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Li Y, Zhang J, Tian F, Anvarifard P, Li N. Association between vitamin D receptor polymorphism and breast cancer in women: An umbrella review of meta-analyses of observational investigations. Exp Gerontol 2024; 194:112502. [PMID: 38917941 DOI: 10.1016/j.exger.2024.112502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/13/2024] [Accepted: 06/22/2024] [Indexed: 06/27/2024]
Abstract
This study aimed to conduct an umbrella review of meta-analyses to synthesize the existing evidence regarding the relationship between vitamin D receptor (VDR) polymorphism and breast cancer (BC) risk. A comprehensive search was performed across multiple databases, including Embase, PubMed, Scopus, the Cochrane Database of Systematic Reviews, and the Web of Science. The investigation included 17 meta-analyses for the BsmI polymorphism, 6 for the Cdx2 polymorphism, and 6 for the Poly (A) polymorphism. Among the 119 datasets analyzed, only 6 (5 %) reported statistically significant outcomes (p < 0.05), comprising 2 comparisons for VDR BsmI polymorphism (3 %), 1 for VDR Cdx-2 polymorphism (4 %), and 3 for VDR Poly (A) polymorphism (14 %), across various genetic models. Notably, significant heterogeneity was observed in 82 comparisons, and publication bias was detected in 16 comparisons. Furthermore, a substantial proportion (86 %) of the included studies exhibited critically low methodological quality. In conclusion, our findings suggest that VDR polymorphism (BsmI, Cdx-2, and Poly (A)) is not strongly associated with BC risk in the general population.
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Affiliation(s)
- Yaxing Li
- The Third Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Junqin Zhang
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Fei Tian
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Paniz Anvarifard
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Na Li
- The Third Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China.
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Francis I, AlAbdali N, Kapila K, John B, Al-Temaimi RA. Vitamin D pathway related polymorphisms and vitamin D receptor expression in breast cancer. INT J VITAM NUTR RES 2019; 91:124-132. [PMID: 31623531 DOI: 10.1024/0300-9831/a000615] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is an emerging risk factor for breast cancer suggesting its role in breast cancer pathogenesis. Recent evidence suggests vitamin D receptor (VDR) expression is a prognosis predictor in breast cancer. We set out to determine the status of VDR expression in histologically characterized breast cancers, and whether common genetic variants modify VDR expression in breast cancer. One-hundred and twenty Kuwaiti female breast cancer fixed tissues were assessed for VDR expression to identify the level and location of its expression by immunohistochemistry. VDR variants (rs731236, rs2228570), and vitamin D binding protein (VDBP) variants (rs4588, rs7041) genotypes were ascertained in breast cancer specimens using Taqman genotyping assays. VDR nuclear expression correlated with low grade tumors (p = 0.01), whereas cytoplasmic expression correlated with lymph node positive tumors (p = 0.03). Absence of VDR expression was a marker for high-grade dedifferentiated tumors (p = 0.01). VDBP rs7041 associated with breast cancer risk (OR 1.92, 95% CI: 1.34 - 2.73; p = 0.0004), and VDR rs2228570 correlated with increased VDR cytoplasmic expression (p < 0.0001). In conclusion, VDR expression is altered in breast cancer confirming its involvement in breast cancer progression. Genetic factors appear to play a role in breast cancer risk, and may modify tumor sensitization to vitamin D.
