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L’Espérance K, Datta GD, Qureshi S, Koushik A. Vitamin D Exposure and Ovarian Cancer Risk and Prognosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041168. [PMID: 32059597 PMCID: PMC7068491 DOI: 10.3390/ijerph17041168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Abstract
Given the poor prognosis of ovarian cancer and limited population-level strategies for early detection and long-term treatment success, knowledge of modifiable risk factors for prevention and improved prognosis is important. Vitamin D has received wide scientific interest in cancer research as having the potential to be one such factor. We carried out a systematic narrative review of the literature on vitamin D and ovarian cancer risk and survival. We included 17 case-control and cohort studies on ovarian cancer incidence. Five analyses were of sun exposure, among which three reported an inverse association. Of 11 analyses of dietary vitamin D, two reported an inverse association. Among five studies of 25(OH)D levels, an inverse association was reported in two. Across all studies the findings were inconsistent, but some recent studies have suggested that vitamin D exposure at earlier ages may be important. Only three studies examining vitamin D exposure in relation to survival among ovarian cancer survivors were identified and the findings were inconsistent. The evidence to date supports a null influence of vitamin D on both ovarian cancer risk and survival. Future research should ensure that exposure assessment captures vitamin D exposure from all sources and for the etiologically or prognostically pertinent period.
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Affiliation(s)
- Kevin L’Espérance
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Geetanjali D. Datta
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Samia Qureshi
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
- Correspondence: ; Tel.: +514-890-8000-15915
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Predicting serum vitamin D concentrations based on self-reported lifestyle factors and personal attributes. Br J Nutr 2018; 120:803-812. [PMID: 30079855 DOI: 10.1017/s000711451800199x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Evidence supports the role of vitamin D in various conditions of development and ageing. Serum 25-hydroxyvitamin D (25(OH)D) is the best indicator for current vitamin D status. However, the cost of its measurement can be prohibitive in epidemiological research. We developed and validated multivariable regression models that quantified the relationships between vitamin D determinants, measured through an in-person interview, and serum 25(OH)D concentrations. A total of 200 controls participating in a population-based case-control study in Montreal, Canada, provided a blood specimen and completed an in-person interview on socio-demographic, reproductive, medical and lifestyle characteristics and personal attributes. Serum 25(OH)D concentrations were quantified by liquid chromatography-tandem MS. Multivariable least squares regression was used to build models that predict 25(OH)D concentrations from interview responses. We assessed high-order effects, performed sensitivity analysis using the lasso method and conducted cross-validation of the prediction models. Prediction models were built for users and non-users of vitamin D supplements separately. Among users, alcohol intake, outdoor time, sun protection, dose of supplement use, menopausal status and recent vacation were predictive of 25(OH)D concentrations. Among non-users, BMI, sun sensitivity, season and recent vacation were predictive of 25(OH)D concentrations. In cross-validation, 46-47 % of the variation in 25(OH)D concentrations were explained by these predictors. In the absence of 25(OH)D measures, our study supports that predicted 25(OH)D scores may be used to assign exposure in epidemiological studies that examine vitamin D exposure.
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Mansuri S, Badawi A, Kayaniyil S, Cole DE, Harris SB, Mamakeesick M, Wolever T, Gittelsohn J, Maguire JL, Connelly PW, Zinman B, Hanley AJ. Traditional foods and 25(OH)D concentrations in a subarctic First Nations community. Int J Circumpolar Health 2017; 75:31956. [PMID: 28156417 PMCID: PMC5035507 DOI: 10.3402/ijch.v75.31956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Sub-optimal vitamin D status is common worldwide and the condition may be associated with increased risk for various chronic diseases. In particular, low vitamin D status is highly prevalent in indigenous communities in Canada, although limited data are available on the determinants of serum 25-hydroxyvitamin D (25(OH)D) concentrations in this population. The relationship between traditional food consumption and vitamin D status has not been well documented. Objective To investigate the determinants of serum 25(OH)D status in a First Nations community in Ontario, Canada, with a focus on the role of traditional food consumption and activities. Methods A cross-sectional analysis was conducted within the Sandy Lake Health and Diabetes Project (2003–2005). A total of 445 participants (>12 years of age) were assessed for serum 25(OH)D status, anthropometric and lifestyle variables, including traditional and non-traditional dietary practices and activities. Diet patterns were identified using factor analysis, and multivariate linear regression analysis was used to analyse the determinants of 25(OH)D concentrations. Results Mean serum 25(OH)D concentrations were 22.1 nmol/L (16.9, 29.9 nmol/L) in men and 20.5 nmol/L (16.0, 27.3 nmol/L) in women. Multivariate determinants of higher serum 25(OH)D included higher consumption of traditional and healthier market foods, higher wild fish consumption, male gender, spring/summer season of blood collection and more frequent physical activity. Significant negative determinants included hours of TV/day, higher BMI and higher consumption of unhealthy market foods. Conclusions Traditional food consumption contributed independently to higher 25(OH)D concentrations in a First Nations community with a high prevalence of sub-optimal vitamin D status.
