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Shen Y, Xia J, Yi C, Li T, Wang P, Dai L, Shi J, Wang K, Sun C, Ye H. The association between circulating 25-hydroxyvitamin D and pancreatic cancer: a systematic review and meta-analysis of observational studies. Eur J Nutr 2024; 63:653-672. [PMID: 38170272 DOI: 10.1007/s00394-023-03302-w] [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: 02/21/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The relationship between circulating 25-hydroxyvitamin D [25(OH)D] and pancreatic cancer has been well studied but remains unclear. The purpose of this study was to elucidate the association between circulating 25(OH)D and pancreatic cancer by using a meta-analytic approach. METHODS PubMed, Embase, and Wed of Science databases were searched through October 15, 2022. A random or fixed-effects model was used to estimate the pooled odds ratio (OR), risk ratio (RR), hazard ratio (HR) and their 95% confidence intervals (CIs). RESULTS A total of 16 studies including 529,917 participants met the inclusion criteria, of which 10 reported incidence and 6 reported mortality. For the highest versus lowest categories of circulating 25(OH)D, the pooled OR of pancreatic cancer incidence in case-control studies was 0.98 (95% CI 0.69-1.27), and the pooled HRs of pancreatic cancer mortality in cohort and case-control studies were 0.64 (95% CI 0.45-0.82) and 0.78 (95% CI 0.62-0.95), respectively. The leave-one-out sensitivity analyses found no outliers and Galbraith plots indicated no substantial heterogeneity. CONCLUSION Evidence from this meta-analysis suggested that high circulating 25(OH)D levels may be associated with decreased mortality but not incidence of pancreatic cancer. Our findings may provide some clues for the treatment of pancreatic cancer and remind us to be cautious about widespread vitamin D supplementation for the prevention of pancreatic cancer.
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Affiliation(s)
- Yajing Shen
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Junfen Xia
- Office of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Chuncheng Yi
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Tiandong Li
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Peng Wang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Liping Dai
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Jianxiang Shi
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Keyan Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Changqing Sun
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Hua Ye
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China.
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Mukhtar S, Moradi A, Kodali A, Okoye C, Klein D, Mohamoud I, Olanisa OO, Parab P, Chaudhary P, Hamid P. On the Menu: Analyzing the Macronutrients, Micronutrients, Beverages, Dietary Patterns, and Pancreatic Cancer Risk. Cureus 2023; 15:e45259. [PMID: 37842365 PMCID: PMC10576649 DOI: 10.7759/cureus.45259] [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: 06/26/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
This narrative review summarizes the principal findings of observational studies, systematic reviews, and meta-analyses on diet and dietary patterns' role in the risk of pancreatic cancer. Etiologically pancreatic cancer is multifactorial. Evidence exists of an association between nutrients, dietary patterns, and pancreatic cancer. An extensive literature search was conducted on PubMed, Cochrane, and Google Scholar. A thorough search of articles published in English till May 2023 and related to the review was performed. The relationship between all macronutrients, micronutrients, and various dietary patterns with the risk of pancreatic cancer was assessed. It is concluded that a diet high in nutrients like red and processed meat, refined sugars, saturated and monounsaturated fats, alcohol, copper, and a Western dietary pattern can increase the likelihood of pancreatic cancer. Contrary to this, a diet consisting of fruits, vegetables, appropriate quantities of vitamins and minerals, and a Mediterranean dietary pattern is associated with a decreased risk of pancreatic cancer.
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Affiliation(s)
- Sonia Mukhtar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ali Moradi
- Medicine, Semmelweis University, Budapest, HUN
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Athri Kodali
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chiugo Okoye
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dhadon Klein
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Iman Mohamoud
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Olawale O Olanisa
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Panah Parab
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Priti Chaudhary
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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Santos HO, Martins CEE, Forbes SC, Delpino FM. A Scoping Review of Vitamin D for Nonskeletal Health: A Framework for Evidence-Based Clinical Practice. Clin Ther 2023:S0149-2918(23)00127-3. [PMID: 37080887 DOI: 10.1016/j.clinthera.2023.03.016] [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: 11/18/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Low serum 25-hydroxy-vitamin D [25(OH)D] levels are prevalent worldwide. Although the benefits of vitamin D supplementation have focused on skeletal disorders (eg, rickets, osteomalacia, osteoporosis), emerging evidence for nonskeletal health merits further discussion. PURPOSE The purpose of this review was to critically examine the vitamin D supplementation literature pertaining to nonskeletal health to help guide clinicians. METHODS A scoping review that included observational studies and randomized clinical trials (RCTs) was performed. Evidence from meta-analyses and individual RCTs are discussed, and controversies and future directions are considered. FINDINGS 25(OH)D deficiency is a ubiquitous condition associated with multiple nonskeletal diseases, including cardiometabolic (heart disease, diabetes, and kidney disease), immune (HIV/AIDS and cancer), lung (from traditional chronic disorders to coronavirus disease 2019), and gut diseases. Vitamin D deficiency also affects health across the life span (children, pregnant, and elderly), mental illness, and reproduction in both men and women. In contrast, vitamin D supplementation does not necessarily improve major medical outcomes, even when low 25(OH)D levels are treated. Screening for 25(OH)D status remains an important practice, primarily for high-risk patients (eg, elderly, women with osteoporosis, people with low exposure to sunlight). It is reasonable to supplement with vitamin D to treat 25(OH)D deficiency, such that if beneficial nonskeletal health occurs, this may be considered as a coadjutant instead of the central tenet of the disease. Furthermore, optimizing dosing regimens is an important clinical consideration. IMPLICATIONS Although 25(OH)D deficiency is prevalent in nonskeletal diseases, there is no uniform evidence that vitamin D supplementation improves major medical outcomes, even when low 25(OH)D levels are corrected. Findings from RCTs warrant caution due to possible selection bias. Overall, vitamin D supplementation must be guided by circulating levels as a reasonable medical practice to correct 25(OH)D deficiency.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
| | | | - Scott C Forbes
- Department of Physical Education Studies, Brandon University, Brandon, Manitoba, Canada
| | - Felipe M Delpino
- Postgraduate in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
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Frost P. The Problem of Vitamin D Scarcity: Cultural and Genetic Solutions by Indigenous Arctic and Tropical Peoples. Nutrients 2022; 14:nu14194071. [PMID: 36235726 PMCID: PMC9573337 DOI: 10.3390/nu14194071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022] Open
Abstract
Vitamin D metabolism differs among human populations because our species has adapted to different natural and cultural environments. Two environments are particularly difficult for the production of vitamin D by the skin: the Arctic, where the skin receives little solar UVB over the year; and the Tropics, where the skin is highly melanized and blocks UVB. In both cases, natural selection has favored the survival of those individuals who use vitamin D more efficiently or have some kind of workaround that ensures sufficient uptake of calcium and other essential minerals from food passing through the intestines. Vitamin D scarcity has either cultural or genetic solutions. Cultural solutions include consumption of meat in a raw or boiled state and extended breastfeeding of children. Genetic solutions include higher uptake of calcium from the intestines, higher rate of conversion of vitamin D to its most active form, stronger binding of vitamin D to carrier proteins in the bloodstream, and greater use of alternative metabolic pathways for calcium uptake. Because their bodies use vitamin D more sparingly, indigenous Arctic and Tropical peoples can be misdiagnosed with vitamin D deficiency and wrongly prescribed dietary supplements that may push their vitamin D level over the threshold of toxicity.
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Affiliation(s)
- Peter Frost
- Anthropology, Université Laval, Quebec City, QC G1V 0A6, Canada
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25(OH)Vitamin D Deficiency and Calcifediol Treatment in Pediatrics. Nutrients 2022; 14:nu14091854. [PMID: 35565821 PMCID: PMC9101124 DOI: 10.3390/nu14091854] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/06/2023] Open
Abstract
Vitamin D is essential for the normal mineralization of bones during childhood. Although diet and adequate sun exposure should provide enough of this nutrient, there is a high prevalence of vitamin D deficiency rickets worldwide. Children with certain conditions that lead to decreased vitamin D production and/or absorption are at the greatest risk of nutritional rickets. In addition, several rare genetic alterations are also associated with severe forms of vitamin-D-resistant or -dependent rickets. Although vitamin D3 is the threshold nutrient for the vitamin D endocrine system (VDES), direct measurement of circulating vitamin D3 itself is not a good marker of the nutritional status of the system. Calcifediol (or 25(OH)D) serum levels are used to assess VDES status. While there is no clear consensus among the different scientific associations on calcifediol status, many clinical trials have demonstrated the benefit of ensuring normal 25(OH)D serum levels and calcium intake for the prevention or treatment of nutritional rickets in childhood. Therefore, during the first year of life, infants should receive vitamin D treatment with at least 400 IU/day. In addition, a diet should ensure a normal calcium intake. Healthy lifestyle habits to prevent vitamin D deficiency should be encouraged during childhood. In children who develop clinical signs of rickets, adequate treatment with vitamin D and calcium should be guaranteed. Children with additional risk factors for 25(OH)D deficiency and nutritional rickets should be assessed periodically and treated promptly to prevent further bone damage.
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Liu D, Meng X, Tian Q, Cao W, Fan X, Wu L, Song M, Meng Q, Wang W, Wang Y. Vitamin D and Multiple Health Outcomes: An Umbrella Review of Observational Studies, Randomized Controlled Trials, and Mendelian Randomization Studies. Adv Nutr 2021; 13:1044-1062. [PMID: 34999745 PMCID: PMC9340982 DOI: 10.1093/advances/nmab142] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/29/2020] [Accepted: 11/19/2021] [Indexed: 12/18/2022] Open
Abstract
Observational studies, randomized controlled trials (RCTs), and Mendelian randomization (MR) studies have yielded inconsistent results on the associations of vitamin D concentrations with multiple health outcomes. In the present umbrella review we aimed to evaluate the effects of low vitamin D concentrations and vitamin D supplementation on multiple health outcomes. We summarized current evidence obtained from meta-analyses of observational studies that examined associations between vitamin D concentrations and multiple health outcomes, meta-analyses of RCTs that investigated the effect of vitamin D supplementation on multiple health outcomes, and MR studies that explored the causal associations of vitamin D concentrations with various diseases (international prospective register of systematic reviews PROSPERO registration number CRD42018091434). A total of 296 meta-analyses of observational studies comprising 111 unique outcomes, 139 meta-analyses of RCTs comprising 46 unique outcomes, and 73 MR studies comprising 43 unique outcomes were included in the present umbrella review. Twenty-eight disease outcomes were identified by both meta-analyses of observational studies and MR studies. Seventeen of these reported disease outcomes had consistent results, demonstrating that lower concentrations of vitamin D were associated with a higher risk for all-cause mortality, Alzheimer's disease, hypertension, schizophrenia, and type 2 diabetes. The combinations of consistent evidence obtained by meta-analyses of observational studies and MR studies together with meta-analyses of RCTs showed that vitamin D supplementation was associated with a decreased risk for all-cause mortality but not associated with the risk for Alzheimer's disease, hypertension, schizophrenia, or type 2 diabetes. The results indicated that vitamin D supplementation is a promising strategy with long-term preventive effects on multiple chronic diseases and thus has the potential to decrease all-cause mortality. However, the current vitamin D supplementation strategy might not be an efficient intervention approach for these diseases, suggesting that new strategies are highly needed to improve the intervention outcomes.