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Affiliation(s)
- Issam Francis
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Noora AlAbdali
- Postgraduate Medical Sciences Program, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Kusum Kapila
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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Singhal S, Kapoor H, Subramanian S, Agrawal DK, Mittal SK. Polymorphisms of Genes Related to Function and Metabolism of Vitamin D in Esophageal Adenocarcinoma. J Gastrointest Cancer 2018; 50:867-878. [PMID: 30187205 DOI: 10.1007/s12029-018-0164-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The vitamin D receptor (VDR) endocrine system has emerged as an endogenous pleiotropic biological cell regulator with anti-neoplastic effects on breast, colorectal, and prostatic adenocarcinomas. We studied the association of gene expression, polymorphisms of VDR, CYP27B1, and CYP24A1 genes and serum vitamin D levels as surrogate markers of disease progression in patients with acid reflux, Barrett's esophagus (BE), or esophageal adenocarcinoma (EAC). METHODS We analyzed blood and tissue samples from patients with biopsy-confirmed BE or EAC for vitamin D levels, gene expressions, and polymorphisms in VDR (FokI [F/f], BsmI [B/b], ApaI [A/a], and TaqI [T/t]), CYP27B1 (HinfI [H/h]), and CYP24A1 (Hpy1881 [Y/y]). Percentages of homozygous dominant/recessive or heterozygous traits were assessed for each polymorphism in all patient subgroups. RESULTS Genomic Bb and FF polymorphisms were highly prevalent in EAC patients, whereas BE patients had a high prevalence of wild-type Hpy1881 (YY polymorphism). Some polymorphisms (Yy for CYP24A1, bb for VDR) were noted only in EAC patients. Yy and bb forms were both uniquely present in some EAC patients without associated Barrett's lesions, but not in patients with concomitant BE. AA and bb polymorphisms were associated with decreased response to neoadjuvant therapy. A high level of VDR and CYP24A1 mRNA expression was observed in EAC tissue of non-responders. Serum vitamin D deficiency was common in EAC patients. CONCLUSIONS Specific polymorphisms in vitamin D metabolism-related genes are associated with the likelihood of reflux-BE-EAC progression. Identifying such polymorphisms may aid in development of better surveillance and diagnostic and therapeutic protocols.
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Affiliation(s)
- Saurabh Singhal
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, Suite 500, Phoenix, AZ, USA
- Clinical and Translational Sciences, Creighton University, 2500 California Plaza, Omaha, NE, USA
| | - Harit Kapoor
- Clinical and Translational Sciences, Creighton University, 2500 California Plaza, Omaha, NE, USA
| | - Saravanan Subramanian
- Clinical and Translational Sciences, Creighton University, 2500 California Plaza, Omaha, NE, USA
| | - Devendra K Agrawal
- Clinical and Translational Sciences, Creighton University, 2500 California Plaza, Omaha, NE, USA
| | - Sumeet K Mittal
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, Suite 500, Phoenix, AZ, USA.
- Clinical and Translational Sciences, Creighton University, 2500 California Plaza, Omaha, NE, USA.
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Copeland RL, Beyene D, Apprey V, Daremipouran MR, Naab TJ, Kassim OO, Kanaan YM. DHPLC Elution Patterns of VDR PCR Products Can Predict Prostate Cancer Susceptibility in African American Men. Cancer Genomics Proteomics 2017; 14:461-467. [PMID: 29109096 PMCID: PMC6070329 DOI: 10.21873/cgp.20056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/11/2017] [Accepted: 09/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/AIM Denaturing high-performance liquid chromatography (DHPLC) is a technique that is used to detect mutations. The aim of the present study was to determine whether DHPLC elution patterns of vitamin D receptor (VDR) gene PCR products can serve as indicators of susceptibility to prostate cancer (PCa) risk. MATERIALS AND METHODS DNA samples of PCa cases and controls were screened for mutations and/or polymorphisms in coding exons of VDR gene using DHPLC analysis. Logistic regression, phi-coefficient (ϕ), and Backward Wald models were used to analyze the data. RESULTS Similar elution patterns of exons 1, 6, 7 and 9 along with higher prevalence of heteroduplex DNA were observed in PCa samples than in controls. Exons 4 and 8 had highly significant protective effects (p<0.05). Whereas, exons 5, 7, and 9 were perfectly positively correlated with PCa risk (ϕ=1), thus presenting candidate exons significantly associated with susceptibility to PCa. CONCLUSION DHPLC elution patterns of the selected exons could be useful to predict susceptibility to develop PCa.