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Affiliation(s)
- Sudaba Mansuri
- a Department of Nutritional Sciences University of Toronto , Toronto , ON , Canada
| | - Alaa Badawi
- b Office of Biotechnology Genomics and Population Health, Public Health Agency of Canada , Toronto , ON , Canada
| | - Sheena Kayaniyil
- a Department of Nutritional Sciences University of Toronto , Toronto , ON , Canada
| | - David E Cole
- c Sunnybrook Research Institute Sunnybrook Health Sciences Centre , Toronto , ON , Canada
| | - Stewart B Harris
- d Center for Studies in Family Medicine Schulich School of Medicine and Dentistry, University of Western Ontario , London , ON , Canada
| | - Mary Mamakeesick
- e Sandy Lake Health and Diabetes Project Sandy Lake , ON , Canada
| | - Thomas Wolever
- a Department of Nutritional Sciences University of Toronto , Toronto , ON , Canada
| | - Joel Gittelsohn
- f Johns Hopkins Bloomberg School of Public Health Johns Hopkins University , Baltimore , MD , USA
| | - Jonathon L Maguire
- g Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto , ON , Canada
| | - Philip W Connelly
- g Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto , ON , Canada
| | - Bernard Zinman
- h Lunenfeld-Tanenbaum Research Institute Mount Sinai Hospital , Toronto , ON , Canada
| | - Anthony J Hanley
- a Department of Nutritional Sciences University of Toronto , Toronto , ON , Canada
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Knight JA, Wong J, Cole DEC, Lee TK, Parra EJ. Predictors of 25-Hydroxyvitamin D Concentration Measured at Multiple Time Points in a Multiethnic Population. Am J Epidemiol 2017; 186:1180-1193. [PMID: 28549072 PMCID: PMC5859989 DOI: 10.1093/aje/kwx180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/13/2016] [Accepted: 01/09/2017] [Indexed: 12/17/2022] Open
Abstract
The evidence for a relationship between serum vitamin D levels and nonskeletal health outcomes is inconsistent. The validity of single or predicted measurements of 25-hydroxyvitamin D (25(OH)D) concentration is unknown, as levels of this biomarker are highly seasonally variable. We compared models of 25(OH)D measured at baseline, at multiple time points throughout the year, and averaged over the year among 309 persons in Toronto, Ontario, Canada (43°N latitude) during 2009-2013. Information and blood samples were collected every 2 months. Baseline and average 25(OH)D concentrations were correlated (r = 0.88). Major factors associated with 25(OH)D level were similar across models and included race/ethnicity (concentrations in non-European groups were lower than those in Europeans), vitamin D supplement use of ≥1,000 IU/day (18.9 nmol/L (95% confidence interval (CI): 16.1, 21.8) vs. no supplement use in a full data set with all factors), and the presence of the group-specific component/vitamin D binding protein gene (GC/DBP) rs4588 functional polymorphism (AA vs. CC: -16.7 nmol/L (95% CI: -26.2, -7.1); CA vs. CC: -10.7 nmol/L (95% CI: -14.9, -6.5)). Most factors had similar associations in Europeans and non-Europeans. Genetic factors may play a greater role in average 25(OH)D concentrations. Prediction models for 25(OH)D are challenging and population-specific, but use of genetic factors along with a few common population-relevant, quantifiable nongenetic factors with strong associations may be the most feasible approach to vitamin D assessment over time.
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Affiliation(s)
- Julia A Knight
- Correspondence to Dr. Julia A. Knight, Prosserman Centre for Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 60 Murray Street, Box 18, Toronto, ON M5T 3L9, Canada (e-mail: )
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Mansuri S, Badawi A, Kayaniyil S, Cole DE, Harris SB, Mamakeesick M, Maguire J, Zinman B, Connelly PW, Hanley AJ. Associations of circulating 25(OH)D with cardiometabolic disorders underlying type 2 diabetes mellitus in an Aboriginal Canadian community. Diabetes Res Clin Pract 2015; 109:440-9. [PMID: 25944538 DOI: 10.1016/j.diabres.2015.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/23/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
Abstract
AIMS To investigate the associations of 25-hydroxyvitamin D (25(OH)D) with insulin resistance (IR), beta-cell function and metabolic syndrome (MetS) in a First Nations population. METHODS We conducted a cross-sectional analysis using data from the Sandy Lake Health and Diabetes Project (2003-2005). A total of 390 participants (>12 y) were assessed for 25(OH)D, fasting glucose, insulin, lipids, blood pressure, inflammatory markers, anthropometric and lifestyle variables and a 75-g oral glucose tolerance test was administered. IR was calculated using the Matsuda insulin sensitivity index (ISOGTT) and the computational homeostasis model assessment of IR (HOMA2-IR). Beta-cell function was calculated using the insulinogenic index (IGI) divided by HOMA-IR (IGI/IR) and the insulin secretion sensitivity index-2 (ISSI-2). The 2009 harmonized criteria were used to define MetS. RESULTS Higher 25(OH)D was associated with a decreased prevalence of dysglycemia (OR = 0.71 95% CI, 0.51-0.97 per SD increase). In addition, there were significant associations of 25(OH)D with measures of insulin action (ISOGTT; beta=0.31; 95% CI, 0.12, 0.49; HOMA2-IR; beta = -29; 95% CI -0.46, -0.11 and beta-cell function (ISSI-2; beta = 0.15; 95% CI, 0.02, 0.28). The prevalence of MetS was 41%. There was a decreased risk (OR=0.73, 95% CI 0.56, 0.94) of MetS per SD increase in baseline 25(OH)D. Finally, there was a significant positive association of 25(OH)D with adiponectin (beta = 0.16; 95% CI = 0.01, 0.31). CONCLUSIONS These results support a potential role for vitamin D metabolism in the natural history of T2DM among Aboriginal Canadians, although carefully designed randomized trials will be required to establish causality.
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Affiliation(s)
- Sudaba Mansuri
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Alaa Badawi
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
| | - Sheena Kayaniyil
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - David E Cole
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Stewart B Harris
- Center for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Jonathon Maguire
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Bernard Zinman
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Philip W Connelly
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.
