Serum vitamin D and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian screening trial.
Serum vitamin D and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian screening trial.
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DOI：
10.1158/0008-5472.can-08-2694
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发表时间：
2009-02-15
期刊：
影响因子：
11.2
通讯作者：
Silverman DT
中科院分区：
文献类型：
--
作者：
Stolzenberg-Solomon RZ;Hayes RB;Horst RL;Anderson KE;Hollis BW;Silverman DT
实验证据表明维生素D具有抗癌作用；然而，一项在芬兰男性吸烟者群体中进行的嵌套病例对照研究发现，较高的25-羟基维生素D[25(OH)D]--由阳光和饮食确定的维生素D状况的最佳指标--与胰腺癌风险显著增加3倍相关。我们在前列腺癌、肺癌、结直肠癌和卵巢筛查试验队列中进行了一项嵌套式病例对照研究，研究对象为年龄在55岁到74岁之间的男性和女性，以测试诊断前血清25(OH)D浓度是否与胰腺癌风险相关。1994至2006年间，发生了184例胰腺癌病例(随访11.7年)。为每个病例选择两名在确诊时还活着的对照组(n=368)，并按年龄、种族、性别和抽血日历日期匹配(以控制季节性变化)。我们使用条件Logistic回归计算优势比(OR)和95%可信区间(95%CI)，调整了吸烟和体重指数。维生素D浓度总体上与胰腺癌无关(最高与最低五分之一，82.3vs45.9nmol/L：OR，1.45；95%CI，0.66-3.15；P趋势=0.49)。然而，在低估计的年度住宅太阳紫外线照射的受试者中观察到正相关，但在中高暴露的受试者中观察到正相关(P交互作用=0.015)。我们没有证实25(OH)D与胰腺癌之间先前的强正相关；然而，在居民UVB暴露水平较低的参与者中，风险增加是相似的。
Experimental evidence suggests that vitamin D has anti-carcinogenic properties; however, a nested case-control study conducted in a population of male Finnish smokers found that higher 25-hydroxyvitamin D [25(OH)D], the best indicator of vitamin D status as determined by the sun and diet, was associated with a significant 3-fold increased risk for pancreatic cancer. We conducted a nested case-control study in the Prostate, Lung, Colorectal, and Ovarian Screening Trial cohort of men and women 55 to 74 years of age at baseline to test whether prediagnostic serum 25(OH)D concentrations were associated with pancreatic cancer risk. Between 1994 and 2006, 184 incident cases of pancreatic adenocarcinoma occurred (follow-up to 11.7 years). Two controls (n = 368) who were alive at the time the case was diagnosed were selected for each case and matched by age, race, sex, and calendar date of blood draw (to control for seasonal variation). We calculated odds ratios (OR) and 95% confidence intervals (95% CI) using conditional logistic regression, adjusting for smoking and body mass index. Vitamin D concentrations were not associated with pancreatic cancer overall (highest versus lowest quintile, >82.3 versus <45.9 nmol/L: OR, 1.45; 95% CI, 0.66–3.15; P trend = 0.49). However, positive associations were observed among subjects with low estimated annual residential solar UBV exposure, but not among those with moderate to high annual exposure (P interaction = 0.015). We did not confirm the previous strong positive association between 25(OH)D and pancreatic cancer; however, the increased risk among participants with low residential UVB exposure is similar.