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Toribio MJ, Priego-Capote F, Pérez-Gómez B, Fernández de Larrea-Baz N, Ruiz-Moreno E, Castelló A, Lucas P, Sierra MÁ, Pino MN, Martínez-Cortés M, Luque de Castro MD, Lope V, Pollán M. Factors Associated with Serum Vitamin D Metabolites and Vitamin D Metabolite Ratios in Premenopausal Women. Nutrients 2021; 13:3747. [PMID: 34836003 PMCID: PMC8621214 DOI: 10.3390/nu13113747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
The most representative indicator of vitamin D status in clinical practice is 25(OH)D3, but new biomarkers could improve the assessment of vitamin D status and metabolism. The objective of this study is to investigate the association of serum vitamin D metabolites and vitamin D metabolite ratios (VMRs) with potentially influential factors in premenopausal women. This is a cross-sectional study based on 1422 women, aged 39-50, recruited from a Madrid Medical Diagnostic Center. Participants answered an epidemiological and a food frequency questionnaire. Serum vitamin D metabolites were determined using an SPE-LC-MS/MS platform. The association between participant's characteristics, vitamin D metabolites, and VMRs was quantified by multiple linear regression models. Mean 25(OH)D3 concentration was 49.2 + 18.9 nmol/L, with greater deficits among obese, nulliparous, dark-skinned women, and with less sun exposure. A lower R2 ratio (1,25(OH)2D3/25(OH)D3) and a higher R4 (24,25(OH)2D3/1,25(OH)2D3) were observed in nulliparous women, with high sun exposure, and those with low caloric intake or high consumption of calcium, vitamin D supplements, or alcohol. Nulliparous women had lower R1 (25(OH)D3/Vit D3) and R3 (24,25(OH)2D3/25(OH)D3), and older women showed lower R3 and R4. Vitamin D status modified the association of the VMRs with seasons. VMRs can be complementary indicators of vitamin D status and its endogenous metabolism, and reveal the influence of certain individual characteristics on the expression of hydroxylase enzymes.
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Affiliation(s)
- María José Toribio
- Servicio de Admisión, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Feliciano Priego-Capote
- Department of Analytical Chemistry, University of Córdoba, 14014 Córdoba, Spain; (F.P.-C.); (M.D.L.d.C.)
- Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - Beatriz Pérez-Gómez
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
| | - Emma Ruiz-Moreno
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
| | - Adela Castelló
- Faculty of Medicine, University of Alcalá, 28871 Alcalá de Henares, Spain;
| | - Pilar Lucas
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
| | - María Ángeles Sierra
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, 28007 Madrid, Spain; (M.N.P.); (M.M.-C.)
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, 28007 Madrid, Spain; (M.N.P.); (M.M.-C.)
| | - María Dolores Luque de Castro
- Department of Analytical Chemistry, University of Córdoba, 14014 Córdoba, Spain; (F.P.-C.); (M.D.L.d.C.)
- Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - Virginia Lope
- Servicio de Admisión, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
| | - Marina Pollán
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (B.P.-G.); (N.F.d.L.-B.); (E.R.-M.); (P.L.); (M.Á.S.); (M.P.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain
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Toribio MJ, Lope V, Castelló A, Salas D, Vidal C, Ascunce N, Santamariña C, Moreo P, Pedraz-Pingarrón C, Sánchez-Contador C, Aragonés N, Pérez-Gómez B, Pollán M. Prevalence of healthy lifestyles against cancer in Spanish women. Sci Rep 2019; 9:10638. [PMID: 31337864 PMCID: PMC6650391 DOI: 10.1038/s41598-019-47180-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/11/2019] [Indexed: 01/30/2023] Open
Abstract
Modifying behavior towards healthier lifestyles could prevent a significant number of malignant tumors. We evaluated the prevalence of healthy habits against cancer in Spanish women free of this disease, taking as a reference the recommendations for cancer prevention included in the European Code Against Cancer (ECAC), and we explored the characteristics associated with it. Our population comprised 3,584 women recruited in a population-based cross-sectional study carried out in 7 breast cancer screening programs. Information was directly surveyed and used to calculate a score based on ECAC recommendations referred to bodyweight, physical activity, diet, breastfeeding, tobacco, alcohol and hormone replacement therapy use. The degree of adherence was estimated with a score that evaluated null (0 points), partial (0.5 points) and full adherence (1 point) of each specific recommendation. Associations were explored using binary and ordinal logistic regression models. The median score was 5.7 out of 9 points. Recommendations with lower adherence were those related to intake of red/processed meat and foods high in salt (23% of total adherence), physical activity (24%) and body weight (29%), and recommendations with greater adherence where those related to hormone replacement therapy use (91%), vegetable intake (84%), alcohol (83%) and tobacco (61%). Overall adherence was better among older women, parous women, and in those living in rural areas, and worse among women with higher caloric intake. These recommendations should be evaluated periodically. Screening programs can be an appropriate place to disseminate this information.