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Sham L, Yeh EA, Magalhaes S, Parra EJ, Gozdzik A, Banwell B, Hanwell HE. Evaluation of fall Sun Exposure Score in predicting vitamin D status in young Canadian adults, and the influence of ancestry. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 145:25-9. [PMID: 25752862 DOI: 10.1016/j.jphotobiol.2015.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/19/2015] [Accepted: 02/05/2015] [Indexed: 11/17/2022]
Abstract
Query of sun-related habits or ancestry could help screen for risk of vitamin D insufficiency (serum 25-hydroxyvitamin D<75nmol/L). We evaluated the association between Sun Exposure Score (calculated from recall of Time Exposed to Sun and Skin Exposed to Sun in the previous week), demographics and anthropometrics (including self-reported ancestry and skin melanin reflectometry), and serum 25(OH)D levels in healthy young Canadian adults in the Greater Toronto Area (GTA; 43°N) during fall. 310 adults (67% female) of European, East Asian, and South Asian ancestries were evaluated. The median (interquartile range) 25(OH)D level was 49.7nmol/L (36.7-70.3) and 80% of participants were vitamin D insufficient. The vast majority of those of East and South Asian ancestry were vitamin D insufficient (91% and 97%, respectively), as were 55% of those of European ancestry. Sun Exposure Score and 25(OH)D concentrations were not associated after accounting for confounders. A multivariable model showed ancestry, recent summer sun exposure, sex, melanin, vitamin D intake, age and year of study significantly predicted 25(OH)D concentration; ancestry was the strongest independent predictor (adjusted R(2)=43%). Although Sun Exposure Score was not a significant predictor of serum 25(OH)D levels, inquiry of ancestry has potential use in screening for vitamin D insufficiency.
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Affiliation(s)
- Lauren Sham
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - E Ann Yeh
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Magalhaes
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Esteban J Parra
- Department of Anthropology, University of Toronto at Mississauga, Mississauga, Ontario, Canada
| | - Agnes Gozdzik
- Department of Anthropology, University of Toronto at Mississauga, Mississauga, Ontario, Canada
| | - Brenda Banwell
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather E Hanwell
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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Wallingford SC, Jones G, Kobayashi LC, Grundy A, Miao Q, Tranmer J, Aronson KJ. UV and dietary predictors of serum 25-hydroxyvitamin D concentrations among young shift-working nurses and implications for bone density and skin cancer. Public Health Nutr 2014; 17:772-9. [PMID: 23835190 PMCID: PMC10282299 DOI: 10.1017/s1368980013001754] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 05/03/2013] [Accepted: 05/20/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE In 2011, the U.S. Institute of Medicine updated the definition of vitamin D inadequacy to serum 25-hydroxyvitamin D (25(OH)D) concentration of 30-<50 nmol/l and of deficiency to serum 25(OH)D < 30 nmol/l. We describe the prevalence of these conditions according to these definitions, seasonal variation in 25(OH)D and predictors of serum 25(OH)D concentrations among working, white women. DESIGN Participants recorded lifestyle factors and dietary intake and provided fasting blood samples for measurement of serum 25(OH)D in both summer and winter. Predictors of serum 25(OH)D variation were analysed using linear regression and generalized linear mixed models. SETTING Kingston General Hospital in Kingston, Ontario, Canada, from April 2008 to July 2009. SUBJECTS Female premenopausal nurses (n 83) working full-time rotating shifts. RESULTS Deficient or inadequate vitamin D status was observed in 9% of participants following summer/autumn and in 13% following winter/spring. Predictors of serum 25(OH)D concentration were vitamin D supplement use, tanning bed use and season. Tanning bed use increased serum 25(OH)D by 23.24 nmol/l (95% CI 8.78, 37.69 nmol/l, P = 0.002) on average. CONCLUSIONS According to the 2011 Institute of Medicine bone health guidelines, over 10% of nurses had deficient or inadequate vitamin D status following winter. Higher serum concentrations were associated with use of tanning beds and vitamin D supplements. As health promotion campaigns and legal restrictions are successful in reducing tanning bed use among women, our data suggest that increased prevalence of vitamin D inadequacy and deficiency may be a consequence, and that low vitamin D status will need to be countered with supplementation.
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Affiliation(s)
- Sarah C Wallingford
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Lindsay C Kobayashi
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Anne Grundy
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Qun Miao
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Joan Tranmer
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Kristan J Aronson
- Department of Community Health and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
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Jacobs ET, Thomson CA, Flatt SW, Newman VA, Rock CL, Pierce JP. Correlates of 25-hydroxyvitamin D and breast cancer stage in the Women's Healthy Eating and Living Study. Nutr Cancer 2013; 65:188-94. [PMID: 23441606 DOI: 10.1080/01635581.2013.756531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Inverse associations between circulating 25-hydroxyvitamin D [25(OH)D] and breast cancer stage have been reported, thus it is critical to understand the variables that contribute to 25(OH)D levels among women with breast cancer. Among 904 women in the Women's Healthy Eating and Living Study, plasma 25(OH)D concentrations were measured and data on demographic characteristics, diet, physical activity, and tumor characteristics were collected at study entry. Statistically significant associations with 25(OH)D concentrations were observed for body mass index (BMI), body surface area (BSA), height, smoking, total vitamin D intake, physical activity, and race or ethnicity. Of the correlates of 25(OH)D, BMI, BSA, height, physical activity, and study site were associated with stage of breast cancer; however, concentrations of 25(OH)D were not significantly related to stage. In fully adjusted logistic regression models, the ORs (95% CIs) for the association between vitamin D deficiency and Stage II and III cancers were 0.85 (0.59-1.22) and 1.23 (0.71-2.15), respectively (P trend = 0.59), compared to Stage I. This study confirms previous work regarding the correlates of 25(OH)D concentrations but does not provide support for an association between vitamin D status and breast cancer stage.
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Affiliation(s)
- Elizabeth T Jacobs
- Arizona Cancer Center and Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724-5024, USA.
