Plasma 25-hydroxyvitamin D concentration and lymphoma risk: results of the European Prospective Investigation into Cancer and Nutrition
Plasma 25-hydroxyvitamin D concentration and lymphoma risk: results of the European Prospective Investigation into Cancer and Nutrition
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DOI：
10.3945/ajcn.112.054676
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发表时间：
2013-09-01
影响因子：
7.1
通讯作者：
Nieters, Alexandra
中科院分区：
文献类型：
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作者：
Luczynska, Anna;Kaaks, Rudolf;Nieters, Alexandra
背景：维生素 D 状态与淋巴瘤风险之间的关系尚无定论。目的：我们检查了诊断前血浆 25-羟基维生素 D [25(OH)D] 与淋巴癌风险之间的关联。设计：我们在欧洲癌症和营养前瞻性调查中进行了一项研究，纳入了 1127 例淋巴瘤病例和 1127 例匹配对照，平均随访时间为 7.1 年。使用条件逻辑回归来估计与血浆 25(OH)D 相关的淋巴瘤风险的多变量调整发病率比率。使用季节标准化和特定季节的 25(OH)D 四分位数。我们还分析了 25(OH)D 作为连续变量并使用预定义的截止值。结果：未观察到血浆 25(OH)D 与总体淋巴癌风险之间存在统计学上的显着关联。仅在随访前 2 年期间做出诊断的患者中才发现与 B 细胞非霍奇金淋巴瘤呈正相关（P 异质性 = 0.03），这表明存在反向因果关系的可能性。仅限于随访时间 >= 2 年的参与者的进一步分析显示 25(OH)D 与慢性淋巴细胞白血病 (CLL) (n = 161) 之间存在显着相关性：调整后的发病率比率为 0.40（95% CI：0.18，0.90；P 趋势 = 0.05）和 0.31（95% CI：0.13，0.76；P 趋势 = 0.05）。 P-趋势 = 0.03) 分别为顶部四分位数与底部季节标准化四分位数和特定季节四分位数的比较。膳食维生素 D 摄入量的数据进一步支持了所观察到的关联（发生率比：0.33；95% CI = 0.12, 0.89；P 趋势 = 0.006）。结论：我们的研究结果并不支持高 25(OH)D 浓度对淋巴癌的总体保护作用。然而，他们表明较高浓度的 25(OH)D 与 CLL 风险降低相关。
Background: The relation between vitamin D status and lymphoma risk is inconclusive.Objective: We examined the association between prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] and lymphoid cancer risk.Design: We conducted a study nested within the European Prospective Investigation into Cancer and Nutrition cohort of 1127 lymphoma cases and 1127 matched controls with a mean follow-up time of 7.1 y. Conditional logistic regression was used to estimate multivariable-adjusted incidence rate ratios of lymphoma risk in relation to plasma 25(OH)D. Season-standardized and season-specific 25(OH)D quartiles were used. We also analyzed 25(OH)D as a continuous variable and used predefined cutoffs.Results: No statistically significant association between plasma 25(OH)D and overall lymphoid cancer risk was observed. A positive association for B-cell non-Hodgkin lymphoma was noted only in those with a diagnosis made during the first 2 y of follow-up (P-heterogeneity = 0.03), which suggests the possibility of reverse causality. Further analysis restricted to participants with >= 2y of follow-up time showed a significant association between 25(OH)D and chronic lymphocytic leukemia (CLL) (n = 161): adjusted incidence rate ratios were 0.40 (95% CI: 0.18, 0.90; P-trend = 0.05) and 0.31 (95% CI: 0.13, 0.76; P-trend = 0.03) for the top compared with the bottom season-standardized and season-specific quartiles, respectively. Data on dietary vitamin D intake provided further support for the observed association (incidence rate ratio: 0.33; 95% CI = 0.12, 0.89; P-trend = 0.006).Conclusions: Our findings do not support a protective role of high 25(OH)D concentration in lymphoid cancers overall. However, they suggest that higher concentrations of 25(OH)D are associated with a reduced risk of CLL.