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Affiliation(s)
- Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China,Centre for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xin Fan
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Manshu Song
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Qun Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China,Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia,School of Public Health, Shandong First Medical University and Shandong Academy of Medical Science, Tai'an, Shandong, China
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Vitamins as Possible Cancer Biomarkers: Significance and Limitations. Nutrients 2021; 13:nu13113914. [PMID: 34836171 PMCID: PMC8622959 DOI: 10.3390/nu13113914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
The Western-style diet, which is common in developed countries and spreading into developing countries, is unbalanced in many respects. For instance, micronutrients (vitamins A, B complex, C, D, E, and K plus iron, zinc, selenium, and iodine) are generally depleted in Western food (causing what is known as ‘hidden hunger’), whereas some others (such as phosphorus) are added beyond the daily allowance. This imbalance in micronutrients can induce cellular damage that can increase the risk of cancer. Interestingly, there is a large body of evidence suggesting a strong correlation between vitamin intake as well as vitamin blood concentrations with the occurrence of certain types of cancer. The direction of association between the concentration of a given vitamin and cancer risk is tumor specific. The present review summarized the literature regarding vitamins and cancer risk to assess whether these could be used as diagnostic or prognostic markers, thus confirming their potential as biomarkers. Despite many studies that highlight the importance of monitoring vitamin blood or tissue concentrations in cancer patients and demonstrate the link between vitamin intake and cancer risk, there is still an urgent need for more data to assess the effectiveness of vitamins as biomarkers in the context of cancer. Therefore, this review aims to provide a solid basis to support further studies on this promising topic.
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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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10
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Is Vitamin D Deficiency Related to Increased Cancer Risk in Patients with Type 2 Diabetes Mellitus? Int J Mol Sci 2021; 22:ijms22126444. [PMID: 34208589 PMCID: PMC8233804 DOI: 10.3390/ijms22126444] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 12/30/2022] Open
Abstract
There is mounting evidence that type 2 diabetes mellitus (T2DM) is related with increased risk for the development of cancer. Apart from shared common risk factors typical for both diseases, diabetes driven factors including hyperinsulinemia, insulin resistance, hyperglycemia and low grade chronic inflammation are of great importance. Recently, vitamin D deficiency was reported to be associated with the pathogenesis of numerous diseases, including T2DM and cancer. However, little is known whether vitamin D deficiency may be responsible for elevated cancer risk development in T2DM patients. Therefore, the aim of the current review is to identify the molecular mechanisms by which vitamin D deficiency may contribute to cancer development in T2DM patients. Vitamin D via alleviation of insulin resistance, hyperglycemia, oxidative stress and inflammation reduces diabetes driven cancer risk factors. Moreover, vitamin D strengthens the DNA repair process, and regulates apoptosis and autophagy of cancer cells as well as signaling pathways involved in tumorigenesis i.e., tumor growth factor β (TGFβ), insulin-like growth factor (IGF) and Wnt-β-Cathenin. It should also be underlined that many types of cancer cells present alterations in vitamin D metabolism and action as a result of Vitamin D Receptor (VDR) and CYP27B1 expression dysregulation. Although, numerous studies revealed that adequate vitamin D concentration prevents or delays T2DM and cancer development, little is known how the vitamin affects cancer risk among T2DM patients. There is a pressing need for randomized clinical trials to clarify whether vitamin D deficiency may be a factor responsible for increased risk of cancer in T2DM patients, and whether the use of the vitamin by patients with diabetes and cancer may improve cancer prognosis and metabolic control of diabetes.
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Pancreatic Cancer Exposome Profile to Aid Early Detection and Inform Prevention Strategies. J Clin Med 2021; 10:jcm10081665. [PMID: 33924591 PMCID: PMC8069449 DOI: 10.3390/jcm10081665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/19/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
Pancreatic cancer (PCa) is associated with a poor prognosis and high mortality rate. The causes of PCa are not fully elucidated yet, although certain exposome factors have been identified. The exposome is defined as the sum of all environmental factors influencing the occurrence of a disease during a life span. The development of an exposome approach for PCa has the potential to discover new disease-associated factors to better understand the carcinogenesis of PCa and help with early detection strategies. Our systematic review of the literature identified several exposome factors that have been associated with PCa alone and in combination with other exposures. A potential inflammatory signature has been observed among the interaction of several exposures (i.e., smoking, alcohol consumption, diabetes mellitus, obesity, and inflammatory markers) that further increases the incidence and progression of PCa. A large number of exposures have been identified such as genetic, hormonal, microorganism infections and immune responses that warrant further investigation. Future early detection strategies should utilize this information to assess individuals' risk for PCa.
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12
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Roy S, Bagchi B. Fluctuation theory of immune response: A statistical mechanical approach to understand pathogen induced T-cell population dynamics. J Chem Phys 2021; 153:045107. [PMID: 32752668 DOI: 10.1063/5.0009747] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In this period of intense interest in human immunity, we attempt here to quantify the immune response against pathogen invasion through T-cell population dynamics. Borrowing concepts from equilibrium statistical mechanics, we introduce a new description of the immune response function (IMRF) in terms of fluctuations in the population number of relevant biological cells (effector and regulatory T-cells). We use a coarse-grained chemical reaction network model (CG-CRNM) to calculate the number fluctuations and show that the response function derived as such can, indeed, capture the crossover observed in a T-cell driven immune response. We employ the network model to learn the effect of vitamin-D as an immunomodulator. We solve our CG-CRNM using a stochastic Gillespie algorithm. Depending on the effector T-cell concentration, we can classify immune regulation regimes into three categories: weak, strong, and moderate. The IMRF is found to behave differently in these three regimes. A damped cross-regulatory behavior found in the dynamics of effector and regulatory T-cell concentration in the diseased states correlates well with the same found in a cohort of patients with specific malignancies and autoimmune diseases. Importantly, the crossover from the weakly regulated steady state to the other (the strongly regulated) is accompanied by a divergence-like growth in the fluctuation of both the effector and the regulatory T-cell concentration, characteristic of a dynamic phase transition. We believe such steady-state IMRF analyses could help not only to phase-separate different immune stages but also aid in the valuable connection between autoimmunity, optimal vitamin-D, and consequences of immunosuppressive stress and malignancy.
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Affiliation(s)
- Susmita Roy
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Campus Road, Mohanpur, West Bengal 741246, India
| | - Biman Bagchi
- Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore 560012, India
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Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System. Int J Mol Sci 2021; 22:ijms22042128. [PMID: 33669918 PMCID: PMC7924658 DOI: 10.3390/ijms22042128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D, a fat-soluble prohormone, is endogenously synthesized in response to sunlight or taken from dietary supplements. Since vitamin D receptors are present in most tissues and cells in the body, the mounting understanding of the role of vitamin D in humans indicates that it does not only play an important role in the musculoskeletal system, but has beneficial effects elsewhere as well. This review summarizes the metabolism of vitamin D, the research regarding the possible risk factors leading to vitamin D deficiency, and the relationships between vitamin D deficiency and numerous illnesses, including rickets, osteoporosis and osteomalacia, muscle weakness and falls, autoimmune disorders, infectious diseases, cardiovascular diseases (CVDs), cancers, and neurological disorders. The system-wide effects of vitamin D and the mechanisms of the diseases are also discussed. Although accumulating evidence supports associations of vitamin D deficiency with physical and mental disorders and beneficial effects of vitamin D with health maintenance and disease prevention, there continue to be controversies over the beneficial effects of vitamin D. Thus, more well-designed and statistically powered trials are required to enable the assessment of vitamin D’s role in optimizing health and preventing disease.
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Sluyter JD, Manson JE, Scragg R. Vitamin D and Clinical Cancer Outcomes: A Review of Meta-Analyses. JBMR Plus 2020; 5:e10420. [PMID: 33553987 PMCID: PMC7839823 DOI: 10.1002/jbm4.10420] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022] Open
Abstract
The relationship between vitamin D status or supplementation and cancer outcomes has been examined in several meta‐analyses. To address remaining knowledge gaps, we conducted a systematic overview and critical appraisal of pertinent meta‐analyses. For meta‐analyses of trials, we assessed their quality using AMSTAR‐2 (A Measurement Tool to Assess Systematic Reviews), strength of associations using umbrella review methodology and credibility of evidence using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) criteria. Meta‐analyses of observational studies reported inverse associations of 25OHD with risk of cancer incidence and cancer mortality and, particularly for colorectal cancer, fulfilled some of Bradford‐Hill's causation criteria. In meta‐analyses of trials, vitamin D supplementation did not affect cancer incidence. However, we found credible evidence that vitamin D supplementation reduced total cancer mortality risk, with five out of six meta‐analyses reporting a relative risk (RR) reduction of up to 16%: RR, 0.84 (95% CI, 0.74–0.95). The strength of the association, however, was classified as weak. This was true among meta‐analyses of high, moderate, and lower quality (AMSTAR‐2–rated). Trials did not include large numbers of vitamin D‐deficient participants; many tested relatively low doses and lacked sufficiently powered data on site‐specific cancers. In conclusion, meta‐analyses show that, although observational evidence indicates that low vitamin D status is associated with a higher risk of cancer outcomes, randomized trials show that vitamin D supplementation reduces total cancer mortality, but not cancer incidence. However, trials with larger proportions of vitamin D‐insufficient participants and longer durations of follow‐up, plus adequately powered data on site‐specific common cancers, would provide further insight into the evidence base. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- John D Sluyter
- School of Population Health, University of Auckland Auckland New Zealand
| | - JoAnn E Manson
- Department of Medicine Brigham and Women's Hospital, and Harvard Medical School Boston MA USA.,Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA USA
| | - Robert Scragg
- School of Population Health, University of Auckland Auckland New Zealand
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Gorchs L, Ahmed S, Mayer C, Knauf A, Fernández Moro C, Svensson M, Heuchel R, Rangelova E, Bergman P, Kaipe H. The vitamin D analogue calcipotriol promotes an anti-tumorigenic phenotype of human pancreatic CAFs but reduces T cell mediated immunity. Sci Rep 2020; 10:17444. [PMID: 33060625 PMCID: PMC7562723 DOI: 10.1038/s41598-020-74368-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
The pancreatic tumour stroma is composed of phenotypically heterogenous cancer-associated fibroblasts (CAFs) with both pro- and anti-tumorigenic functions. Here, we studied the impact of calcipotriol, a vitamin D3 analogue, on the activation of human pancreatic CAFs and T cells using 2- and 3-dimensional (2D, 3D) cell culture models. We found that calcipotriol decreased CAF proliferation and migration and reduced the release of the pro-tumorigenic factors prostaglandin E2, IL-6, periostin, and leukemia inhibitory factor. However, calcipotriol promoted PD-L1 upregulation, which could influence T cell mediated tumour immune surveillance. Calcipotriol reduced T cell proliferation and production of IFN-γ, granzyme B and IL-17, but increased IL-10 secretion. These effects were even more profound in the presence of CAFs in 2D cultures and in the presence of CAFs and pancreatic tumour cell line (PANC-1) spheroids in 3D cultures. Functional assays on tumour infiltrating lymphocytes also showed a reduction in T cell activation by calcipotriol. This suggests that calcipotriol reduces the tumour supportive activity of CAFs but at the same time reduces T cell effector functions, which could compromise the patients’ tumour immune surveillance. Thus, vitamin D3 analogues appear to have dual functions in the context of pancreatic cancer, which could have important clinical implications.