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Affiliation(s)
- Robert L Copeland
- Department of Pharmacology, Howard University, Washington, DC, U.S.A
- Cancer Center, Howard University, Washington, DC, U.S.A
| | - Desta Beyene
- Cancer Center, Howard University, Washington, DC, U.S.A
| | - Victor Apprey
- Department of Community and Family Medicine, Howard University, Washington, DC, U.S.A
| | | | - Tammey J Naab
- Department of Pathology, Howard University, Washington, DC, U.S.A
| | - Olakunle O Kassim
- Department of Microbiology, Howard University, Washington, DC, U.S.A
| | - Yasmine M Kanaan
- Cancer Center, Howard University, Washington, DC, U.S.A.
- Department of Microbiology, Howard University, Washington, DC, U.S.A
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Amadori D, Serra P, Masalu N, Pangan A, Scarpi E, Bugingo AM, Katabalo D, Ibrahim T, Bongiovanni A, Miserocchi G, Spadazzi C, Liverani C, Turri V, Tedaldi R, Mercatali L. Vitamin D receptor polymorphisms or serum levels as key drivers of breast cancer development? The question of the vitamin D pathway. Oncotarget 2017; 8:13142-13156. [PMID: 28061456 PMCID: PMC5355083 DOI: 10.18632/oncotarget.14482] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/15/2016] [Indexed: 01/25/2023] Open
Abstract
As total vitamin D levels are often lower in black than in white Americans, the former are frequently classified as vitamin D-deficient. To fully understand African vitamin D (25(OH)D) status, other factors should be considered, e.g. vitamin D blood carrier, vitamin D-binding protein (DBP), vitamin D receptor (VDR) and DBP polymorphisms. A prospective study on an indigenous black Tanzanian and a Caucasian Italian population was performed on 50 healthy donors from both populations and 35 Caucasian and 18 African breast cancer patients. 25(OH)D and DBP serum levels were analyzed by ELISA. A1012G, Cdx2 and Fok1 VDR polymorphisms and DBP polymorphisms rs4588 and rs7041 were genotyped by real-time PCR. Vitamin D and DBP levels were lower in healthy African donors than in Caucasians. Africans had a significantly higher frequency of AA and CC for Cdx2 and Fok1 polymorphisms, respectively. These allelic variants were related to a higher transcription of VDR gene and a higher activity of VDR receptor. With regard to polymorphism distribution, Africans showed innate higher levels and activity of VDR. We conclude that a strengthening of the vitamin D pathway could have a protective role against the development of breast cancer in the African population.
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Affiliation(s)
- Dino Amadori
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Patrizia Serra
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Nestory Masalu
- Department of Oncology, Bugando Medical Center, Mwanza, Tanzania, Africa
| | - Akwilina Pangan
- Department of Oncology, Bugando Medical Center, Mwanza, Tanzania, Africa
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giacomo Miserocchi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Valentina Turri
- Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Rosanna Tedaldi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Wang K, Wu G, Li J, Song W. Role of vitamin D receptor gene Cdx2 and Apa1 polymorphisms in prostate cancer susceptibility: a meta-analysis. BMC Cancer 2016; 16:674. [PMID: 27553621 PMCID: PMC4995777 DOI: 10.1186/s12885-016-2722-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 08/14/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Vitamin D receptor (VDR) gene polymorphisms affect the risk of prostate cancer. However, studies investigating the relationship between VDR gene polymorphisms (Cdx2 and ApaI) and prostate cancer risk are equivocal. Therefore, we conducted a meta-analysis of all the studies to review the evidence available. METHODS A comprehensive search of PubMed, EMBASE, and ISI Web of Science for studies published until September 2015 was conducted. Odds ratios (ORs) and 95 % confidence intervals (CIs) were analyzed to determine the association between VDR Cdx2 and ApaI polymorphisms, and prostate cancer risk. RESULTS The meta-analysis included 10 studies involving 4979 cases and 4380 controls to analyze the VDR Cdx2 polymorphism. An additional 11 studies involving 2837 cases and 2884 controls were analyzed for the VDR ApaI polymorphism. Evidence failed to support the role of VDR Cdx2 and ApaI polymorphisms in prostate cancer. For Cdx2, the pooled OR was 1.11 (95 % CI = 0.93-1.33) for AA vs. GG genotypes, 0.97 (95 % CI = 0.88-1.06) for GA vs. AA genotypes, 0.99 (95 % CI = 0.91-1.08) for AA + GA vs. GG, and 1.12 (95 % CI = 0.95-1.31) for AA vs. GA + GG. No significant relationship was observed in any subgroup analysis based on ethnicity, controls, and Hardy-Weinberg equilibrium (HWE). ORs for the ApaI polymorphism were similar. CONCLUSIONS VDR Cdx2 and ApaI polymorphisms are not associated with prostate cancer. Additional evidence is required to confirm this conclusion.
