Effects of supplemental vitamin D and calcium on biomarkers of inflammation in colorectal adenoma patients: a randomized, controlled clinical trial.
Effects of supplemental vitamin D and calcium on biomarkers of inflammation in colorectal adenoma patients: a randomized, controlled clinical trial.
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DOI：
10.1158/1940-6207.capr-11-0105
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发表时间：
2011-10
期刊：
影响因子：
--
通讯作者：
Bostick RM
中科院分区：
文献类型：
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作者：
Hopkins MH;Owen J;Ahearn T;Fedirko V;Flanders WD;Jones DP;Bostick RM
维生素D和钙影响炎症、肿瘤生长和与致癌相关的免疫监视的几种途径。此外，流行病学证据表明，钙和维生素D可以降低结直肠腺瘤和癌症的风险。为了研究钙和维生素D对结直肠腺瘤患者炎症生物标志物的影响，我们进行了一项试点，随机，双盲，安慰剂对照，2×2析因临床试验（n=92），2 g/天钙和/或800 IU/天维生素D3补充剂与安慰剂相比，为期6个月。使用酶联免疫测定法测量促炎标志物（CRP、TNF-α、IL-6、IL-1β和IL-8）和抗炎标志物（IL-10）的血浆浓度。治疗6个月后，在维生素D3补充组中，CRP总体下降32%（p=0.11），男性下降37%（p=0.05），非NSAID使用者下降41%（p=0.05）。在维生素D3补充组中，TNF-α降低13%，IL-6降低32%，IL-1β降低50%，IL-8降低15%;在钙补充组中，IL-6降低37%，IL-8降低11%，IL-1β降低27%。虽然这些变化没有统计学意义，但维生素D3治疗组的综合炎症标志物z评分总体下降77%（p=0.003），男性下降83%（p=0.01），非NSAID使用者下降48%（p=0.01）。没有证据表明维生素D3和钙之间存在协同作用或对IL-10有影响。这些初步结果与单独补充维生素D3或钙的促肿瘤炎症生物标志物减少的模式一致，并支持进一步研究维生素D3作为炎症和结直肠肿瘤的化学预防剂。
Vitamin D and calcium affect several pathways involved in inflammation, tumor growth, and immune surveillance relevant to carcinogenesis. Also, epidemiologic evidence indicates that calcium and vitamin D may reduce risk for colorectal adenomas and cancer. To investigate the effects of calcium and vitamin D on biomarkers of inflammation in colorectal adenoma patients, we conducted a pilot, randomized, double-blind, placebo-controlled, 2×2 factorial clinical trial (n=92), of 2 g/day calcium and/or 800 IU/day vitamin D3 supplementation vs. placebo over six months. Plasma concentrations of pro-inflammatory markers (CRP, TNF-α, IL-6, IL-1β, and IL-8) and an anti-inflammatory marker (IL-10) were measured using enzyme-linked immunoassays. After six months of treatment, in the vitamin D3 supplementation group, CRP decreased 32% overall (p=0.11), 37% in men (p=0.05), and 41% among non-NSAID users (p=0.05) relative to placebo. In the vitamin D3 supplementation group, TNF-α decreased 13%, IL-6 32%, IL-1β 50%, and IL-8 15%; in the calcium supplementation group, IL-6 decreased 37%, IL-8 11%, and IL-1β 27%. Although these changes were not statistically significant, a combined inflammatory markers z-score decreased 77% (p=0.003) in the vitamin D3 treatment group overall, 83% (p=0.01) among men, and 48% among non-NSAID users (p=0.01). There was no evidence of synergy between vitamin D3 and calcium or effects on IL-10. These preliminary results are consistent with a pattern of reduction in tumor-promoting inflammation biomarkers with vitamin D3 or calcium supplementation alone, and support further investigation of vitamin D3 as a chemopreventive agent against inflammation and colorectal neoplasms.