Higher blood 25(OH)D level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies.
Higher blood 25(OH)D level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies.
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DOI：
10.1371/journal.pone.0049312
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Wang H
中科院分区：
文献类型：
--
作者：
Chen P;Li M;Gu X;Liu Y;Li X;Li C;Wang Y;Xie D;Wang F;Yu C;Li J;Chen X;Chu R;Zhu J;Ou Z;Wang H
实验数据表明，维生素D对乳腺癌有保护作用；然而，流行病学结果仍然具有包容性。通过一项基于中国人群的病例对照研究和观察性研究的荟萃分析，我们系统地评估了血液25(OH)D水平与乳腺癌风险的关系。在上海市593例乳腺癌患者和580例无癌对照中，80%的正常女性存在严重维生素D缺乏症（低于20 ng/mL）， 15.2%的女性存在轻度缺乏症（20 ~ 30 ng/mL），仅有4.8%的女性维生素D水平充足（50 ~ 30 ng/mL），而乳腺癌患者的这一比例分别为96.1%、3.2%和0.7%。与血浆25(OH)D水平最低的女性相比，血浆25(OH)D水平最高的女性患乳腺癌的风险显著降低（Q4 vs.Q1: OR = 0.10, 95% CI = 0.06-0.15），血浆25(OH)D水平每增加1 ng/ml，患乳腺癌的几率降低16% （OR = 0.84, 95% CI = 0.81-0.87； P<0.001）。从观察性研究的荟萃分析中，我们发现，在11项嵌套病例对照和回顾性研究（合并OR = 0.86, 95% CI = 0.75-1.00）和10项病例对照研究（7项基于人群的研究，OR = 0.35, 95% CI = 0.24-0.52； 3项基于医院的研究，OR = 0.08, 95% CI = 0.02-0.33）中，血液中25(OH)D水平最高分位数的女性与血液中25(OH)D水平最低分位数的女性相比，乳腺癌风险显著降低。这些结果表明维生素D可能对乳腺癌有化学预防作用。
Experimental data suggest a protective effect of vitamin D on breast cancer; however, epidemiologic results remain inclusive. With a Chinese population-based case-control study and meta-analysis of the observational studies, we here systematically evaluated the association of blood 25(OH)D level and breast cancer risk. With 593 breast cancer cases and 580 cancer-free controls from Shanghai, China, we found that 80% of the normal women had severe vitamin D deficiency (less than 20 ng/mL) and 15.2% had mild deficiency (20 to 30 ng/mL) and only 4.8% of women had sufficient vitamin D level (>30 ng/mL) while the proportion was 96.1%, 3.2% and 0.7% respectively for the breast cancer patients. Compared to those with the lowest quartile of plasma 25(OH)D level, women with highest quartile 25(OH)D level showed a significant decreased breast cancer risk (Q4 vs.Q1: OR = 0.10, 95% CI = 0.06–0.15) and every 1 ng/ml increment of plasma 25(OH)D level led to a 16% lower odds of breast cancer (OR = 0.84, 95% CI = 0.81–0.87; P<0.001). From the meta-analysis of the observational studies, we found that women with highest quantile of blood 25(OH)D level was associated with a significantly reduced breast cancer risk compared to those with lowest quantile of blood 25(OH)D level for the 11 nested case-control and retrospective studies (pooled OR = 0.86, 95% CI = 0.75–1.00) and 10 case-control studies (7 population based, OR = 0.35, 95% CI = 0.24–0.52; 3 hospital based, OR = 0.08, 95% CI = 0.02–0.33). These results suggest that vitamin D may have a chemo-preventive effect against breast cancer.
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