Serum 25(OH)-Vitamin D concentration and risk of esophageal squamous dysplasia
Serum 25(OH)-Vitamin D concentration and risk of esophageal squamous dysplasia
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DOI：
10.1158/1055-9965.epi-07-0461
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发表时间：
2007-09-01
影响因子：
3.8
通讯作者：
Qiao, You-Lin
中科院分区：
文献类型：
--
作者：
Abnet, Christian C.;Chen, Wen;Qiao, You-Lin
背景资料：鳞状不典型增生是食管鳞状细胞癌的前体病变，营养因素在该癌症的病因中起重要作用。以前的研究使用的各种措施维生素D暴露之间的关联得出了不同的结论，维生素D和发展食管癌的风险。方法：我们测量了血清25-羟基维生素D [25（OH）D]浓度的横断面分析720例受试者从林县，中国，一个人口在发展食管鳞状细胞癌的高风险。所有受试者均接受了内镜检查和活检，并根据是否存在组织学鳞状不典型增生进行分类。我们使用粗和多变量调整广义线性模型来估计鳞状不典型增生和血清25（OH）D浓度的性别特异性四分位数之间的关联的相对风险（RR）和95%置信区间（95%CI）。异型增生受试者的中位血清25（OH）D浓度显著高于非异型增生受试者，分别为36.5和31.5 nmol/L（Wilcoxon双样本检验，P = 0.0004）。在多变量校正模型中，与最低四分位数相比，最高四分位数的受试者发生鳞状上皮不典型增生的风险显著增加（1111，1.86; 95% CI，1.35-2.62）。当分别对男性和女性进行检查时，增加的风险相似：男性（RR，1.74; 95%CI，1.08-2.93）;女性（RR，1.96; 95%CI，1.28-3.18）。没有明显的测量或未测量混杂源解释这一发现。
Background: Squamous dysplasia is the precursor lesion for esophageal squamous cell carcinoma, and nutritional factors play an important role in the etiology of this cancer. Previous studies using a variety of measures for vitamin D exposure have reached different conclusions about the association between vitamin D and the risk of developing esophageal cancer.Methods: We measured serum 25-hydroxyvitamin D [25(OH)D] concentrations in a cross-sectional analysis of 720 subjects from Linxian, China, a population at high risk for developing esophageal squamous cell carcinoma. All subjects underwent endoscopy and biopsy and were categorized by the presence or absence of histologic squamous dysplasia. We used crude and multivariate-adjusted generalized linear models to estimate the relative risks (RR) and 95% confidence intervals (95% CI) for the association between squamous dysplasia and sex-specific quartiles of serum 25(OH)D concentration.Results: Two-hundred and thirty of 720 subjects (32%) had squamous dysplasia. Subjects with dysplasia had significantly higher median serum 25(OH)D concentrations than subjects without dysplasia, 36.5 and 31.5 nmol/L, respectively (Wilcoxon two-sample test, P = 0.0004). In multivariate-adjusted models, subjects in the highest compared with the lowest quartiles were at a significantly increased risk of squamous dysplasia (1111, 1.86; 95% CI, 1.35-2.62). Increased risks were similar when examined in men and women separately: men (RR, 1.74; 95% CI, 1.08-2.93); women (RR, 1.96; 95% CI, 1.28-3.18).Conclusions: Higher serum 25(OH)D concentrations were associated with significantly increased risk of squamous dysplasia. No obvious source of measured or unmeasured confounding explains this finding.