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Yousef FM, Jacobs ET, Kang PT, Hakim IA, Going S, Yousef JM, Al-Raddadi RM, Kumosani TA, Thomson CA. Vitamin D status and breast cancer in Saudi Arabian women: case-control study. Am J Clin Nutr 2013; 98:105-10. [PMID: 23697705 PMCID: PMC3987815 DOI: 10.3945/ajcn.112.054445] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The role of vitamin D in breast cancer prevention is equivocal. Saudi Arabian women may be at greater risk of vitamin D deficiency because of a darker skin type and a greater likelihood of reduced ultraviolet B radiation exposure. Data regarding the vitamin D status of Saudi Arabian women and its relation to breast cancer risk are lacking. OBJECTIVE The purpose of this research was to evaluate the association between circulating concentrations of 25-hydroxyvitamin D [25(OH)D] and breast cancer risk in Saudi Arabian women. DESIGN A case-control study was conducted among 120 breast cancer cases and 120 controls. The study population was drawn from patients admitted to King Fahd Hospital in Jeddah, Saudi Arabia, from June to August 2009. Participants completed questionnaires on diet and medical history, and serum samples were collected from all women to measure circulating 25(OH)D concentrations. RESULTS The participants had a mean age of 47.8 y and a mean body mass index (BMI; in kg/m(2)) of 30.0. Breast cancer cases had significantly lower (mean ± SD) serum concentrations of 25(OH)D (9.4 ± 6.4 ng/mL) than did controls (15.4 ± 12.3 ng/mL; P = 0.001). In comparison with those in the highest category of vitamin D status for this population (≥20 ng/mL), the adjusted ORs (95% CIs) for invasive breast cancer were 6.1 (2.4, 15.1) for women with a serum 25(OH)D concentration <10 ng/mL and 4.0 (1.6, 10.4) for women with a serum concentration of ≥10 to <20 ng/mL (P-trend = 0.0001). CONCLUSION An inverse association exists between serum 25(OH)D concentrations and breast cancer risk in Saudi Arabian women. This trial was registered at clinicaltrials.gov as NCT01817231.
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Affiliation(s)
- Fatimah M Yousef
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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Ataie-Jafari A, Rahmat AB, Abbasi F, Cheong Loke S, Qorbani M, Larijani B. Vitamin D status and associated factors in recent-onset type 1 diabetic children in Iran. J Diabetes Metab Disord 2012; 11:12. [PMID: 23497668 PMCID: PMC3598177 DOI: 10.1186/2251-6581-11-12] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 08/03/2012] [Indexed: 01/14/2023]
Abstract
Background In this study, the prevalence of vitamin D deficiency was assessed in a group of children and adolescent patients with recent-onset type 1 diabetes mellitus (T1DM). Methods Fifty-three patients with age 8–18 years and duration of T1DM less than 8 weeks were recruited. A food frequency questionnaire (FFQ) was used to assess dietary vitamin D and calcium intake. Sunshine exposure was measured using a questionnaire to quantify the amount of time children spent in the sun and other sun-related habits, and a sun index score was generated. Serum 25(OH)D < 20 ng/ml was considered as vitamin D deficiency. Logistic regression was used to assess predictors of vitamin D deficiency. Results All patients were vitamin D deficient (77%) or insufficient (23%). In a logistic regression model, it was shown that the risk of being vitamin D deficient was significantly decreased by sunlight exposure ≥ 15 minutes during the weekends versus < 15 minutes (OR: 0.06, 95% CI: 0.01–0.75; P=0.029). In addition, vitamin D deficiency in boys was lower than girls in this model (OR: 0.164 [95% CI: 0.02–1.11]; P = 0.063). Conclusion Vitamin D deficiency is highly prevalent among children and adolescents with T1DM in Iran. Boys and children with ≥ 15 minutes sunlight exposure in weekends were less likely to be vitamin D deficient than girls and those with < 15 minutes sunlight exposure.
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Affiliation(s)
- Asal Ataie-Jafari
- Endocrinology and Metabolism Research Center/Tehran University of Medical Sciences, 5th floor, Shariati hospital, North Karegar Avenue, Tehran, Iran.
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Greenfield JA, Park PS, Farahani E, Malik S, Vieth R, McFarlane NA, Shepherd TG, Knight JA. Solar ultraviolet-B radiation and vitamin D: a cross-sectional population-based study using data from the 2007 to 2009 Canadian Health Measures Survey. BMC Public Health 2012; 12:660. [PMID: 22894564 PMCID: PMC3489623 DOI: 10.1186/1471-2458-12-660] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 08/03/2012] [Indexed: 01/04/2023] Open
Abstract
Background Exposure to solar ultraviolet-B (UV-B) radiation is a major source of vitamin D3. Chemistry climate models project decreases in ground-level solar erythemal UV over the current century. It is unclear what impact this will have on vitamin D status at the population level. The purpose of this study was to measure the association between ground-level solar UV-B and serum concentrations of 25-hydroxyvitamin D (25(OH)D) using a secondary analysis of the 2007 to 2009 Canadian Health Measures Survey (CHMS). Methods Blood samples collected from individuals aged 12 to 79 years sampled across Canada were analyzed for 25(OH)D (n = 4,398). Solar UV-B irradiance was calculated for the 15 CHMS collection sites using the Tropospheric Ultraviolet and Visible Radiation Model. Multivariable linear regression was used to evaluate the association between 25(OH)D and solar UV-B adjusted for other predictors and to explore effect modification. Results Cumulative solar UV-B irradiance averaged over 91 days (91-day UV-B) prior to blood draw correlated significantly with 25(OH)D. Independent of other predictors, a 1 kJ/m2 increase in 91-day UV-B was associated with a significant 0.5 nmol/L (95% CI 0.3-0.8) increase in mean 25(OH)D (P = 0.0001). The relationship was stronger among younger individuals and those spending more time outdoors. Based on current projections of decreases in ground-level solar UV-B, we predict less than a 1 nmol/L decrease in mean 25(OH)D for the population. Conclusions In Canada, cumulative exposure to ambient solar UV-B has a small but significant association with 25(OH)D concentrations. Public health messages to improve vitamin D status should target safe sun exposure with sunscreen use, and also enhanced dietary and supplemental intake and maintenance of a healthy body weight.