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Affiliation(s)
- María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - Adela Castelló
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas
- General Directorate Public Health, and FISABIO, Valencia, Spain
| | - Carmen Vidal
- Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Nieves Ascunce
- Navarra Breast cancer Screening Program, Public Health Institute, Pamplona, Spain
| | - Carmen Santamariña
- Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain
| | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Health Service of Aragon, Zaragoza, Spain
| | - Carmen Pedraz-Pingarrón
- Castile-Leon Breast Cancer Screening Program, General Directorate Public Health SACYL, Burgos, Spain
| | - Carmen Sánchez-Contador
- Balearic Islands Breast Cancer Screening Program, Health Promotion for Women and Childhood, General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, Balearic Islands, Palma, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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Lope V, Toribio MJ, Pérez-Gómez B, Castelló A, Mena-Bravo A, Sierra MÁ, Lucas P, Herrán-Vidaurrázaga MDC, González-Vizcayno C, Pino MN, Cruz-Campos I, Roca-Navarro MJ, Aragonés N, Romieu I, Martínez-Cortés M, Luque de Castro MD, Pollán M. Serum 25-hydroxyvitamin D and mammographic density in premenopausal Spanish women. J Steroid Biochem Mol Biol 2019; 189:101-107. [PMID: 30836177 DOI: 10.1016/j.jsbmb.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/29/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
The role of vitamin D in mammographic density is still unclear. This study examines the association between serum 25-hydroxyvitamin D (25(OH)D) and mammographic density, overall and by specific women characteristics. DDM-Madrid is a cross-sectional study that recruited 1403 premenopausal women in a breast radiodiagnosis unit of Madrid City Council. Information was collected with a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography-tandem mass spectrometry. Percent mammographic density was assessed using a semi-automated computer tool (DM-Scan). Multivariable linear regression models were used to quantify the associations, categorizing 25(OH)D levels (nmol/L) into 3 groups according to the cut-offs established by the US Endocrine Society. Models were adjusted for age, education, body mass index, age at menarche, parity, previous breast biopsies, family history of breast cancer, physical activity, energy intake, use of corticoids, hypercholesterolemia and day of sample extraction. Mean serum 25(OH)D level was 49.4 + 18.9 nmol/L. Women with sufficient concentrations of 25(OH)D showed a slight decrease in mammographic density (β >75nmol/L=-3.40; p = 0.037). No differences were observed according to women characteristics except for parity, where the protective effect of 25(OH)D was only seen among nulliparous (β >75nmol/L=-13.00; p-heterogeneity = 0.006). In light of the protective effect of vitamin D on mammographic density and the high prevalence of vitamin D insufficiency in our population, improving these levels could be an effective measure for the prevention of health problems related to the lack of this essential vitamin.
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Affiliation(s)
- Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Adela Castelló
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Antonio Mena-Bravo
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - María Ángeles Sierra
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Pilar Lucas
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | | | | | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | | | | | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico; Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - María D Luque de Castro
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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