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Affiliation(s)
- Laia Gorchs
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Sultan Ahmed
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Chanté Mayer
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alisa Knauf
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carlos Fernández Moro
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Pathology/Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Mattias Svensson
- Department of Medicine, Centre for Infectious Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Rainer Heuchel
- Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Elena Rangelova
- Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Pancreatic Surgery Unit, Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Bergman
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Infectious Disease Clinic, The Immunodeficiency Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Helen Kaipe
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. .,Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
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16
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Vitamin D Prevents Pancreatic Cancer-Induced Apoptosis Signaling of Inflammatory Cells. Biomolecules 2020; 10:biom10071055. [PMID: 32679840 PMCID: PMC7408286 DOI: 10.3390/biom10071055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 12/16/2022] Open
Abstract
Combined approaches based on immunotherapy and drugs supporting immune effector cell function might increase treatment options for pancreatic ductal adenocarcinoma (PDAC), vitamin D being a suitable drug candidate. In this study, we evaluated whether treatment with the vitamin D analogue, calcipotriol, counterbalances PDAC induced and SMAD4-associated intracellular calcium [Ca2+]i alterations, cytokines release, immune effector function, and the intracellular signaling of peripheral blood mononuclear cells (PBMCs). Calcipotriol counteracted the [Ca2+]i depletion of PBMCs induced by SMAD4-expressing PDAC cells, which conditioned media augmented the number of calcium flows while reducing whole [Ca2+]i. While calcipotriol inhibited spontaneous and PDAC-induced tumor necrosis factor alpha (TNF-α) release by PBMC and reduced intracellular transforming growth factor beta (TGF-β), it did not counteract the lymphocytes proliferation induced in allogenic co-culture by PDAC-conditioned PBMCs. Calcipotriol mainly antagonized PDAC-induced apoptosis and partially restored PDAC-inhibited NF-κB signaling pathway. In conclusion, alterations induced by PDAC cells in the [Ca2+]i of immune cells can be partially reverted by calcipotriol treatment, which promotes inflammation and antagonizes PBMCs apoptosis. These effects, together with the dampening of intracellular TGF-β, might result in an overall anti-tumor effect, thus supporting the administration of vitamin D in PDAC patients.
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17
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Principe DR, Rana A. Updated risk factors to inform early pancreatic cancer screening and identify high risk patients. Cancer Lett 2020; 485:56-65. [PMID: 32389710 DOI: 10.1016/j.canlet.2020.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
Pancreatic adenocarcinoma (PDAC) is associated with poor clinical outcomes and incomplete responses to conventional therapy. Therefore, there is an unmet clinical need to better understand the predisposing factors for pancreatic cancer in hopes of providing early screening to high-risk patients. While select risk factors such as age, race, and family history, or predisposing syndromes are unavoidable, there are several new and established risk factors that allow for intervention, namely by counseling patients to make the appropriate lifestyle modifications. Here, we discuss the best-studied risk factors for PDAC such as tobacco use and chronic pancreatitis, as well as newly emerging risk factors including select nutritional deficits, bacterial infections, and psychosocial factors. As several of these risk factors appear to be additive or synergistic, by understanding their relationships and offering coordinated, multidisciplinary care to high-risk patients, it may be possible to reduce pancreatic cancer incidence and improve clinical outcomes through early detection.
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Affiliation(s)
- Daniel R Principe
- Medical Scientist Training Program, University of Illinois College of Medicine, Chicago, IL, USA; Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL, USA.
| | - Ajay Rana
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL, USA; Jesse Brown VA Medical Center, Chicago, IL, USA.
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Single Nucleotide Polymorphisms in 25-Hydroxyvitamin D3 1-Alpha-Hydroxylase ( CYP27B1) Gene: The Risk of Malignant Tumors and Other Chronic Diseases. Nutrients 2020; 12:nu12030801. [PMID: 32197412 PMCID: PMC7146376 DOI: 10.3390/nu12030801] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/31/2022] Open
Abstract
: Vitamin D is widely known for its roles in the promotion of apoptosis and differentiation, with simultaneous inhibition of proliferation, inflammation, angiogenesis, invasion, and metastasis. Modern literature lacks complete information on polymorphisms in CYP27B1, the only enzyme capable of vitamin D activation. This review presents gathered data that relate to genetic variants in CYP27B1 gene in correlation to multiple diseases, mostly concerning colorectal, prostate, breast, lung, and pancreatic cancers, as well as on other pathologies, such as non-Hodgkin's lymphoma, oral lichen planus, or multiple sclerosis.
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19
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Kim H, Giovannucci E. Vitamin D Status and Cancer Incidence, Survival, and Mortality. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:39-52. [DOI: 10.1007/978-3-030-46227-7_3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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20
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Charoenngam N, Shirvani A, Holick MF. The ongoing D-lemma of vitamin D supplementation for nonskeletal health and bone health. Curr Opin Endocrinol Diabetes Obes 2019; 26:301-305. [PMID: 31644469 DOI: 10.1097/med.0000000000000508] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW The goal of this review is to give some perspective on the results and conclusions of three recent randomized controlled vitamin D intervention studies that have challenged the health benefit of vitamin D supplementation for reducing risk for cardiovascular disease, cancer, all-cause mortality and type 2 diabetes and improving bone health. RECENT FINDINGS Vitamin D supplementation to adults who were vitamin D sufficient or insufficient did not reduce risk for developing cardiovascular disease, cancer, type 2 diabetes nor increases bone mineral density (BMD). Patients who were vitamin D deficient with cancer and received vitamin D reduced risk for mortality by 25% and prediabetic adults who were vitamin D deficient and received vitamin D reduced their risk of developing type 2 diabetes by 62%. Older adults receiving 4000 and 10 000 IUs of vitamin D3 daily for 3 years had reduced radial BMD but had no change in either total hip areal bone density or bone strength in the radius and tibia. SUMMARY Caution is needed when evaluating results and conclusions from randomized controlled trials that investigate health benefits of vitamin D; most studies suggest health benefits when vitamin D supplementation is provided to vitamin D deficient populations and little benefit when given to populations that are vitamin D sufficient/insufficient.
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Affiliation(s)
- Nipith Charoenngam
- Vitamin D, Skin and Bone Research Laboratory, Section of Endocrinology, Nutrition, and Diabetes, Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Arash Shirvani
- Vitamin D, Skin and Bone Research Laboratory, Section of Endocrinology, Nutrition, and Diabetes, Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA
| | - Michael F Holick
- Vitamin D, Skin and Bone Research Laboratory, Section of Endocrinology, Nutrition, and Diabetes, Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA
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21
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Chatterjee R, Erban JK, Fuss P, Dolor R, LeBlanc E, Staten M, Sheehan P, Pittas A. Vitamin D supplementation for prevention of cancer: The D2d cancer outcomes (D2dCA) study. Contemp Clin Trials 2019; 81:62-70. [PMID: 31048088 PMCID: PMC6570503 DOI: 10.1016/j.cct.2019.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/19/2019] [Accepted: 04/25/2019] [Indexed: 02/08/2023]
Abstract
Evidence on biological plausibility from mechanistic studies and data from observational studies suggest that vitamin D may be linked to risk of several types of cancer. However, evidence from clinical trials evaluating the effect of vitamin D supplementation on cancer risk is limited. The Vitamin D and Type 2 Diabetes (D2d) study is a multi-center, randomized, placebo-controlled clinical trial conducted to examine the causal relationship between oral vitamin D supplementation and development of diabetes among overweight adults with prediabetes. The D2d study provides a unique opportunity to assess the effect of vitamin D supplementation at a higher dose (4000 IU/day) than has been used in other clinical trials with cancer outcomes, in a population at higher than average risk for cancer. This paper provides: Krishnan and Feldman (2011) a) baseline characteristics of the D2d population included in the D2d cancer outcomes secondary study (D2dCA) and comparison to other large trials of vitamin D supplementation and cancer risk; Leyssens et al. (2013) b) description of data that are being collected during the trial and the planned statistical analyses to test whether vitamin D supplementation at a dose of 4000 IU/day has an effect on incident cancer overall, on incidence of certain types of cancer, and on incidence of precancerous lesions. Results of D2dCA will help guide future research and clinical recommendations related to vitamin D and cancer risk.
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Affiliation(s)
- Ranee Chatterjee
- Division of General Internal Medicine, 200 Morris Street, 3(rd) Floor, Box 104427, Durham, NC 27701, USA.
| | - John K Erban
- Cancer Center, Tufts Medical Center, 800 Washington St, Box 245, Boston, MA 02111, USA.
| | - Paul Fuss
- Division of Endocrinology, Tufts Medical Center, 800 Washington Street, Box 268, Boston, MA 02111, USA.
| | - Rowena Dolor
- Division of General Internal Medicine, 200 Morris Street, 3(rd) Floor, Box 104427, Durham, NC 27701, USA.
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research NW, 3800 N Interstate, Portland, OR 97229, USA.
| | - Myrlene Staten
- Kelly Government Services for the National Institute of Diabetes and Digestive and Kidney Diseases, 6701 Democracy Boulevard, Room 6107, Bethesda, MD 20817, USA.
| | - Patricia Sheehan
- Spaulding Rehabilitation Network, 300 1(st) Ave, Charlestown, MA 02129, USA.
| | - Anastassios Pittas
- Division of Endocrinology, Tufts Medical Center, 800 Washington Street, Box 268, Boston, MA 02111, USA.
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22
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Keum N, Lee DH, Greenwood DC, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. Ann Oncol 2019; 30:733-743. [PMID: 30796437 PMCID: PMC6821324 DOI: 10.1093/annonc/mdz059] [Citation(s) in RCA: 211] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous meta-analyses of randomized controlled trials (RCTs) of vitamin D supplementation and total cancer incidence and mortality found inconsistent results, and most included trials administered generally low doses of vitamin D (≤1100 IU/day). We updated the meta-analysis by incorporating recent RCTs that have tested higher doses of vitamin D supplements. MATERIALS AND METHODS PubMed and Embase were searched from the inception to November 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS For total cancer incidence, 10 trials were included [6537 cases; 3-10 years of follow-up; 54-135 nmol/l of attained levels of circulating 25(OH) vitamin D [25(OH)D] in the intervention group]. The summary RR was 0.98 (95% CI, 0.93-1.03; P = 0.42; I2 = 0%). The results remained null across subgroups tested, including even when attained 25(OH)D levels exceeded 100 nmol/l (RR, 0.95; 95% CI, 0.83-1.09; P = 0.48; I2 = 26%). For total cancer mortality, five trials were included [1591 deaths; 3-10 years of follow-up; 54-135 nmol/l of attained levels of circulating 25(OH)D in the intervention group]. The summary RR was 0.87 (95% CI, 0.79-0.96; P = 0.005; I2 = 0%), which was largely attributable to interventions with daily dosing (as opposed to infrequent bolus dosing). No statistically significant heterogeneity was observed by attained levels of circulating 25(OH)D (Pheterogeneity = 0.83), with RR being 0.88 (95% CI, 0.78-0.98; P = 0.02; I2 = 0%) for ≤100 nmol/l and 0.85 (95% CI, 0.70-1.03; P = 0.11; I2 = 0%) for >100 nmol/l. CONCLUSIONS In an updated meta-analysis of RCTs, vitamin D supplementation significantly reduced total cancer mortality but did not reduce total cancer incidence.
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Affiliation(s)
- N Keum
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea.
| | - D H Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - D C Greenwood
- Division of Biostatistics, University of Leeds, Leeds, UK
| | - J E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - E Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.