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Affiliation(s)
- Jamie A Greenfield
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, 180 Queen Street West, Toronto, Canada
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Cescon DW, Ganz PA, Beddows S, Ennis M, Mills BK, Goodwin PJ. Feasibility of a randomized controlled trial of vitamin D vs. placebo in women with recently diagnosed breast cancer. Breast Cancer Res Treat 2012; 134:759-67. [PMID: 22706631 DOI: 10.1007/s10549-012-2120-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 05/26/2012] [Indexed: 12/11/2022]
Abstract
Low serum vitamin D levels have been associated with poor outcomes in women diagnosed with early breast cancer. However, no randomized controlled trials (RCTs) have been performed to determine whether vitamin D supplementation might be an effective intervention in this population. We prospectively evaluated vitamin D adequacy and supplementation rates in a contemporary cross-sectional sample of breast cancer patients from 2 large urban centers and examined the feasibility of an RCT of vitamin D supplementation. Women with recently diagnosed early breast cancer were prospectively identified and recruited in Toronto and Los Angeles between March 2009 and January 2010. Anthropometric measurements, dietary, lifestyle, and medication histories were obtained by means of structured questionnaires and interviews. Tumor and treatment characteristics were abstracted from clinical records and blood samples were collected for analysis of 25-OH vitamin D. 173 eligible patients (median age 57) were enrolled. Clinical and treatment characteristics were similar between centres. 84.4 % of women reported use of vitamin D-containing supplements with median daily doses of 1,400 IU. Median 25-OH vitamin D levels were 85.5 and 98.5 nmol/L (P = 0.1), and levels of deficiency (<50 nmol/L), insufficiency (50-72 nmol/L), and adequacy (>72 nmol/L) were 3.8, 23.8, 72.5 % (Toronto) and 4.3, 20.7, 75 % (Los Angeles). 25-OH vitamin D levels were strongly correlated with vitamin D supplement use (r = 0.41, P < 0.0001). 68 % of women expressed willingness to participate in a vitamin D supplementation RCT; however, only 12.7 % of the study population met the pre-specified feasibility criteria (25-OH vitamin D <72 nmol/L, willing to participate, and taking ≤1,000 IU vitamin D supplement/day). Both vitamin D levels and supplementation rates are higher than in previous reports. While the majority of women would be willing to participate in an RCT of vitamin D supplementation, low levels of deficiency/insufficiency and high rates of supplement use would limit the feasibility of such a study.
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Affiliation(s)
- David W Cescon
- Mount Sinai Hospital, 1284-600 University Avenue, Toronto, ON, M5G 1X5, Canada
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13
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Genome-wide association analysis of circulating vitamin D levels in children with asthma. Hum Genet 2012; 131:1495-505. [PMID: 22673963 DOI: 10.1007/s00439-012-1185-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 05/23/2012] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency is becoming more apparent in many populations. Genetic factors may play a role in the maintenance of vitamin D levels. The objective of this study was to perform a genome-wide analysis (GWAS) of vitamin D levels, including replication of prior GWAS results. We measured 25-hydroxyvitamin D (25(OH)D) levels in serum collected at the time of enrollment and at year 4 in 572 Caucasian children with asthma, who were part of a multi-center clinical trial, the Childhood Asthma Management Program. Replication was performed in a second cohort of 592 asthmatics from Costa Rica and a third cohort of 516 Puerto Rican asthmatics. In addition, we attempted replication of three SNPs that were previously identified in a large GWAS of Caucasian individuals. The setting included data from a clinical trial of childhood asthmatics and two cohorts of asthmatics recruited for genetic studies of asthma. The main outcome measure was circulating 25(OH)D levels. The 25(OH)D levels at the two time-points were only modestly correlated with each other (intraclass correlation coefficient = 0.33) in the CAMP population. We identified SNPs that were nominally associated with 25(OH)D levels at two time-points in CAMP, and replicated four SNPs in the Costa Rican cohort: rs11002969, rs163221, rs1678849, and rs4864976. However, these SNPs were not significantly associated with 25(OH)D levels in a third population of Puerto Rican asthmatics. We were able to replicate the SNP with the strongest effect, previously reported in a large GWAS: rs2282679 (GC), and we were able to replicate another SNP, rs10741657 (CYP2R1), to a lesser degree. We were able to replicate two of three prior significant findings in a GWAS of 25(OH)D levels. Other SNPs may be additionally associated with 25(OH)D levels in certain populations.
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14
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Abstract
The prevalence of asthma and other atopic disorders continues to increase worldwide. Examination of the epidemiologic patterns has revealed that this rise has occurred primarily in western, industrialised countries and countries transitioning to this lifestyle. While many changes have occurred in human populations over the years, it has been hypothesised that some of the relevant changes that have led to the rise in asthma and atopic disorders have been the changes from a traditional diet to a more western diet consisting of decreased intake of fruits and vegetables (sources of antioxidant vitamins and carotenoids) leading to decreased intakes of vitamins E and A, and a decrease in sun exposure (e.g. greater time spent indoors and heavy use of sunscreen) leading to decreased circulating levels of vitamin D. This review will examine the evidence for an effect of fat-soluble vitamins (vitamins A, D and K) on the development and severity of asthma and allergies. While observational studies suggest that these vitamins may play a salutary role in asthma and allergies, large, well-designed clinical trials are lacking. Of the fat-soluble vitamins, vitamin D holds great promise as an agent for primary and secondary prevention of disease. Ongoing clinical trials will help determine whether results of observational studies can be applied to the clinical setting.
