A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers
A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers
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DOI：
10.1158/0008-5472.can-06-1876
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发表时间：
2006-10-15
期刊：
影响因子：
11.2
通讯作者：
Albanes, Demetrius
中科院分区：
文献类型：
--
作者：
Stolzenberg-Solomon, Rachael Z.;Vieth, Reinhold;Albanes, Demetrius
在一些生态学研究中，阳光照射与胰腺癌的低死亡率有关。皮肤暴露于UVB光诱导皮肤产生25-羟基维生素D [25（OH）D]的前体。胰岛和导管细胞表达25（OH）D-3-1 α-羟化酶，该酶产生生物活性1，25（OH）2维生素D形式。因此，25（OH）D浓度可能影响胰腺功能，并可能影响胰腺癌的病因。我们在芬兰男性吸烟者中进行了一项前瞻性巢式病例对照研究，以α-生育酚，β-胡萝卜素癌症预防队列为研究对象，基线年龄为50至69岁，以测试诊断前血清25（OH）D浓度确定的更充足的维生素D状态是否与胰腺癌风险降低相关。在1985年至2001年期间发生的200例外分泌胰腺癌病例（随访长达16.7年）与400例在诊断病例时存活且无癌症的对照组的年龄和抽血日期相匹配。采用条件Logistic回归计算比值比（OR）和95%置信区间（95%CI）。较高的维生素D浓度与胰腺癌风险增加3倍相关（最高与最低五分位数，> 65.5与< 32.0 nmol/L：OR，2.92; 95% CI，1.56-5.48，P趋势= 0.001），排除随访期间早期诊断的病例后仍然存在。与预期相反，诊断前维生素D状态较高的受试者与状态较低的受试者相比，胰腺癌风险增加。我们的研究结果需要在其他人群中复制，在解释和影响时需要谨慎。我们的研究结果是有趣的，并可能提供线索，进一步了解这种高度致命的癌症的病因。
Sun exposure is associated with lower death rates for pancreatic cancer in some ecological studies. Skin exposure to UVB light induces cutaneous production of precursors to 25-hydroxyvitamin D [25(OH)D]. Pancreatic islet and duct cells express 25(OH)D-3-1 alpha-hydroxylase that generates the biologically active 1,25(OH)2 vitamin D form. Thus, 25(OH)D concentrations could affect pancreatic function and possibly pancreatic cancer etiology. We conducted a prospective nested case-control study in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention cohort of male Finnish smokers, ages 50 to 69 years at baseline, to test whether more adequate vitamin D status, as determined by prediagnostic serum 25(OH)D concentrations, was associated with lower pancreatic cancer risk. Two hundred incident exocrine pancreatic cancer cases that occurred between 1985 and 2001 (up to 16.7 years of follow-up) were matched by age and date of blood draw to 400 controls who were alive and free of cancer at the time the case was diagnosed. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using conditional logistic regression. Higher vitamin D concentrations were associated with a 3-fold increased risk for pancreatic cancer (highest versus lowest quintile, > 65.5 versus < 32.0 nmol/L: OR, 2.92; 95% CI, 1.56-5.48, P-trend = 0.001) that remained after excluding cases diagnosed early during follow-up. Contrary to expectations, subjects with higher prediagnostic vitamin D status had an increased pancreatic cancer risk compared with those with lower status. Our findings need to be replicated in other populations and caution is warranted in their interpretation and implication. Our results are intriguing and may provide clues that further the understanding of the etiology of this highly fatal cancer.