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Abd-Elsalam S, Mohamed A, Aref A, Talima S, A Elshimy R, Gerges S, Meghed M, Zahran F, EL-Adawy E. Association of serum level of vitamin D and VDR polymorphism Fok1 with the risk or survival of pancreatic cancer in Egyptian population. Indian J Cancer 2019; 56:130-134. [PMID: 31062731 DOI: 10.4103/ijc.ijc_299_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Li L, Shang F, Zhu Y, Sun Y, Sudi RS. Modulation of VDR and Cell Cycle-Related Proteins by Vitamin D in Normal Pancreatic Cells and Poorly Differentiated Metastatic Pancreatic Cancer Cells. Nutr Cancer 2018; 71:818-824. [PMID: 30358420 DOI: 10.1080/01635581.2018.1521445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Lei Li
- Department of Gastroenterology, Taian City Central Hospital, Taian, Shandong, People’s Republic of China
| | - Feifei Shang
- School of Basic Medical Science, Taishan Medical University, Taian, Shandong, People’s Republic of China
| | - Yadong Zhu
- School of Basic Medical Science, Taishan Medical University, Taian, Shandong, People’s Republic of China
| | - Yanfu Sun
- Taian City Central Hospital Branch Hospital, Taian, Shandong, People’s Republic of China
| | - Radha Sharan Sudi
- School of Basic Medical Science, Taishan Medical University, Taian, Shandong, People’s Republic of China
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Mondul AM, Weinstein SJ, Layne TM, Albanes D. Vitamin D and Cancer Risk and Mortality: State of the Science, Gaps, and Challenges. Epidemiol Rev 2018; 39:28-48. [PMID: 28486651 DOI: 10.1093/epirev/mxx005] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/19/2017] [Indexed: 12/31/2022] Open
Abstract
There has been substantial enthusiasm recently regarding the potential role of vitamin D in the primary and secondary prevention of cancer. Laboratory studies demonstrate a range of anticarcinogenic effects for vitamin D compounds, but human studies have yielded little consistent evidence supporting a protective association. Higher circulating levels of vitamin D (i.e., 25-hydroxyvitamin D or 25(OH)D) appear to be associated with reduced risk of colorectal and bladder malignancies, but higher risk of prostate and possibly pancreatic cancers, with no clear association for most other organ sites examined. Despite there being no official institutional recommendations regarding the use of vitamin D supplements for cancer prevention, screenings for vitamin D deficiency and vitamin D supplement use have increased substantially over the past decade. These widespread practices demonstrate that population sociobehavioral changes are often adopted before scientifically well-informed policies and recommendations are available. This review critically examines the currently available epidemiologic literature regarding the associations between circulating 25(OH)D, vitamin D supplementation, and vitamin D-related genetic variation and cancer risk and mortality, with a particular emphasis on prospective studies. We identify several important gaps in our scientific knowledge that should be addressed in order to provide sufficient reproducible data to inform evidence-based recommendations related to optimal 25(OH)D concentrations (and any role for vitamin D supplementation) for the primary and secondary prevention of cancer. With few exceptions, such recommendations cannot be made at this time.
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van Duijnhoven FJ, Jenab M, Hveem K, Siersema PD, Fedirko V, Duell EJ, Kampman E, Halfweeg A, van Kranen HJ, van den Ouweland JM, Weiderpass E, Murphy N, Langhammer A, Ness‐Jensen E, Olsen A, Tjønneland A, Overvad K, Cadeau C, Kvaskoff M, Boutron‐Ruault M, Katzke VA, Kühn T, Boeing H, Trichopoulou A, Kotanidou A, Kritikou M, Palli D, Agnoli C, Tumino R, Panico S, Matullo G, Peeters P, Brustad M, Olsen KS, Lasheras C, Obón‐Santacana M, Sánchez M, Dorronsoro M, Chirlaque M, Barricarte A, Manjer J, Almquist M, Renström F, Ye W, Wareham N, Khaw K, Bradbury KE, Freisling H, Aune D, Norat T, Riboli E, Bueno‐de‐Mesquita HB. Circulating concentrations of vitamin D in relation to pancreatic cancer risk in European populations. Int J Cancer 2018; 142:1189-1201. [PMID: 29114875 PMCID: PMC5813219 DOI: 10.1002/ijc.31146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 12/13/2022]
Abstract
Evidence from in vivo, in vitro and ecological studies are suggestive of a protective effect of vitamin D against pancreatic cancer (PC). However, this has not been confirmed by analytical epidemiological studies. We aimed to examine the association between pre-diagnostic circulating vitamin D concentrations and PC incidence in European populations. We conducted a pooled nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nord-Trøndelag Health Study's second survey (HUNT2) cohorts. In total, 738 primary incident PC cases (EPIC n = 626; HUNT2 n = 112; median follow-up = 6.9 years) were matched to 738 controls. Vitamin D [25(OH)D2 and 25(OH)D3 combined] concentrations were determined using isotope-dilution liquid chromatography-tandem mass spectrometry. Conditional logistic regression models with adjustments for body mass index and smoking habits were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (95%CI). Compared with a reference category of >50 to 75 nmol/L vitamin D, the IRRs (95% CIs) were 0.71 (0.42-1.20); 0.94 (0.72-1.22); 1.12 (0.82-1.53) and 1.26 (0.79-2.01) for clinically pre-defined categories of ≤25; >25 to 50; >75 to 100; and >100 nmol/L vitamin D, respectively (p for trend = 0.09). Corresponding analyses by quintiles of season-standardized vitamin D concentrations also did not reveal associations with PC risk (p for trend = 0.23). Although these findings among participants from the largest combination of European cohort studies to date show increasing effect estimates of PC risk with increasing pre-diagnostic concentrations of vitamin D, they are not statistically significant.
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Affiliation(s)
- Fränzel J.B. van Duijnhoven
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
- Division of Human NutritionWageningen University & ResearchWageningenThe Netherlands
| | - Mazda Jenab
- International Agency for Research on Cancer (IARC‐WHO)LyonFrance
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General PracticeNorwegian University of Science and TechnologyLevangerNorway
| | - Peter D. Siersema
- Department of Gastroenterology and HepatologyUniversity Medical Center UtrechtThe Netherlands
- Department of Gastroenterology and HepatologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public HealthWinship Cancer Institute, Emory UniversityAtlantaGA
| | - Eric J. Duell
- Unit of Nutrition and CancerCancer Epidemiology Research Program, Catalan Institute of Oncology (ICO‐IDIBELL), L'Hospitalet de LlobregatBarcelonaSpain
| | - Ellen Kampman
- Division of Human NutritionWageningen University & ResearchWageningenThe Netherlands
| | - Anouk Halfweeg
- Division of Human NutritionWageningen University & ResearchWageningenThe Netherlands
| | - Henk J. van Kranen
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | - Elisabete Weiderpass
- Department of Community MedicineFaculty of Health Sciences, University of Tromsø, The Arctic University of NorwayTromsøNorway
- Cancer Registry of Norway, Institute for Population‐based Cancer ResearchOsloNorway
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Genetic Epidemiology Group, Folkhälsan Research CenterHelsinkiFinland
| | - Neil Murphy
- International Agency for Research on Cancer (IARC‐WHO)LyonFrance
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and General PracticeNorwegian University of Science and TechnologyLevangerNorway
| | - Eivind Ness‐Jensen
- HUNT Research Centre, Department of Public Health and General PracticeNorwegian University of Science and TechnologyLevangerNorway
| | - Anja Olsen
- Danish Cancer Society Research CenterCopenhagenDenmark
| | | | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus UniversityAarhus CDenmark
| | - Claire Cadeau
- Université Paris‐Saclay, Université Paris‐Sud, UVSQ, CESP, INSERMVillejuifFrance
- Gustave RoussyVillejuifF‐94805France
| | - Marina Kvaskoff
- Université Paris‐Saclay, Université Paris‐Sud, UVSQ, CESP, INSERMVillejuifFrance
- Gustave RoussyVillejuifF‐94805France
| | | | - Verena A. Katzke
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Tilman Kühn
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Heiner Boeing
- Department of EpidemiologyGerman Institute for Human Nutrition Potsdam‐RehbrückeNuthetalGermany
| | - Antonia Trichopoulou
- Hellenic Health FoundationAthensGreece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical StatisticsUniversity of Athens Medical SchoolGreece
| | - Anastasia Kotanidou
- Hellenic Health FoundationAthensGreece
- Department of Critical Care Medicine and Pulmonary ServicesUniversity of Athens Medical School, Evangelismos HospitalAthensGreece
| | | | - Domenico Palli
- Molecular and Nutritional Epidemiology UnitCancer Research and Prevention Institute—ISPOFlorenceItaly
| | - Claudia Agnoli
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanoItaly
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit“Civic ‐ M.P.Arezzo” Hospital, ASP Ragusa(Italy)
| | - Salvatore Panico
- Dipartimento di medicina clinica e chirurgiaFederico II universityNaplesItaly
| | - Giuseppe Matullo
- Department of Medical SciencesUniversity of TorinoTorinoItaly
- Italian Institute for Genomic Medicine (IIGM/HuGeF)TorinoItaly
| | - Petra Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center UtrechtUtrechtThe Netherlands
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonUnited Kingdom
| | - Magritt Brustad
- Department of Community MedicineFaculty of Health Sciences, University of Tromsø, The Arctic University of NorwayTromsøNorway
| | - Karina Standahl Olsen
- Department of Community MedicineFaculty of Health Sciences, University of Tromsø, The Arctic University of NorwayTromsøNorway
| | | | - Mireia Obón‐Santacana
- Unit of Nutrition and CancerCancer Epidemiology Research Program, Catalan Institute of Oncology (ICO‐IDIBELL), L'Hospitalet de LlobregatBarcelonaSpain
| | - María‐José Sánchez
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de GranadaGranadaSpain
- CIBER de Epidemiología y Salud Pública (CIBERESP)Spain
| | - Miren Dorronsoro
- Public Health Direction and Biodonostia‐Ciberesp, Basque Regional Health DepartmentSan SebastianSpain
| | - Maria‐Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP)Spain
- Department of EpidemiologyRegional Health Council, IMIB‐ArrixacaMurciaSpain
- Department of Health and Social SciencesUniversidad de MurciaMurciaSpain
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP)Spain
- Navarra Public Health InstitutePamplonaSpain
- Navarra Institute for Health Research (IdiSNA) PamplonaSpain
| | - Jonas Manjer
- Department of SurgeryLund University, Skåne University Hospital MalmöMalmöSweden
| | - Martin Almquist
- Department of SurgeryEndocrine‐Sarcoma unit, Skane University HospitalLundSweden
| | - Frida Renström
- Genetic and Molecular Epidemiology Unit, Department of Clinical SciencesLund UniversityMalmöSweden
- Department of Biobank ResearchUmeå UniversityUmeåSweden
| | - Weimin Ye
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- The Medical Biobank at Umeå UniversityUmeåSweden
| | - Nick Wareham
- MRC Epidemiology Unit, University of CambridgeCambridgeUnited Kingdom
| | | | - Kathryn E. Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of Oxford, OxfordUnited Kingdom
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC‐WHO)LyonFrance
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonUnited Kingdom
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonUnited Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonUnited Kingdom
| | - H. B(as) Bueno‐de‐Mesquita
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
- Department of Gastroenterology and HepatologyUniversity Medical Center UtrechtThe Netherlands
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonUnited Kingdom
- Department of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
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Karppinen T, Ala-Houhala M, Ylianttila L, Kautiainen H, Lakkala K, Hannula HR, Turunen E, Viljakainen H, Reunala T, Snellman E. The effect of vernal solar UV radiation on serum 25-hydroxyvitamin D concentration depends on the baseline level: observations from a high latitude in Finland. Int J Circumpolar Health 2018; 76:1272790. [PMID: 28452681 PMCID: PMC5328343 DOI: 10.1080/22423982.2016.1272790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Humans obtain vitamin D from conversion of 7-dehydrocholesterol in the skin by ultraviolet B (UVB) radiation or from dietary sources. As the radiation level is insufficient in winter, vitamin D deficiency is common at higher latitudes. We assessed whether vernal solar UVB radiation at latitudes 61°N and 67°N in Finland has an impact on serum 25-hydroxyvitamin D [S-25(OH)D] concentrations. Twenty-seven healthy volunteers participated in outdoor activities in snow-covered terrain for 4–10 days in March or April, with their face and hands sun-exposed. The personal UVB doses and S-25(OH)D levels were monitored. A mean UVB dose of 11.8 standard erythema doses (SED) was received during an average of 12.3 outdoor hours. The mean S-25(OH)D concentration in subjects with a baseline concentration below 90.0 nmol/L (n=13) increased significantly, by 6.0 nmol/L from an initial mean of 62.4 nmol/L (p<0.001), whereas in those with a basal concentration above 90.0 nmol/L (n=12) it decreased significantly, by 6.7 nmol/L from a mean of 116.9 nmol/L (p<0.01). To conclude, only 7% of total body surface area was exposed to vernal sunlight and this was capable of increasing S-25(OH)D levels in subjects with a baseline level below 90 nmol/L but not in those with higher levels.