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Affiliation(s)
- Augusto A Litonjua
- Channing Laboratory and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
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15
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Pilz S, Kienreich K, Stückler D, Meinitzer A, Tomaschitz A. Associations of Sun Exposure with 25-Hydroxyvitamin D and Parathyroid Hormone Levels in a Cohort of Hypertensive Patients: The Graz Endocrine Causes of Hypertension (GECOH) Study. Int J Endocrinol 2012; 2012:732636. [PMID: 22518130 PMCID: PMC3296164 DOI: 10.1155/2012/732636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 12/05/2011] [Indexed: 02/06/2023] Open
Abstract
Sunlight-induced vitamin D, synthesis in the skin is the major source of vitamin D, but data on the relationship of sun-related behaviour with vitamin D and parathyroid hormone (PTH) levels are relatively sparse. We evaluated whether habitual sun exposure is associated with 25-hydroxyvitamin D (25[OH]D) and PTH levels and whether there exist seasonal variations. We examined 111 hypertensive patients in Austria (latitude 47° N). Frequent sunbathing at home and outdoor sports were associated with higher 25(OH)D levels (P < 0.05 for both). Red or blond scalp hair as a child, memory of sunburns, preferring sunbathing, frequent stays on the beach or in open-air pools, and solarium use were associated with lower PTH levels (P < 0.05 for all). Multiple linear regression analyses including age, sex, and body mass index showed that sun exposure score was significantly associated with 25(OH)D (beta coefficient = 0.27; P = 0.004) and by trend with PTH (beta coefficient = -0.16; P = 0.09). These associations were more prominent in summer in which 25(OH)D levels were significantly higher compared to winter. Translation of these findings into recommendations for the prevention and treatment of vitamin D deficiency remains a challenge for the future.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
- *Stefan Pilz: and
| | - Katharina Kienreich
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Daniel Stückler
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Andreas Tomaschitz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
- *Andreas Tomaschitz:
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Anderson LN, Cotterchio M, Kirsh VA, Knight JA. Ultraviolet sunlight exposure during adolescence and adulthood and breast cancer risk: a population-based case-control study among Ontario women. Am J Epidemiol 2011; 174:293-304. [PMID: 21659351 DOI: 10.1093/aje/kwr091] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Recent studies suggest that vitamin D may be associated with reduced breast cancer risk, but most studies have evaluated only dietary vitamin D intake. The associations among ultraviolet radiation from sunlight, factors related to cutaneous vitamin D production, and breast cancer risk were evaluated in a population-based case-control study conducted in Ontario, Canada, between 2003 and 2004 (n = 3,101 cases and n = 3,471 controls). Time spent outdoors was associated with reduced breast cancer risk during 4 periods of life (>21 vs. ≤6 hours/week age-adjusted odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.60, 0.85 in the teenage years; OR = 0.64, 95% CI: 0.53, 0.76 in the 20s-30s; OR = 0.74, 95% CI: 0.61, 0.88 in the 40s-50s; and OR = 0.50, 95% CI: 0.37, 0.66 in the 60s-74 years). Sun protection practices and ultraviolet radiation were not associated with breast cancer risk. A combined solar vitamin D score, including all the variables related to vitamin D production, was significantly associated with reduced breast cancer risk. These associations were not confounded or modified by menopausal status, dietary vitamin D intake, or physical activity. This study suggests that factors suggestive of increased cutaneous production of vitamin D are associated with reduced breast cancer risk.
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Affiliation(s)
- Laura N Anderson
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada.
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McCullough ML, Weinstein SJ, Freedman DM, Helzlsouer K, Flanders WD, Koenig K, Kolonel L, Laden F, Le Marchand L, Purdue M, Snyder K, Stevens VL, Stolzenberg-Solomon R, Virtamo J, Yang G, Yu K, Zheng W, Albanes D, Ashby J, Bertrand K, Cai H, Chen Y, Gallicchio L, Giovannucci E, Jacobs EJ, Hankinson SE, Hartge P, Hartmuller V, Harvey C, Hayes RB, Horst RL, Shu XO. Correlates of circulating 25-hydroxyvitamin D: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010; 172:21-35. [PMID: 20562191 PMCID: PMC2892536 DOI: 10.1093/aje/kwq113] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/12/2010] [Indexed: 12/19/2022] Open
Abstract
Low vitamin D status is common globally and is associated with multiple disease outcomes. Understanding the correlates of vitamin D status will help guide clinical practice, research, and interpretation of studies. Correlates of circulating 25-hydroxyvitamin D (25(OH)D) concentrations measured in a single laboratory were examined in 4,723 cancer-free men and women from 10 cohorts participating in the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers, which covers a worldwide geographic area. Demographic and lifestyle characteristics were examined in relation to 25(OH)D using stepwise linear regression and polytomous logistic regression. The prevalence of 25(OH)D concentrations less than 25 nmol/L ranged from 3% to 36% across cohorts, and the prevalence of 25(OH)D concentrations less than 50 nmol/L ranged from 29% to 82%. Seasonal differences in circulating 25(OH)D were most marked among whites from northern latitudes. Statistically significant positive correlates of 25(OH)D included male sex, summer blood draw, vigorous physical activity, vitamin D intake, fish intake, multivitamin use, and calcium supplement use. Significant inverse correlates were body mass index, winter and spring blood draw, history of diabetes, sedentary behavior, smoking, and black race/ethnicity. Correlates varied somewhat within season, race/ethnicity, and sex. These findings help identify persons at risk for low vitamin D status for both clinical and research purposes.