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Affiliation(s)
- Kewei Wang
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu 214122 People’s Republic of China
| | - Guosheng Wu
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu 214122 People’s Republic of China
| | - Jinping Li
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu 214122 People’s Republic of China
| | - Wentao Song
- Nanchang Center for Disease Control and Prevention, 833 Lijing Road, Nanchang, Jiangxi People’s Republic of China
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Abstract
The objective was to perform a meta-analysis to summarize the available evidence from prospective nested case-control studies on the association of vitamin D receptor (VDR) polymorphism and the risk of breast cancer.We searched PubMed, ISI web of science, EMBASE, and reference lists for included articles. Study specific odds ratios (ORs) and 95% confidence intervals (CIs) were pooled by using fixed-effect or random-effects models.Eight studies were included in the meta-analysis. There were no association between Fok1 gene allele contrast f versus F (OR: 0.859; 95%CI: 0.685-1.079), ff versus FF (OR: 0.893; 95%CI: 0.763-1.045), recessive models ff versus FF+Ff (OR: 0.932; 95%CI: 0.796-1.092), and dominant models ff+Ff versus FF (OR: 0.899; 95%CI: 0.780-1.037). The estimated VDR polymorphism showed no significant association between Bsm1, Taq1, Apa1 polymorphism, and breast cancer risk. In the Caucasian ethnic subgroup, no association was found between allele contrast, recessive models, and dominant models on Fok1, Bsm1 polymorphism, and breast cancer risk.VDR polymorphism (Fok1, Bsm1, Taq1, and Apa1) were not associated with the risk of breast cancer in the general population as well as Caucasian population.
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Affiliation(s)
- Demin Lu
- From the Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou (DL, SZ) and Ningbo First Hospital, Ningbo, Zhejiang, China (LJ)
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Pulito C, Terrenato I, Di Benedetto A, Korita E, Goeman F, Sacconi A, Biagioni F, Blandino G, Strano S, Muti P, Mottolese M, Falvo E. Cdx2 polymorphism affects the activities of vitamin D receptor in human breast cancer cell lines and human breast carcinomas. PLoS One 2015; 10:e0124894. [PMID: 25849303 PMCID: PMC4388514 DOI: 10.1371/journal.pone.0124894] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/07/2015] [Indexed: 12/02/2022] Open
Abstract
Vitamin D plays a role in cancer development and acts through the vitamin D receptor (VDR). It regulates the action of hormone responsive genes and is involved in cell cycle regulation, differentiation and apoptosis. VDR is a critical component of the vitamin D pathway and different common single nucleotide polymorphisms have been identified. Cdx2 VDR polymorphism can play an important role in breast cancer, modulating the activity of VDR. The objective of this study is to assess the relationship between the Cdx2 VDR polymorphism and the activities of VDR in human breast cancer cell lines and carcinomas breast patients. Cdx2 VDR polymorphism and antiproliferative effects of vitamin D treatment were investigated in a panel of estrogen receptor-positive (MCF7 and T-47D) and estrogen receptor-negative (MDA-MB-231, SUM 159PT, SK-BR-3, BT549, MDA-MB-468, HCC1143, BT20 and HCC1954) human breast cancer cell lines. Furthermore, the potential relationship among Cdx2 VDR polymorphism and a number of biomarkers used in clinical management of breast cancer was assessed in an ad hoc set of breast cancer cases. Vitamin D treatment efficacy was found to be strongly dependent on the Cdx2 VDR status in ER-negative breast cancer cell lines tested. In our series of breast cancer cases, the results indicated that patients with variant homozygote AA were associated with bio-pathological characteristics typical of more aggressive tumours, such as ER negative, HER2 positive and G3. Our results may suggest a potential effect of Cdx2 VDR polymorphism on the efficacy of vitamin D treatment in aggressive breast cancer cells (estrogen receptor negative). These results suggest that Cdx2 polymorphism may be a potential biomarker for vitamin D treatment in breast cancer, independently of the VDR receptor expression.