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Affiliation(s)
- Toni Karppinen
- a Medical School , University of Tampere , Tampere , Finland.,b Department of Dermatology , Tampere University Hospital , Tampere , Finland.,c Department of Dermatology , Päijät-Häme Central Hospital , Lahti , Finland
| | - Meri Ala-Houhala
- b Department of Dermatology , Tampere University Hospital , Tampere , Finland
| | - Lasse Ylianttila
- d Non ionizing radiation laboratory , Radiation and Nuclear Safety Authority , Helsinki , Finland
| | - Hannu Kautiainen
- e Unit of Primary Health Care , Helsinki University Central Hospital , Helsinki , Finland.,f Department of General Practice , University of Helsinki , Helsinki , Finland.,g Unit of Primary Health Care , Kuopio University Hospital , Helsinki and Kuopio , Finland
| | - Kaisa Lakkala
- h Finnish Meteorological Institute , Arctic Research Centre , Sodankylä , Finland
| | - Henna-Reetta Hannula
- h Finnish Meteorological Institute , Arctic Research Centre , Sodankylä , Finland
| | - Esa Turunen
- i Aeronomy division , Sodankylä Geophysical Observatory , Sodankylä , Finland
| | - Heli Viljakainen
- j Children's Hospital, Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - Timo Reunala
- a Medical School , University of Tampere , Tampere , Finland
| | - Erna Snellman
- a Medical School , University of Tampere , Tampere , Finland.,b Department of Dermatology , Tampere University Hospital , Tampere , Finland
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28
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Pinto JPNS, Goergen J, Muniz FWMG, Haas AN. Vitamin D levels and risk for periodontal disease: A systematic review. J Periodontal Res 2018; 53:298-305. [PMID: 29492977 DOI: 10.1111/jre.12531] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the existing evidence supporting or refuting the following questions: (i) Do patients with lower vitamin D levels have higher risk for periodontal disease? (ii) Are periodontal treatment outcomes improved by the adjuvant supplementation of vitamin D or by elevated serum vitamin D levels? MATERIAL AND METHODS MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to September 2017. Studies were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. RESULTS Overall, 27 studies were included (13 cross-sectional studies, 6 case-control studies, 5 cohort studies, 2 randomized clinical trials and 1 case series study). Sixty-five percent of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters. None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels. No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found. No meta-analysis was performed due to high variability across studies. CONCLUSION The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary.
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Affiliation(s)
- J P N S Pinto
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - J Goergen
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - F W M G Muniz
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A N Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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29
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Altieri B, Grant WB, Della Casa S, Orio F, Pontecorvi A, Colao A, Sarno G, Muscogiuri G. Vitamin D and pancreas: The role of sunshine vitamin in the pathogenesis of diabetes mellitus and pancreatic cancer. Crit Rev Food Sci Nutr 2018; 57:3472-3488. [PMID: 27030935 DOI: 10.1080/10408398.2015.1136922] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests that vitamin D exerts multiple effects beyond bone and calcium metabolism. Vitamin D seems to play a role in pancreatic disease, including type 1 and type 2 diabetes mellitus as well as pancreatic cancer. Vitamin D's immune-modulatory action suggests that it could help prevent type 1 diabetes. In type 2 diabetes, vitamin D may influence β-cell function, insulin sensitivity, and systematic inflammation-all characteristic pathways of that disease. Data from observational studies correlated vitamin D deficiency with risk of type 1 and type 2 diabetes. Prospective and ecological studies of pancreatic cancer incidence generally support a beneficial effect of higher 25-hydroxyvitamin D concentration as well as inverse correlations between UVB dose or exposure and incidence and/or mortality rate of pancreatic cancer. This review discusses the literature regarding vitamin D's role in risk of diabetes and pancreatic cancer. The results to date generally satisfy Hill's criteria for causality regarding vitamin D and incidence of these pancreatic diseases. However, large randomized, blinded, prospective studies are required to more fully evaluate the potential therapeutic role of vitamin D in preventing pancreatic diseases.
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Affiliation(s)
- Barbara Altieri
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - William B Grant
- b Sunlight , Nutrition, and Health Research Center , San Francisco , California , USA
| | - Silvia Della Casa
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Francesco Orio
- c Endocrinology, Department of Sports Science and Wellness , Parthenope University , Naples , Italy.,d Fertility Techniques SSD , San Giovanni di Dio e Ruggi D'Aragona University Hospital , Salerno , Italy
| | - Alfredo Pontecorvi
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Annamaria Colao
- e Department of Clinical Medicine and Surgery, Section of Endocrinology , University "Federico II," Naples , Italy
| | - Gerardo Sarno
- f Department of General Surgery and Transplantation Unit , San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana , Salerno , Italy
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30
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Salem AA, Mackenzie GG. Pancreatic cancer: A critical review of dietary risk. Nutr Res 2017; 52:1-13. [PMID: 29764623 DOI: 10.1016/j.nutres.2017.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/31/2017] [Accepted: 12/08/2017] [Indexed: 12/14/2022]
Abstract
Pancreatic cancer is a deadly disease. It is estimated that about 90% of pancreatic cancer cases are due to environmental risk factors. Among these, approximately 50% of pancreatic cancer cases may be attributed to diet, which is largely modifiable. Given this large attribution to diet, there have been numerous epidemiological studies assessing the risk of various dietary factors on the incidence of pancreatic cancer. However, many of these studies present conflicting and/or inconclusive findings. The objective of this review is two-fold: (a) to summarize the current evidence on the association between various dietary factors and the risk of developing pancreatic cancer and (b) to discuss what additional studies are needed to better elucidate the role of diet as a potential risk factor for pancreatic cancer. We summarized the evidence by using data primarily from meta-analyses and pooled analysis when available, focusing on the most studied nutrients, foods, and dietary patterns. We observed that, while the association between individual nutrients and pancreatic cancer risk have been heavily studied, the evidence is mostly conflicting and inconclusive. In contrast, the evidence of certain associations among dietary patterns and pancreatic cancer risk is clearer, has more power, and is less conflicting. Therefore, we propose a shift in the focus of nutritional epidemiological research with regards to pancreatic cancer risk. We discourage further epidemiological research studies that focus on single nutrients, whereas we strongly encourage additional studies that investigate how a combination of diet and other lifestyle factors may promote or prevent pancreatic carcinogenesis.
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Affiliation(s)
- Asmaa A Salem
- Department of Nutrition, University of California, Davis, One Shields Ave, Davis, CA, 95616
| | - Gerardo G Mackenzie
- Department of Nutrition, University of California, Davis, One Shields Ave, Davis, CA, 95616.
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31
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Zhu M, Qiu S, Zhang X, Wang Y, Souraka TDM, Wen X, Liang C, Tu J. The associations between CYP24A1 polymorphisms and cancer susceptibility: A meta-analysis and trial sequential analysis. Pathol Res Pract 2017; 214:53-63. [PMID: 29254801 DOI: 10.1016/j.prp.2017.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/07/2017] [Accepted: 11/16/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Published data have shown that vitamin D may have a protective effect on cancer development. CYP24A1, the main enzyme responsible for the degradation of active vitamin D, plays an important role in many cancer related cellular processes. Up to now, relationships between CYP24A1 polymorphisms and cancer susceptibility have been widely investigated, whereas the results are inconsistent. The aim of present meta-analysis was to explore the associations between CYP24A1 polymorphisms and cancer susceptibility. METHODS We searched on EMBASE, Web of Science, PubMed and China National Knowledge Infrastructure (CNKI) electronic databases (up to July 1, 2017) for relevant studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to make the evaluation clear. RESULTS Twenty-nine studies published in eight publications involving 20,593 cases and 25,458 controls were included. Five CYP24A1 gene polymorphisms were evaluated: rs2181874, rs2585428, rs4809960, rs6022999, and rs6068816. Our analyses suggested that rs2585428 and rs4809960 polymorphisms were significantly associated with overall cancer risk. Stratification analyses of ethnicity indicated that rs2585428 and rs4809960 polymorphisms decreased the risk of cancer among Caucasians. When studies were stratified by cancer type, our results indicated that rs2585428 significantly decreased the risk of pancreas cancer, while rs4809960 significantly decreased the risk of breast cancer. There were no associations of rs2181874, rs6022999, or rs6068816 with overall cancer risks. CONCLUSION Associations between CYP24A1 polymorphisms and cancer risks were examined, and additional multi-center studies with large samples are necessary to validate our results.
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Affiliation(s)
- Man Zhu
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Shili Qiu
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Xianwei Zhang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Yingchao Wang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Tapara D M Souraka
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Xue Wen
- Center of Reproductive Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Chunzi Liang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China.
| | - Jiancheng Tu
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China.
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32
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Molina P, Carrero JJ, Bover J, Chauveau P, Mazzaferro S, Torres PU. Vitamin D, a modulator of musculoskeletal health in chronic kidney disease. J Cachexia Sarcopenia Muscle 2017; 8:686-701. [PMID: 28675610 PMCID: PMC5659055 DOI: 10.1002/jcsm.12218] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/04/2017] [Accepted: 04/20/2017] [Indexed: 02/06/2023] Open
Abstract
The spectrum of activity of vitamin D goes beyond calcium and bone homeostasis, and growing evidence suggests that vitamin D contributes to maintain musculoskeletal health in healthy subjects as well as in patients with chronic kidney disease (CKD), who display the combination of bone metabolism disorder, muscle wasting, and weakness. Here, we review how vitamin D represents a pathway in which bone and muscle may interact. In vitro studies have confirmed that the vitamin D receptor is present on muscle, describing the mechanisms whereby vitamin D directly affects skeletal muscle. These include genomic and non-genomic (rapid) effects, regulating cellular differentiation and proliferation. Observational studies have shown that circulating 25-hydroxyvitamin D levels correlate with the clinical symptoms and muscle morphological changes observed in CKD patients. Vitamin D deficiency has been linked to low bone formation rate and bone mineral density, with an increased risk of skeletal fractures. The impact of low vitamin D status on skeletal muscle may also affect muscle metabolic pathways, including its sensitivity to insulin. Although some interventional studies have shown that vitamin D may improve physical performance and protect against the development of histological and radiological signs of hyperparathyroidism, evidence is still insufficient to draw definitive conclusions.