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Zeleniuch-Jacquotte A, Gallicchio L, Hartmuller V, Helzlsouer KJ, McCullough ML, Setiawan VW, Shu XO, Weinstein SJ, Weiss JM, Arslan AA, De Vivo I, Gao YT, Hayes RB, Henderson BE, Horst RL, Koenig KL, Patel AV, Purdue MP, Snyder K, Steplowski E, Yu K, Zheng W, Hankinson SE. Circulating 25-hydroxyvitamin D and risk of endometrial cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010; 172:36-46. [PMID: 20562189 PMCID: PMC2892537 DOI: 10.1093/aje/kwq114] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/12/2010] [Indexed: 11/14/2022] Open
Abstract
A nested case-control study, including 830 cases and 992 controls from 7 cohorts, was conducted to evaluate the association of circulating 25-hydroxyvitamin D (25(OH)D), the best indicator of vitamin D status, with risk of endometrial cancer. Matching factors included age at blood donation, date of blood donation, and race. Conditional logistic regression was used in the main analysis. The median concentration of 25(OH)D was slightly lower in cases (49.4 nmol/L) than in controls (50.8 nmol/L) (P = 0.08). However, there was no association between 25(OH)D concentration and disease risk, after adjustment for body mass index. Compared with the 50-<75 nmol/L 25(OH)D category, the body mass index-adjusted odds ratios and 95% confidence intervals were 1.08 (95% confidence interval: 0.73, 1.57) for the <25 nmol/L category and 0.90 (95% confidence interval: 0.51, 1.58) for the > or =100 nmol/L category (P(trend) = 0.99). Similarly null results were observed after further adjustment for other known risk factors and in stratified analyses. Although an effect of circulating 25(OH)D at high concentrations cannot be ruled out (the highest category of 25(OH)D was > or =100 nmol/L, and for stratified analyses, > or =75 nmol/L), these results do not support a protective role of vitamin D against endometrial cancer.
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Affiliation(s)
- Anne Zeleniuch-Jacquotte
- Department of Environmental Medicine and Cancer Institute, New York University, New York, 10016-3240, USA.
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19
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Abstract
The hypothesis that adequate vitamin D nutrition can contribute to the prevention of multiple sclerosis (MS) was originally proposed to explain the geographical distribution of MS, but only recently has the relation between various measures of vitamin D (eg, sun exposure, dietary sources, and serum concentrations of 25-hydroxyvitamin D) and risk of developing MS been rigorously investigated. Overall, the results of these studies support a protective effect of vitamin D, but there are uncertainties and many unanswered questions, including how vitamin D exerts a protective effect, how genetic variations modify the effect, and whether vitamin D can influence the course of MS progression.
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Affiliation(s)
- Alberto Ascherio
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
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20
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Vitamin D association with estradiol and progesterone in young women. Cancer Causes Control 2010; 21:479-83. [PMID: 19916051 DOI: 10.1007/s10552-009-9466-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 11/02/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Vitamin D may reduce breast cancer risk through an effect on steroid hormones in cycling women.We conducted a study to determine whether there is an association between circulating 25-hydroxyvitamin D (25(OH)D) and estradiol and progesterone in young women. METHODS Volunteer women aged 18-22 and not using hormonal contraceptives were recruited during summer and winter. They provided demographic and lifestyle information and a blood sample. Women recruited in winter gave a second sample after taking vitamin D supplement for 4 weeks. There were 101 women sampled during the luteal phase (1-14 days prior to the start of the next menstrual period). Generalized estimating equation linear regression models were used to examine the relationship between 25(OH)D and estradiol and progesterone. RESULTS Per increase of 10 nmol/l of 25(OH)D, progesterone multiplicatively decreased by a factor of 10% (95% CI 5-14%, p < 0.001) and estradiol decreased by a factor of 3% (95% CI 0-6%, p = 0.04) after adjustment for age, body mass index, ethnicity, season, alcohol use, smoking, and physical activity. CONCLUSIONS Higher levels of vitamin D may reduce progesterone and estradiol, providing a potential mechanism for reduction in breast cancer risk from increased vitamin D exposure in young women.
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21
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Vitamin D and calcium intakes and breast cancer risk in pre- and postmenopausal women. Am J Clin Nutr 2010; 91:1699-707. [PMID: 20392891 DOI: 10.3945/ajcn.2009.28869] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Some evidence suggests that vitamin D may reduce breast cancer risk. Despite the biological interaction between vitamin D and calcium, few studies have evaluated their joint effects on breast cancer risk. OBJECTIVE The objective was to evaluate the associations and potential interaction between vitamin D and calcium (from food and supplements) and breast cancer risk in a population-based case-control study. DESIGN Breast cancer cases aged 25-74 y (diagnosed 2002-2003) were identified through the Ontario Cancer Registry. Controls were identified by using random digit dialing; 3101 cases and 3471 controls completed epidemiologic and food-frequency questionnaires. Adjusted odds ratios (ORs) and 95% CIs were estimated by using multivariate logistic regression. RESULTS Vitamin D and calcium intakes from food only and total combined intakes (food and supplements) were not associated with breast cancer risk, although the mean intake of vitamin D was low. Vitamin D supplement intake >10 microg/d (400 IU/d) compared with no intake was associated with a reduced risk of breast cancer (adjusted OR: 0.76; 95% CI: 0.59, 0.98). No categories of calcium supplement intake were significantly associated with reduced breast cancer risk, but a significant inverse trend was observed (P = 0.04). There were no significant interactions involving vitamin D, calcium, or menopausal status. CONCLUSIONS No associations were found between overall vitamin D or calcium intake and breast cancer risk. Vitamin D from supplements was independently associated with reduced breast cancer risk. Further research is needed to investigate the effects of higher doses of vitamin D and calcium supplements.
