Optimal vitamin D status for colorectal cancer prevention - A quantitative meta analysis
Optimal vitamin D status for colorectal cancer prevention - A quantitative meta analysis
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DOI：
10.1016/j.amepre.2006.11.004
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发表时间：
2007-03-01
影响因子：
5.5
通讯作者：
Holick, Michael F.
中科院分区：
文献类型：
--
作者：
Gorham, Edward D.;Garland, Cedric F.;Holick, Michael F.
工作背景：以前的研究，如妇女的健康倡议，已经表明，低剂量的维生素D并不能防止结直肠癌，但荟萃分析表明，较高的剂量可能会降低其incidence.Methods：五项研究血清25（OH）D与结直肠癌的风险被确定使用PubMed。使用标准方法合并所有5项血清研究的结果进行合并分析。将汇总结果分为五分位数，25（OH）D中位值为6、16、22、27和37 ng/mL。使用Peto的无假设方法，以25（OH）D的最低五分位数作为参考组，通过合并数据的五分位数计算比值比。根据汇总数据中每个五分位数的比值绘制剂量-反应曲线。结果：血清25（OH）D联合研究中结直肠癌的比值比从低到高依次为1.00、0.82、0.66、0.59和0.46（p（趋势）< 0.0001）。根据合并数据同质性的DerSimonian-Laird检验，研究具有同质性（chi（2）= 1.09，df=4，p=0.90）。最高五分位数与最低五分位数的合并比值比为0.49（p < 0.0001，95%置信区间，0.35-0.68）。与对照组相比，血清25（OH）D水平>= 33 ng/mL与结肠直肠癌风险降低50%相关。
Background: Previous studies, such as the Women's Health Initiative, have shown that a low dose of vitamin D did not protect against colorectal cancer, yet a meta-analysis indicates that a higher dose may reduce its incidence.Methods: Five studies of serum 25(OH)D in association with colorectal cancer risk were identified using PubMed. The results of all five serum studies were combined using standard methods for pooled analysis. The pooled results were divided into quintiles with median 25(OH)D values of 6, 16, 22, 27, and 37 ng/mL. Odds ratios were calculated by quintile of the pooled data using Peto's Assumption-Free Method, with the lowest quintile of 25(OH)D as the reference group. A dose-response curve was plotted based on the odds for each quintile of the pooled data. Data were abstracted and analyzed in 2006.Results: Odds ratios for the combined serum 25(OH)D studies, from lowest to highest quintile, were 1.00, 0.82, 0.66, 0.59, and 0.46 (p(trend)< 0.0001) for colorectal cancer. According to the DerSimonian-Laird test for homogeneity of pooled data, the studies were homogeneous (chi(2) = 1.09, df=4, p=0.90. The pooled odds ratio for the highest quintile versus the lowest was 0.49 (p < 0.0001, 95% confidence interval, 0.35-0.68). A 50% lower risk of colorectal cancer was associated with a serum 25 (OH) D level >= 33 ng/mL, compared to