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Affiliation(s)
- Pablo Molina
- Department of NephrologyHospital Universitario Doctor PesetValenciaSpain
- REDinRENMadridSpain
- Department of MedicineUniversitat de ValènciaValenciaSpain
| | - Juan J. Carrero
- Division of Renal MedicineCLINTEC, Karolinska InstitutetStockholmSweden
| | - Jordi Bover
- REDinRENMadridSpain
- Department of NephrologyFundació PuigvertBarcelonaSpain
- IIB Sant PauBarcelonaSpain
| | - Philippe Chauveau
- Service de Néphrologie Transplantation DialyseCentre Hospitalier Universitaire de Bordeaux et Aurad‐AquitaineBordeauxFrance
| | - Sandro Mazzaferro
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric SciencesSapienza University of RomeRomeItaly
| | - Pablo Ureña Torres
- Department of Nephrology and DialysisClinique du Landy, Ramsay‐Générale de SantéSaint OuenParisFrance
- Department of Renal PhysiologyNecker Hospital, University of Paris DescartesParisFrance
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33
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Zhang X, Huang XZ, Chen WJ, Wu J, Chen Y, Wu CC, Wang ZN. Plasma 25-hydroxyvitamin D levels, vitamin D intake, and pancreatic cancer risk or mortality: a meta-analysis. Oncotarget 2017; 8:64395-64406. [PMID: 28969079 PMCID: PMC5610011 DOI: 10.18632/oncotarget.18888] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/04/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The associations between vitamin D status, including plasma 25-hydroxyvitamin D [25(OH)D] levels and vitamin D intake, and pancreatic cancer risk and mortality are inconsistent. The aims of this study are to evaluate the antitumor and therapeutic effects of vitamin D status for pancreatic cancer patients. METHODS A literature search for relevant studies was conducted using PubMed and Embase databases. Risk ratio (RR), hazard ratio (HR), and 95% confidence interval (CI) were used as the effect measures. All statistical analyses were performed using Stata software 12.0. RESULTS Our results indicated that high plasma 25(OH)D levels were inversely associated with pancreatic cancer mortality without significant heterogeneity (HR=0.81, 95% CI=0.68-0.96). However, high plasma 25(OH)D levels could not reduce pancreatic cancer risk (RR=1.02, 95% CI=0.66-1.57). Moreover, vitamin D intake was also not associated with pancreatic cancer risk (RR=1.11, 95% CI=0.67-1.86). CONCLUSIONS Our results indicate that high plasma 25(OH)D levels were significantly associated with improved survival in pancreatic cancer patients. However, there were no significant associations between vitamin D intake or plasma 25(OH)D levels and pancreatic cancer risk.
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Affiliation(s)
- Xi Zhang
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Xuan-Zhang Huang
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Wen-Jun Chen
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Jian Wu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - You Chen
- Department of Pediatric Dentistry, The Wenzhou Dental Hospital, Lucheng, Wenzhou 325027, P.R. China
| | - Cong-Cong Wu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Zhen-Ning Wang
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Heping, Shenyang 110001, P.R. China
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34
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Dooley J, Lagou V, Heirman N, Dresselaers T, Himmelreich U, Liston A. Murine Pancreatic Acinar Cell Carcinoma Growth Kinetics Are Independent of Dietary Vitamin D Deficiency or Supplementation. Front Oncol 2017; 7:133. [PMID: 28702373 PMCID: PMC5488083 DOI: 10.3389/fonc.2017.00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 06/07/2017] [Indexed: 11/13/2022] Open
Abstract
Vitamin D has been proposed as a therapeutic strategy in pancreatic cancer, yet evidence for an effect of dietary vitamin D on pancreatic cancer is ambiguous, with conflicting data from human epidemiological and intervention studies. Here, we tested the role of dietary vitamin D in the in vivo context of the well-characterized Ela1-TAg transgenic mouse model of pancreatic acinar cell carcinoma. Through longitudinal magnetic resonance imaging of mice under conditions of either dietary vitamin D deficiency (<5 IU/kg vitamin D) or excess (76,500 IU/kg vitamin D), compared to control diet (1,500 IU/kg vitamin D), we measured the effect of variation of dietary vitamin D on tumor kinetics. No measurable impact of dietary vitamin D was found on pancreatic acinar cell carcinoma development, growth or mortality, casting further doubt on the already equivocal data supporting potential therapeutic use in humans. The lack of any detectable effect of vitamin D, within the physiological range of dietary deficiency or supplementation, in this model further erodes confidence in vitamin D as an effective antitumor therapeutic in pancreatic acinar cell carcinoma.
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Affiliation(s)
- James Dooley
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Vasiliki Lagou
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Nathalie Heirman
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Tom Dresselaers
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Uwe Himmelreich
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Adrian Liston
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
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35
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Choi YM, Kim WG, Kim TY, Bae SJ, Kim HK, Jang EK, Jeon MJ, Han JM, Shong YK, Kim WB. Serum vitamin D3 levels are not associated with thyroid cancer prevalence in euthyroid subjects without autoimmune thyroid disease. Korean J Intern Med 2017; 32:102-108. [PMID: 27581957 PMCID: PMC5214716 DOI: 10.3904/kjim.2015.090] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 09/09/2015] [Accepted: 09/13/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIMS Previous studies have suggested that elevated serum vitamin D levels might protect against thyroid cancer. Elevated serum thyroid stimulating hormone levels and autoimmune thyroid disease (AITD) are suggested to be thyroid cancer promoting factors but have not been well controlled in previous studies. We designed the present study to evaluate whether serum vitamin D levels are associated with thyroid cancer in euthyroid patients with no clinical evidence of AITD. METHODS This cross-sectional study included subjects who underwent routine health check-ups, including serum 25-hydroxy vitamin D3 (25(OH)D3) levels, anti-thyroid peroxidase antibody (TPO-Ab), and thyroid ultrasonography (US). Inclusion criteria were euthyroid, negative TPO-Ab, and no evidence of AITD by US findings. Thyroid cancer diagnoses were based on fine needle aspiration cytology and/or postsurgical histopathological findings. RESULTS We enrolled 5,186 subjects (64% male, 37% female) in this study, including 53 patients (1%) with a diagnosis of thyroid cancer (33 males, 20 females). Mean 25(OH)D3 levels were similar between the thyroid cancer and control groups (p = 0.20). Subgroup analysis according to sex or seasonal variation also revealed no differences in 25(OH)D3 levels between the two groups. Based on the levels of 25(OH)D3, there was no significant difference in the prevalence of thyroid cancer; the prevalence was 0.71%, 0.94%, 1.40%, and 0.82% in the deficient, insufficient, sufficient, and excess groups, respectively (p = 0.64). CONCLUSIONS The levels of serum 25(OH)D3 are not associated with thyroid cancer prevalence in euthyroid subjects with no clinical evidence of AITD.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Tae Yong Kim, M.D. Division of Endocrinology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3249 Fax: +82-2-3010-6962 E-mail:
| | - Sung Jin Bae
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Kyung Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Min Han
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Platz EA. Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes. Epidemiol Rev 2017; 39:1-10. [PMID: 28460082 PMCID: PMC5868280 DOI: 10.1093/epirev/mxx009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 12/14/2022] Open
Abstract
"Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers). Authors discuss policies, systems, and environment (PSE) changes that may be supported by epidemiologic evidence, for example, how existing public health and clinical policies and guidelines targeting noncancer outcomes may indirectly reduce cancer burden and how some cancer control policies could be refined to enhance effectiveness. Authors also discuss where systems and environment changes are necessary to ensure routine implementation of up-to-date, evidence-based policies and guidelines. Two other articles discuss infrastructure to support identification of existing and emerging cancer problems that could be reduced or avoided, including by PSE changes. These frameworks may guide impactful cancer research relevant to cancer centers' catchment areas, as well as cancer control efforts in countries where noncommunicable diseases including cancer are on the rise. The weight of the evidence of these reviews supports opportunities for PSE changes and infrastructure that could reduce the cancer burden in populations.
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Affiliation(s)
- Elizabeth A. Platz
- Correspondence to Dr. Elizabeth A. Platz, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E6132, Baltimore, MD 21205 (e-mail: )
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Vitamin D and spinal cord injury: should we care? Spinal Cord 2016; 54:1060-1075. [PMID: 27645263 DOI: 10.1038/sc.2016.131] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 07/26/2016] [Accepted: 08/11/2016] [Indexed: 12/18/2022]
Abstract
STUDY DESIGN Narrative review. OBJECTIVES This review provides an overview of the etiological factors and consequences of vitamin D insufficiency in relation to spinal cord injury (SCI) as well as important considerations for vitamin D supplementation. SETTING Montreal, Canada. METHODS Literature search. RESULTS Vitamin D insufficiency is common in SCI individuals owing to the presence of many contributing factors including limited sun exposure and intake, use of medication and endocrine perturbations. Although there are several biological plausible mechanisms by which vitamin D may act upon musculoskeletal and cardiometabolic health, the impact of vitamin D insufficiency on such systems remains ill defined in SCI. In the absence of guidelines for the management of vitamin D insufficiency in this high-risk population and in an attempt to provide clinical guidance, considerations for vitamin D supplementation such as the type of vitamin D, dosing regimens and toxicity are discussed and tentative recommendations suggested with particular reference to issues faced by SCI patients. CONCLUSION Although high rates of vitamin D insufficiency are encountered in SCI individuals, its consequences and the amount of vitamin D required to prevent insufficiency are still unknown, indicating a need for more intervention studies with well-defined outcome measures. Routine screening and monitoring of vitamin D as well as treatment of suboptimal status should be instituted in both acute and chronic setting. The close interactions between vitamin D and related bone minerals should be kept in mind when supplementing SCI individuals, and practices should be individualized with clinical conditions.
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Xiao AY, Tan MLY, Wu LM, Asrani VM, Windsor JA, Yadav D, Petrov MS. Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol 2016; 1:45-55. [PMID: 28404111 DOI: 10.1016/s2468-1253(16)30004-8] [Citation(s) in RCA: 379] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is a lack of robust estimates of the worldwide incidence and mortality of acute pancreatitis, chronic pancreatitis, pancreatic cysts, and pancreatic cancer in the general population. Our aim was to quantitate and compare the incidence and mortality of major pancreatic diseases in high-quality population-based cohort studies. METHODS Three databases (PubMed, Embase, and Scopus) were searched independently by two reviewers. Data from eligible studies were subject to meta-analysis to obtain global estimates. A number of prespecified subgroup analyses and meta-regression analyses were also done. FINDINGS 48 population-based cohort studies (35 on pancreatic cancer, ten on acute pancreatitis, three on chronic pancreatitis, and none on pancreatic cysts) were identified, with a total study population of 296 million individuals and 119 000 patients with pancreatic diseases. Global estimates of incidence and mortality were 8·14 cases (95% CI 6·63-9·98) per 100 000 person-years and 6·92 deaths (95% CI 3·72-12·89) per 100 000 person-years for pancreatic cancer, 33·74 cases (95% CI 23·33-48·81) per 100 000 person-years and 1·60 deaths (95% CI 0·85-1·58) per 100 000 person-years for acute pancreatitis, and 9·62 cases (95% CI 7·86-11·78) per 100 000 person-years and 0·09 deaths (95% CI 0·02-0·47) per 100 000 person-years for chronic pancreatitis. Subgroup analysis based on the WHO regions showed that the incidences of both pancreatic cancer and acute pancreatitis, and mortality from pancreatic cancer, were significantly higher in the American region than in the European and Western Pacific regions, while the incidence of chronic pancreatitis was significantly higher in the European region than in the American region. Mortality from pancreatic cancer was lowest in the Southeast Asian region. The incidence of chronic pancreatitis was twice as high in men as in women, although there was no difference between sexes for pancreatic cancer or acute pancreatitis. INTERPRETATION Globally, acute pancreatitis is the most common pancreatic disease whilst pancreatic cancer is the most lethal. However, their burden is not equal across the globe. The epidemiological estimates reported in this study could inform future high-quality studies. FUNDING None.
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Affiliation(s)
- Amy Y Xiao
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Marianne L Y Tan
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Landy M Wu
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Varsha M Asrani
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - John A Windsor
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Maxim S Petrov
- Department of Surgery, University of Auckland, Auckland, New Zealand.
