39:2525-2538. [PMID: 31784301 DOI: 10.1016/j.clnu.2019.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/26/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) exhibits a linear progression from normal colonic epithelium, adenoma initiation, carcinoma transformation and even to metastasis. Diet changes might influence carcinogenesis and prognosis. We aimed to determine the effects of vitamin D and calcium on colorectal adenoma incidence, malignancy development and prognosis. METHODS Systematic literature searches (PubMed, Embase, and Cochrane Library databases) and hand searches were performed by September 30, 2019. A random-effects model was adopted to pool relative ratios (RRs) for colorectal tumour incidence or hazard ratios (HRs) for CRC mortality. Stratified analyses were performed by gender, tumour location, calcium intake level and ethnic group. RESULTS Total 854,195 cases from 166 studies were included. The colorectal adenoma incidence was inversely correlated with the circulating 25-hydroxyvitamin D [25(OH)D] level (RR: 0.80, 95% CI: 0.71-0.89), vitamin D intake (RR: 0.87, 95% CI: 0.82-0.92) and calcium intake (RR: 0.86, 95% CI: 0.81-0.91). The CRC incidence was decreased by circulating 25(OH)D (RR: 0.67, 95% CI: 0.59-0.77), vitamin D intake (RR: 0.85, 95% CI: 0.78-0.93) and calcium intake (RR: 0.75, 95% CI: 0.70-0.79). High-level circulating 25(OH)D triggered better overall survival (HR: 0.67, 95% CI: 0.57-0.79) and CRC-specific survival (HR: 0.63, 95% CI: 0.53-0.74). Stratified analyses showed that vitamin D and calcium significantly suppressed colorectal tumour incidence among women. Left-sided CRC risk was reversely related to circulating 25(OH)D (RR: 0.60, 95% CI: 0.41-0.88) and vitamin D intake (RR: 0.73, 95% CI: 0.57-0.93). Circulating 25(OH)D decreased colorectal adenoma (RR: 0.63, 95% CI: 0.48-0.82) and CRC (RR: 0.69, 95% CI: 0.56-0.86) risk in populations with higher calcium intake. European and American populations benefited more from vitamin D intake against colorectal tumour. A significant dose-response relationship was observed between intake of vitamin D or calcium and colorectal tumour incidence. CONCLUSIONS Vitamin D and calcium play additively chemopreventive roles in colorectal adenoma incidence, malignant transformation and progression, especially for women and left-sided CRC patients.
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Affiliation(s)
- Dongdong Huang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China; Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Siqin Lei
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yihua Wu
- Department of Toxicology, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Menghan Weng
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China; Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Yuwei Zhou
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiawei Xu
- Department of Toxicology, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Dajing Xia
- Department of Toxicology, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Enping Xu
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Maode Lai
- Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Honghe Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Disease Proteomics of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China.
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