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Kawase T, Matsuo K, Suzuki T, Hirose K, Hosono S, Watanabe M, Inagaki M, Iwata H, Tanaka H, Tajima K. Association between vitamin D and calcium intake and breast cancer risk according to menopausal status and receptor status in Japan. Cancer Sci 2010; 101:1234-40. [DOI: 10.1111/j.1349-7006.2010.01496.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hall LM, Kimlin MG, Aronov PA, Hammock BD, Slusser JR, Woodhouse LR, Stephensen CB. Vitamin D intake needed to maintain target serum 25-hydroxyvitamin D concentrations in participants with low sun exposure and dark skin pigmentation is substantially higher than current recommendations. J Nutr 2010; 140:542-50. [PMID: 20053937 PMCID: PMC2821886 DOI: 10.3945/jn.109.115253] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cutaneous cholecalciferol synthesis has not been considered in making recommendations for vitamin D intake. Our objective was to model the effects of sun exposure, vitamin D intake, and skin reflectance (pigmentation) on serum 25-hydroxyvitamin D (25[OH]D) in young adults with a wide range of skin reflectance and sun exposure. Four cohorts of participants (n = 72 total) were studied for 7-8 wk in the fall, winter, spring, and summer in Davis, CA [38.5 degrees N, 121.7 degrees W, Elev. 49 ft (15 m)]. Skin reflectance was measured using a spectrophotometer, vitamin D intake using food records, and sun exposure using polysulfone dosimeter badges. A multiple regression model (R(2) = 0.55; P < 0.0001) was developed and used to predict the serum 25(OH)D concentration for participants with low [median for African ancestry (AA)] and high [median for European ancestry (EA)] skin reflectance and with low [20th percentile, approximately 20 min/d, approximately 18% body surface area (BSA) exposed] and high (80th percentile, approximately 90 min/d, approximately 35% BSA exposed) sun exposure, assuming an intake of 200 iu/d (5 ug/d). Predicted serum 25(OH)D concentrations for AA individuals with low and high sun exposure in the winter were 24 and 42 nmol/L and in the summer were 40 and 60 nmol/L. Corresponding values for EA individuals were 35 and 60 nmol/L in the winter and in the summer were 58 and 85 nmol/L. To achieve 25(OH)D > or =75 nmol/L, we estimate that EA individuals with high sun exposure need 1300 iu/d vitamin D intake in the winter and AA individuals with low sun exposure need 2100-3100 iu/d year-round.
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Affiliation(s)
- Laura M. Hall
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523,To whom correspondence should be addressed. E-mail:
| | - Michael G. Kimlin
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Pavel A. Aronov
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Bruce D. Hammock
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - James R. Slusser
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Leslie R. Woodhouse
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Charles B. Stephensen
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
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Circulating vitamin d and risk of epithelial ovarian cancer. JOURNAL OF ONCOLOGY 2009; 2009:672492. [PMID: 19727412 PMCID: PMC2735000 DOI: 10.1155/2009/672492] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 06/24/2009] [Indexed: 11/17/2022]
Abstract
We conducted a nested case-control study within two prospective cohorts, the New York University Women's Health Study and the Northern Sweden Health and Disease Study, to examine the association between prediagnostic circulating levels of 25-hydroxy vitamin D (25(OH)D) and the risk of subsequent invasive epithelial ovarian cancer (EOC). The 25(OH)D levels were measured in serum or plasma from 170 incident cases of EOC and 373 matched controls. Overall, circulating 25(OH)D levels were not associated with the risk of EOC in combined cohort analysis: adjusted OR for the top tertile versus the reference tertile, 1.09 (95% CI, 0.59–2.01). In addition, there was no evidence of an interaction effect between VDR SNP genotype or haplotype and circulating 25(OH)D levels in relation to ovarian cancer risk, although more complex gene-environment interactions may exist.
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Abstract
PURPOSE OF REVIEW Vitamin D deficiency has been rediscovered as a public-health problem worldwide. It has been postulated that vitamin D deficiency may explain a portion of the asthma epidemic. The purpose of this review is to present the evidence for a role of vitamin D in asthma. RECENT FINDINGS Both animal models and studies in human fetal tissues show that vitamin D plays a role in fetal lung growth and maturation. Epidemiologic studies have also suggested that higher prenatal vitamin D intakes have a protective role against wheezing illnesses in young children. Vitamin D may protect against wheezing illnesses through its role in upregulating antimicrobial proteins or through its multiple immune effects. In addition, vitamin D may play a therapeutic role in steroid resistant asthmatics, and lower vitamin D levels have recently been associated with higher risks for asthma exacerbations. SUMMARY Improving vitamin D status holds promise in primary prevention of asthma, in decreasing exacerbations of disease, and in treating steroid resistance. However, the appropriate level of circulating vitamin D for optimal immune functioning remains unclear. Because vitamin D deficiency is prevalent even in sun-replete areas, clinical trials are needed to definitively answer questions about the role of vitamin D in asthma.
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Blackmore KM, Lesosky M, Barnett H, Raboud JM, Vieth R, Knight JA. Vitamin D from dietary intake and sunlight exposure and the risk of hormone-receptor-defined breast cancer. Am J Epidemiol 2008; 168:915-24. [PMID: 18756015 DOI: 10.1093/aje/kwn198] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Evidence has emerged for a role of vitamin D in the development of breast cancer, and there is some suggestion that its antiproliferative effect is greater in hormone-receptor-positive cells. Few epidemiologic studies have considered the association between vitamin D and hormone-receptor-defined breast cancer, and the results are conflicting. Considering 759 cases and 1,135 controls from a case-control study (Ontario, Canada, 2003-2005), the authors examined the association between vitamin D intake at specific ages and combined estrogen-receptor- (ER) and progesterone-receptor- (PR) defined breast cancer. While increased intake of vitamin D (from the sun and diet) was most consistently associated with a significantly reduced risk of ER+/PR+ tumors (e.g., odds ratio = 0.76, 95% confidence interval: 0.59, 0.97 for use of cod liver oil during adolescence), comparable nonsignificant associations were found for receptor-negative (ER-/PR-) (odds ratio = 0.74, 95% confidence interval: 0.53, 1.04) and mixed (ER+/PR-) (odds ratio = 0.79, 95% confidence interval: 0.51, 1.22) tumors. This study suggests that vitamin D is associated with a reduced risk of breast cancer regardless of ER/PR status of the tumor. Future studies with a larger number of receptor-negative and mixed tumors are required.
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Affiliation(s)
- Kristina M Blackmore
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 60 Murray Street, Box 18, Toronto, Ontario, Canada M5T3L9.
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