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Yuan C, Qian ZR, Babic A, Morales-Oyarvide V, Rubinson DA, Kraft P, Ng K, Bao Y, Giovannucci EL, Ogino S, Stampfer MJ, Gaziano JM, Sesso HD, Buring JE, Cochrane BB, Chlebowski RT, Snetselaar LG, Manson JE, Fuchs CS, Wolpin BM. Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival. J Clin Oncol 2016; 34:2899-905. [PMID: 27325858 DOI: 10.1200/jco.2015.66.3005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Although vitamin D inhibits pancreatic cancer proliferation in laboratory models, the association of plasma 25-hydroxyvitamin D [25(OH)D] with patient survival is largely unexplored. PATIENTS AND METHODS We analyzed survival among 493 patients from five prospective US cohorts who were diagnosed with pancreatic cancer from 1984 to 2008. We estimated hazard ratios (HRs) for death by plasma level of 25(OH)D (insufficient, < 20 ng/mL; relative insufficiency, 20 to < 30 ng/mL; sufficient ≥ 30 ng/mL) by using Cox proportional hazards regression models adjusted for age, cohort, race and ethnicity, smoking, diagnosis year, stage, and blood collection month. We also evaluated 30 tagging single-nucleotide polymorphisms in the vitamin D receptor gene, requiring P < .002 (0.05 divided by 30 genotyped variants) for statistical significance. RESULTS Mean prediagnostic plasma level of 25(OH)D was 24.6 ng/mL, and 165 patients (33%) were vitamin D insufficient. Compared with patients with insufficient levels, multivariable-adjusted HRs for death were 0.79 (95% CI, 0.48 to 1.29) for patients with relative insufficiency and 0.66 (95% CI, 0.49 to 0.90) for patients with sufficient levels (P trend = .01). These results were unchanged after further adjustment for body mass index and history of diabetes (P trend = .02). The association was strongest among patients with blood collected within 5 years of diagnosis, with an HR of 0.58 (95% CI, 0.35 to 0.98) comparing patients with sufficient to patients with insufficient 25(OH)D levels. No single-nucleotide polymorphism at the vitamin D receptor gene met our corrected significance threshold of P < .002; rs7299460 was most strongly associated with survival (HR per minor allele, 0.80; 95% CI, 0.68 to 0.95; P = .01). CONCLUSION We observed longer overall survival in patients with pancreatic cancer who had sufficient prediagnostic plasma levels of 25(OH)D.
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Affiliation(s)
- Chen Yuan
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Zhi Rong Qian
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Ana Babic
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Vicente Morales-Oyarvide
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Douglas A Rubinson
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Peter Kraft
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Kimmie Ng
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Ying Bao
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Edward L Giovannucci
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Shuji Ogino
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Meir J Stampfer
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - John Michael Gaziano
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Howard D Sesso
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Julie E Buring
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Barbara B Cochrane
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Rowan T Chlebowski
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Linda G Snetselaar
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - JoAnn E Manson
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Charles S Fuchs
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
| | - Brian M Wolpin
- Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA.
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Camara SN, Yin T, Yang M, Li X, Gong Q, Zhou J, Zhao G, Yang ZY, Aroun T, Kuete M, Ramdany S, Camara AK, Diallo AT, Feng Z, Ning X, Xiong JX, Tao J, Qin Q, Zhou W, Cui J, Huang M, Guo Y, Gou SM, Wang B, Liu T, Olivier OET, Conde T, Cisse M, Magassouba AS, Ballah S, Keita NLM, Souare IS, Toure A, Traore S, Balde AK, Keita N, Camara ND, Emmanuel D, Wu HS, Wang CY. High risk factors of pancreatic carcinoma. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2016; 36:295-304. [PMID: 27376795 DOI: 10.1007/s11596-016-1583-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/15/2016] [Indexed: 12/20/2022]
Abstract
Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.
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Affiliation(s)
- Soriba Naby Camara
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Yin
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ming Yang
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiang Li
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qiong Gong
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Zhou
- Department of Breast and Thyroid Surgery, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Gang Zhao
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhi-Yong Yang
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tajoo Aroun
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Martin Kuete
- Department of Planning Family and Reproductive Institute, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sonam Ramdany
- Department of General Medicine, Sir Seewoosagur Ramgoolam National Hospital of Pamplemousses, Mauritius, 21017, Mauritius
| | | | - Aissatou Taran Diallo
- Department of General Surgery, National Hospital of Ignace Deen, Conakry, 1147, Guinea
| | - Zhen Feng
- Department of Gastroenterology and Hepatology, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xin Ning
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jiong-Xin Xiong
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Tao
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qi Qin
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wei Zhou
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Cui
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Min Huang
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yao Guo
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shan-Miao Gou
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Bo Wang
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Liu
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ohoya Etsaka Terence Olivier
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tenin Conde
- Department of Thoracic Surgery, National Hospital of Donka, Conakry, Guinea
| | - Mohamed Cisse
- Department of Dermatology, National Hospital of Donka, Conakry, Guinea
| | | | - Sneha Ballah
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Naby Laye Moussa Keita
- Department of Biochemistry, University Gamal Abdel Nasser of Conakry, Conakry, 1147, Guinea
| | - Ibrahima Sory Souare
- Department of Neurosurgery, Friendship Hospital Sino-Guinea of Kipe, Conakry, Guinea
| | - Aboubacar Toure
- Department of General Surgery, National Hospital of Ignace Deen, Conakry, 1147, Guinea
| | - Sadamoudou Traore
- Department of Medical Imaging, Good Shepherd Medical Center, The University of Texas, Longview, 75601, USA
| | | | - Namory Keita
- Department of Gynecology and Obstetrics, National Hospital of Donka, Conakry, Guinea
| | - Naby Daouda Camara
- Department of General Surgery, National Hospital of Ignace Deen, Conakry, 1147, Guinea
| | - Dusabe Emmanuel
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - He-Shui Wu
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chun-You Wang
- Department of General Surgery, Pancreatic Disease Institute, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Abstract
Vitamin D has taken a center-stage role in our basic and population research quest for the panacea for all human maladies, including cancer, yet sufficient evidence for a beneficial role has existed only for bone health. This Commentary discusses and places into a broader context the report of Chandler and colleagues that found a protective association for higher vitamin D status in colorectal cancer in women, consistent with most other cohort studies but not with limited supplementation trial data. Little human evidence exists for the preventive potential in other malignancies, including breast cancer, with the exception of possible benefit in bladder cancer and an adverse serologic association with prostate cancer (pancreatic cancer risk may be similarly influenced) that is supported by vitamin D genetic data. Current vitamin D trials are examining high-dose supplementation (i.e., 1,600-3,333 IU daily) for effects on multiple outcomes, but they may not have sufficient power to test efficacy in colorectal or other specific malignancies and are unlikely to inform any benefit for higher physiologic levels. A more complete understanding of vitamin D and human carcinogenesis will come from multifaceted lines of research, including elucidation of organ site-specific biologic mechanisms, prospective serologic analyses, testing of vitamin D-related genetic variation, and short-term clinical-metabolic biomarker studies of multidose vitamin D supplementation, including metabolomic profiling of controlled supplementation in these and past or ongoing trials.
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Affiliation(s)
- Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
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Epidemiology and Inherited Predisposition for Sporadic Pancreatic Adenocarcinoma. Hematol Oncol Clin North Am 2016; 29:619-40. [PMID: 26226901 DOI: 10.1016/j.hoc.2015.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Given the changing demographics of Western populations, the numbers of pancreatic cancer cases are projected to increase during the next decade. Diabetes, recent cigarette smoking, and excess body weight are the cancer's most consistent risk factors. The search for common and rare germline variants that influence risk of pancreatic cancer through genome-wide association studies and high-throughput-sequencing-based studies is underway and holds the promise of increasing the knowledge of variants and genes that play a role in inherited susceptibility of this disease. Research reported in this review has advanced the understanding of pancreatic cancer.
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McGovern EM, Lewis ME, Niesley ML, Huynh N, Hoag JB. Retrospective analysis of the influence of 25-hydroxyvitamin D on disease progression and survival in pancreatic cancer. Nutr J 2016; 15:17. [PMID: 26867933 PMCID: PMC4751746 DOI: 10.1186/s12937-016-0135-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/03/2016] [Indexed: 02/08/2023] Open
Abstract
Background Vitamin D deficiency is implicated in neoplastic processes in multiple organs, including the pancreas. While animal and human data have established a relationship between serum vitamin D (25(OH)D) and the development of pancreatic cancer, few studies have examined the effects of 25(OH)D on time to progression (TTP) and overall survival (OS) in this patient population. We hypothesize that lower baseline serum concentrations (BSC) of 25(OH)D will be associated with decreased TTP and OS. Methods This retrospective analysis of 1222 patients with pancreatic cancer aims to identify potential relationships between 25(OH)D and both TTP and OS, while controlling for the effects of ethnicity and body mass index (BMI). Baseline 25(OH)D was divided into quartiles defined as deficient (<20 ng/mL), insufficient (20–39 ng/mL), sufficient (40–59 ng/mL), and optimal (≥60 ng/ml). Statistical significance was declared if the two-sided p-value was ≤ 0.05. Results For the 627 subjects included for analysis, the median 25(OH)D was 27 ng/mL (range 4 to 114), 30.0 % were 25(OH)D deficient (<20 ng/mL), and 47.2 % were insufficient (20–39 ng/mL). Ethnicity (p < 0.0001) and BMI (p = 0.05) were significantly associated with (BSC)of 25(OH)D, while TTP (p = 0.39) and OS (p = 0.37) were not associated. Conclusion Suboptimal vitamin D levels (<60 ng/mL) occurred in 96 % of patients analyzed. Both ethnicity and BMI were statistically significantly associated with vitamin D deficiency and insufficiency. Similar to results previously reported in the literature, this analysis did not identify a significant association between BSC of 25(OH)D and OS or TTP in patients with pancreatic cancer.
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Affiliation(s)
- Erica M McGovern
- Department of Clinical Research, Cancer Treatment Centers of America® at Eastern Regional Medical Center, 1331 E. Wyoming Ave, Philadelphia, PA, 19124, USA
| | - Mark E Lewis
- Department of Clinical Research, Cancer Treatment Centers of America® at Eastern Regional Medical Center, 1331 E. Wyoming Ave, Philadelphia, PA, 19124, USA.
| | - Michelle L Niesley
- Department of Clinical Research, Cancer Treatment Centers of America® at Eastern Regional Medical Center, 1331 E. Wyoming Ave, Philadelphia, PA, 19124, USA
| | - Nhu Huynh
- Department of Nutrition, Cancer Treatment Centers of America® at Eastern Regional Medical Center, 1331 E. Wyoming Ave, Philadelphia, PA, 19124, USA
| | - Jeffrey B Hoag
- Department of Pulmonary and Critical Care Medicine, Cancer Treatment Centers of America® at Eastern Regional Medical Center, 1331 E. Wyoming Ave, Philadelphia, PA, 19124, USA
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Garland CF, Cuomo RE, Gorham ED, Zeng K, Mohr SB. Cloud cover-adjusted ultraviolet B irradiance and pancreatic cancer incidence in 172 countries. J Steroid Biochem Mol Biol 2016; 155:257-63. [PMID: 25864626 DOI: 10.1016/j.jsbmb.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 03/24/2015] [Accepted: 04/04/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Controversy exists regarding whether vitamin D deficiency could influence the etiology of pancreatic cancer. Several cohort studies have found that high serum 25-hydroxyvitamin D [25(OH)D] concentrations are associated with low risk of pancreatic cancer, while others have not. HYPOTHESIS Low ultraviolet B irradiance is associated with high incidence of pancreatic cancer. METHODS Age-standardized pancreatic cancer incidence rates were obtained from GLOBOCAN in 2008. The association between cloud-adjusted UVB irradiance and age-standardized incidence rates of pancreatic cancer was analyzed using regression. RESULTS Overall, the lower the cloud-adjusted UVB irradiance, the higher the incidence rate of pancreatic cancer. Residents of countries with low UVB irradiance had approximately 6 times the incidence rates as those in countries with high UVB irradiance (p<0.0001 for males and p<0.0001 for females). This association persisted after adjustment for traditional risk factors of pancreatic cancer (p=0.0182 for males and p=0.0029 for females). CONCLUSIONS There was an inverse association of cloud-adjusted UVB irradiance with incidence of pancreatic cancer that persisted after adjustment. This result is consistent with an inverse association of overall vitamin D deficiency in countries with lower UVB irradiance with risk of pancreatic cancer. Further research on the role of 25(OH)D in reduction of pancreatic cancer in individuals would be desirable to expand the limited avenues available for prevention of this highly fatal disease. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.