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Affiliation(s)
- Claudio Pulito
- Molecular Chemoprevention Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Department of Epidemiology, Regina Elena National Cancer Institute, Rome, Italy
| | - Anna Di Benedetto
- Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy
| | - Etleva Korita
- Molecular Chemoprevention Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Frauke Goeman
- Translational Oncogenomics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Sacconi
- Translational Oncogenomics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Biagioni
- Translational Oncogenomics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Blandino
- Translational Oncogenomics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Strano
- Molecular Chemoprevention Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Paola Muti
- Department of Oncology, Juravinski Cancer Center-McMaster University Hamilton, Hamilton, ON L8V 5C2, Ontario, Canada
| | - Marcella Mottolese
- Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy
| | - Elisabetta Falvo
- Laboratory of Pharmacogenomics (Area Molecular Medicine), Regina Elena National Cancer Institute, Rome, Italy
- * E-mail:
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Bidgoli SA, Azarshab H. Role of vitamin D deficiency and lack of sun exposure in the incidence of premenopausal breast cancer: a case control study in Sabzevar, Iran. Asian Pac J Cancer Prev 2015; 15:3391-6. [PMID: 24870727 DOI: 10.7314/apjcp.2014.15.8.3391] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Vitamin D has been suggested as one of the critical factors for female reproductive health with protective activities against different cancers but there are conflicting facts regarding its role on breast cancer without any clear data on premenopausal cases. This study aimed to evaluate the role of vitamin D from dietary sources and sunlight exposure on the incidence of premenopausal breast cancer. MATERIALS AND METHODS We conducted a case control study on 60 newly diagnosed premenopausal breast cancer patients and 116 normal women who lived in Sabzevar and surrounding villages in Razavi, Khorasan, a rural and conservative area of Iran. RESULTS The mean concentrations of 25-OH vitamin D in cases and controls were 15.2 ± 8.15 vs 15.5 ± 7/45 ng/ml, both well below normal values elsewhere. In fact 50% of analyzed individuals showed very severe or severe vitamin D deficiency and the rest (25%) were detected in suboptimal levels. Although the lack of vitamin D and calcium supplementation increased slightly the risk of premenopausal breast cancer (p=0.009, OR=1.115, CI 95%=1.049-1.187), higher prevalence of weekly egg consumption (86.66% vs 96.55%, p=0.023, OR=0.232, CI 95% 0.065-0.806) showed a slight protective role. The last but the most important risk factor was lack of sunlight exposure because the breast cancer patients had total body coverage from sun (p=0.007, OR=10.131, CI 98% 0.314-78.102). CONCLUSION This study pointed out the role of vitamin D and other possible risk factors on the development and growth of breast tumors in this special geographical region. Although this study has revealed the interactions between hormonal and environmental factors in this province of Iran, understanding the deficiency pattern and its contribution to other lifestyle factors elsewhere is also necessary.
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Affiliation(s)
- Sepideh Arbabi Bidgoli
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch (IAUPS), Tehran, Iran E-mail :
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