Predicted 25-hydroxyvitamin D in relation to incidence of breast cancer in a large cohort of African American women.
Predicted 25-hydroxyvitamin D in relation to incidence of breast cancer in a large cohort of African American women.
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DOI：
10.1186/s13058-016-0745-x
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发表时间：
2016-08-12
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影响因子：
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通讯作者：
Cozier YC
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作者：
Palmer JR;Gerlovin H;Bethea TN;Bertrand KA;Holick MF;Ruiz-Narvaez EN;Wise LA;Haddad SA;Adams-Campbell LL;Kaufman HW;Rosenberg L;Cozier YC
维生素D缺乏症与结直肠癌风险增加有关，在非洲裔美国人中特别常见。以前关于维生素D状况和乳腺癌风险的研究，主要是在白色妇女中进行的，结果相互矛盾。我们研究了59，000名非裔美国妇女的预测维生素D状态与乳腺癌发病率之间的关系。自1995年以来，黑人妇女健康研究的参与者每两年接受一次邮寄问卷调查，并通过医院和癌症登记记录证实了自我报告的癌症诊断。使用线性回归的重复五重交叉验证，基于2013-2015年从2856名参与者中获得的血浆标本中测量的25（OH）D和同一时间范围内基于胆固醇的变量，推导出最佳25-羟基维生素D（25（OH）D）预测模型。在包括1454例偶发浸润性乳腺癌的整个队列中，使用考克斯比例风险模型计算预测维生素D评分的每个四分位数相对于最高四分位数的发病率比（IRR）。每个两年暴露期的预测维生素D评分是到那时为止所有暴露期的预测评分的累积平均值。22%的25（OH）D测量值被归类为“缺乏”（<20 ng/mL），另外25%被归类为“不足”（20-29 ng/mL）。预测模型解释了25（OH）D测量值的25%变异，所有交叉验证运行中预测值与观察值的相关系数平均为0.49（SD 0.026）。乳腺癌风险随着预测25（OH）D的四分位数降低而增加，趋势p <0.015;最低与最高四分位数的IRR为1.23（95%置信区间1.04，1.46）。在前瞻性数据中，估计25（OH）D累积预测值最低四分位数的非裔美国妇女患乳腺癌的风险比相对较高水平的妇女高23%。预防维生素D缺乏可能是降低非裔美国妇女乳腺癌发病率的有效手段。
Vitamin D deficiency, which has been linked to an increased risk of colorectal cancer, is particularly common among African Americans. Previous studies of vitamin D status and breast cancer risk, mostly conducted in white women, have had conflicting results. We examined the relationship between predicted vitamin D status and incidence of breast cancer in a cohort of 59,000 African American women. Participants in the Black Women’s Health Study have been followed by biennial mail questionnaires since 1995, with self-reported diagnoses of cancer confirmed by hospital and cancer registry records. Repeated five-fold cross-validation with linear regression was used to derive the best 25-hydroxyvitamin D (25(OH)D) prediction model based on measured 25(OH)D in plasma specimens obtained from 2856 participants in 2013–2015 and questionnaire-based variables from the same time frame. In the full cohort, including 1454 cases of incident invasive breast cancer, Cox proportional hazards models were used to compute the incidence rate ratio (IRR) for each quartile of predicted vitamin D score relative to the highest quartile. Predicted vitamin D score for each two-year exposure period was a cumulative average of predicted scores from all exposure periods up to that time. Twenty-two percent of women with measured 25(OH)D were categorized as “deficient” (<20 ng/mL) and another 25 % as “insufficient” (20–29 ng/mL). The prediction model explained 25 % of variation in measured 25(OH)D and the correlation coefficient for predicted versus observed 25(OH)D averaged across all cross-validation runs was 0.49 (SD 0.026). Breast cancer risk increased with decreasing quartile of predicted 25(OH)D, p for trend 0.015; the IRR for the lowest versus highest quartile was 1.23 (95 % confidence interval 1.04, 1.46). In prospective data, African American women in the lowest quartile of cumulative predicted 25(OH)D were estimated to have a 23 % increased risk of breast cancer relative to those with relatively high levels. Preventing vitamin D deficiency may be an effective means of reducing breast cancer incidence in African American women.