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Affiliation(s)
- Cedric F Garland
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Raphael E Cuomo
- Division of Global Health, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA; Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Edward D Gorham
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Kenneth Zeng
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
| | - Sharif B Mohr
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, La Jolla, CA, USA
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Chiang KC, Yen CL, Yeh CN, Hsu JT, Chen LW, Kuo SF, Wang SY, Sun CC, Kittaka A, Chen TC, Yeh TS, Hsu SY, Juang HH. Hepatocellular carcinoma cells express 25(OH)D-1α-hydroxylase and are able to convert 25(OH)D to 1α,25(OH)₂D, leading to the 25(OH)D-induced growth inhibition. J Steroid Biochem Mol Biol 2015; 154:47-52. [PMID: 26170242 DOI: 10.1016/j.jsbmb.2015.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/14/2015] [Accepted: 06/16/2015] [Indexed: 01/06/2023]
Abstract
Hepatocellular carcinoma (HCC) is the most diagnosed liver cancer without effective treatments available for advanced HCC. Vitamin D is getting popular due to its anti-cancer characteristics. However, the clinical application of 1α,25(OH)2D, the active form of vitamin, is hampered by its hypercalcemia side effect. 1α,25(OH)2D is converted from 25(OH)D, the index of serum vitamin D status, by CYP27B1, which is originally found in kidneys but recently detected in non-renal tissues. 25(OH)D has been shown to repress some cancers expressing CYP27B1 due to the local conversion of 25(OH)D to 1α,25(OH)2D, which works in a intra-, auto-, or paracrine manner and thus minimizes the risk of hypercalcemia. In this study, we found CYP27B1 expression in human hepatocyte, HCC, and HepG2 cells. As we treated HepG2 cells with 25(OH)D, the 1α,25(OH)2D target gene CYP24A1 expression was increased and was further upregulated as CYP27B1 transfection or downregulated as CYP27B1 knockdown. Other 1α,25(OH)2D target genes in HepG2 cells, p21 and p27 were also stimulated by 25(OH)D after CYP27B1 transfection. Further, 25(OH)D could inhibit HepG2 cells growth, which was potentiated by CYP27B1 transfection. Collectively, we showed for the first time that HCC expressed CYP27B1 and was able to covert 25(OH)D to 1α,25(OH)2D in vitro, thus responsive to 25(OH)D treatment. Our data justifies the application of 25(OH)D and CYP27B1 gene transfection therapy in further HCC treatment studies.
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Affiliation(s)
- Kun-Chun Chiang
- General Surgery Department, Chang Gung Memorial Hospital, Chang Gung University, Keelung 204, Taiwan, ROC
| | - Cho-Li Yen
- Gastroenterology Department, Chang Gung Memorial Hospital, Chang Gung University, Keelung 204, Taiwan, ROC
| | - Chun-Nan Yeh
- General Surgery Department, Chang Gung Memorial Hospital, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan, ROC
| | - Jun-Te Hsu
- General Surgery Department, Chang Gung Memorial Hospital, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan, ROC
| | - Li-Wei Chen
- Gastroenterology Department, Chang Gung Memorial Hospital, Chang Gung University, Keelung 204, Taiwan, ROC
| | - Sheng-Fong Kuo
- Department of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan, ROC
| | - Shang-Yu Wang
- General Surgery Department, Chang Gung Memorial Hospital, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan, ROC
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan, ROC
| | - Atsushi Kittaka
- Faculty of Pharmaceutical Sciences, Teikyo University, 2-11-1 Kaga, Itabashi, Tokyo, Japan
| | - Tai C Chen
- Boston University School of Medicine, Boston, MA 02118, USA
| | - Ta-Sen Yeh
- General Surgery Department, Chang Gung Memorial Hospital, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan, ROC
| | - Shu-Yuan Hsu
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, TaoYuan, Taiwan, ROC
| | - Horng-Heng Juang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, TaoYuan, Taiwan, ROC.
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46
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Barreto SG, Neale RE. Vitamin D and pancreatic cancer. Cancer Lett 2015; 368:1-6. [DOI: 10.1016/j.canlet.2015.06.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/04/2015] [Accepted: 06/25/2015] [Indexed: 12/17/2022]
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Davis-Yadley AH, Malafa MP. Vitamins in pancreatic cancer: a review of underlying mechanisms and future applications. Adv Nutr 2015; 6:774-802. [PMID: 26567201 PMCID: PMC4642423 DOI: 10.3945/an.115.009456] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although there is increasing evidence that vitamins influence pancreatic adenocarcinoma biology and carcinogenesis, a comprehensive review is lacking. In this study, we performed a PubMed literature search to review the anticancer mechanisms and the preclinical and clinical studies that support the development of the bioactive vitamins A, C, D, E, and K in pancreatic cancer intervention. Preclinical studies have shown promising results for vitamin A in pancreatic cancer prevention, with clinical trials showing intriguing responses in combination with immunotherapy. For vitamin C, preclinical studies have shown slower tumor growth rates and/or increased survival when used alone or in combination with gemcitabine, with clinical trials with this combination revealing decreased primary tumor sizes and improved performance status. Preclinical studies with vitamin D analogues have shown potent antiproliferative effects and repression of migration and invasion of pancreatic cancer cells, with a clinical trial showing increased time to progression when calciferol was added to docetaxel. For vitamin E, preclinical studies have shown that δ-tocotrienol and γ-tocotrienol inhibited tumor cell growth and survival and augmented gemcitabine activity. Early-phase clinical trials with δ-tocotrienol are ongoing. Vitamin K demonstrates activation of apoptosis and inhibition of cellular growth in pancreatic tumor cells; however, there are no clinical studies available for further evaluation. Although preclinical and clinical studies are encouraging, randomized controlled trials with endpoints based on insights gained from mechanistic and preclinical studies and early-phase clinical trials are required to determine the efficacy of bioactive vitamin interventions in pancreatic cancer.
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Affiliation(s)
- Ashley H Davis-Yadley
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL; and Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mokenge P Malafa
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Vitamin D, Essential Minerals, and Toxic Elements: Exploring Interactions between Nutrients and Toxicants in Clinical Medicine. ScientificWorldJournal 2015; 2015:318595. [PMID: 26347061 PMCID: PMC4539504 DOI: 10.1155/2015/318595] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 07/12/2015] [Indexed: 11/18/2022] Open
Abstract
In clinical medicine, increasing attention is being directed towards the important areas of nutritional biochemistry and toxicant bioaccumulation as they relate to human health and chronic disease. Optimal nutritional status, including healthy levels of vitamin D and essential minerals, is requisite for proper physiological function; conversely, accrual of toxic elements has the potential to impair normal physiology. It is evident that vitamin D intake can facilitate the absorption and assimilation of essential inorganic elements (such as calcium, magnesium, copper, zinc, iron, and selenium) but also the uptake of toxic elements (such as lead, arsenic, aluminum, cobalt, and strontium). Furthermore, sufficiency of essential minerals appears to resist the uptake of toxic metals. This paper explores the literature to determine a suitable clinical approach with regard to vitamin D and essential mineral intake to achieve optimal biological function and to avoid harm in order to prevent and overcome illness. It appears preferable to secure essential mineral status in conjunction with adequate vitamin D, as intake of vitamin D in the absence of mineral sufficiency may result in facilitation of toxic element absorption with potential adverse clinical outcomes.
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Piper MR, Freedman DM, Robien K, Kopp W, Rager H, Horst RL, Stolzenberg-Solomon RZ. Vitamin D-binding protein and pancreatic cancer: a nested case-control study. Am J Clin Nutr 2015; 101:1206-15. [PMID: 25904602 PMCID: PMC4441803 DOI: 10.3945/ajcn.114.096016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 03/16/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vitamin D-binding protein (DBP) is the primary carrier of 25-hydroxyvitamin D [25(OH)D] in the circulation. One prospective study in male smokers found a protective association between DBP and pancreatic cancer, particularly among men with higher 25(OH)D concentrations. OBJECTIVE The objective was to examine the association between DBP and pancreatic cancer risk in an American population. DESIGN We conducted a nested case-control study in the Prostate, Lung, Colorectal, and Ovarian Cancer screening trial cohort of men and women aged 55-74 y at baseline. Between 1993 and 2010, 295 incident pancreatic adenocarcinoma cases were reported (follow-up to 15.1 y). Two controls (n = 590) were matched to each case by age, race, sex, and month of blood draw. We calculated smoking- and diabetes-adjusted ORs and 95% CIs with the use of conditional logistic regression. RESULTS DBP concentration was not significantly associated with pancreatic cancer overall [highest (≥7149.4 nmol/L) vs. lowest (<3670.4 nmol/L) quintile; OR: 1.75; 95% CI: 0.91, 3.37; P-trend = 0.25]. For serum 25(OH)D compared with the referent (50 to <75 nmol/L), individuals in the highest group had a significantly higher risk (≥100 nmol/L; OR: 3.23; 95% CI: 1.24, 8.44), whereas those in the lowest group had no significant association (<25 nmol/L; OR: 2.50; 95% CI: 0.92, 6.81). Further adjustment for DBP did not alter this association. CONCLUSION Our results do not support the hypothesis that serum DBP or 25(OH)D plays a protective role in pancreatic cancer. This trial was registered at clinicaltrials.gov as NCT00339495.
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Affiliation(s)
- Marina R Piper
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - D Michal Freedman
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Kim Robien
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - William Kopp
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Helen Rager
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Ronald L Horst
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Rachael Z Stolzenberg-Solomon
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH).
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Evliyaoğlu O, Acar M, Özcabı B, Erginöz E, Bucak F, Ercan O, Kucur M. Vitamin D Deficiency and Hashimoto's Thyroiditis in Children and Adolescents: a Critical Vitamin D Level for This Association? J Clin Res Pediatr Endocrinol 2015; 7:128-33. [PMID: 26316435 PMCID: PMC4563184 DOI: 10.4274/jcrpe.2011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Vitamin D has been suggested to be active as an immunomodulator in autoimmune diseases such as Hashimoto's thyroiditis (HT). The goal of the present study was to investigate the vitamin D status in HT patients. METHODS This prevalence case-control study was conducted on 90 patients with HT (of ages 12.32 ± 2.87 years) and 79 age-matched healthy controls (11.85 ± 2.28 years). Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured in all 169 subjects. RESULTS The prevalence of vitamin D deficiency in HT patients (64 of 90; 71.1%) was significantly higher than that in the control group (41 of 79; 51.9%) (p=0.025). Mean serum 25(OH)D3 level in the HT group was significantly lower compared to the control group (16.67 ± 11.65 vs. 20.99 ± 9.86 ng/mL, p=0.001). HT was observed 2.28 times more frequently in individuals with 25(OH)D3 levels <20 ng/mL (OR: 2.28, CI: 1.21-4.3). CONCLUSION Vitamin D deficiency is associated with HT in children and adolescents. Levels lower than 20 ng/mL seem to be critical. The mechanism for this association is not clear.
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Affiliation(s)
- Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 533 633 15 64 E-mail:
| | - Manolya Acar
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Ethem Erginöz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Public Health, İstanbul, Turkey
| | - Feride Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Mine Kucur
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Biochemistry, İstanbul, Turkey
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