Plasma 25-hydroxyvitamin D and risk of pancreatic cancer.
Plasma 25-hydroxyvitamin D and risk of pancreatic cancer.
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DOI：
10.1158/1055-9965.epi-11-0836
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发表时间：
2012-01
期刊：
影响因子：
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通讯作者：
Fuchs CS
中科院分区：
文献类型：
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作者：
Wolpin BM;Ng K;Bao Y;Kraft P;Stampfer MJ;Michaud DS;Ma J;Buring JE;Sesso HD;Lee IM;Rifai N;Cochrane BB;Wactawski-Wende J;Chlebowski RT;Willett WC;Manson JE;Giovannucci EL;Fuchs CS
实验室研究表明，维生素D可以抑制胰腺癌细胞的生长。然而，维生素D和胰腺癌风险的流行病学研究一直相互矛盾。为了确定血浆25-羟基维生素D（25[OH]D）（IDS Inc.与胰腺癌风险相关，我们对2008年5个队列的451例病例和1167例对照进行了巢式病例对照研究的汇总分析。对照组的中位随访时间为HPFS 14.1年，NHS 18.3年，PHS 25.3年，WHI 12.2年，WHS 14.4年。采用Logistic回归分析比较血浆25（OH）D水平与胰腺癌发生率的关系。病例组的平均血浆25（OH）D低于对照组（61.3 vs. 64.5 nmol/L，P=0.005）。在逻辑回归模型中，血浆25（OH）D与胰腺癌的几率呈负相关。与底层五分位数相比，五分位数2 - 5的参与者的多变量调整优势比（OR [95%置信区间]）分别为0.79（0.56-1.10）、0.75（0.53-1.06）、0.68（0.48-0.97）和0.67（0.46-0.97）; P趋势=0.03）。与25[OH]D水平不足（<50 nmol/L）的受试者相比，25 [OH] D相对不足（50-<75 nmol/L）的受试者的OR为0.75（0.58-0.98），而25 [OH]D水平充足（≥75 nmol/L）的受试者的OR为0.71（0.52-0.97）。如既往研究所示，在25（OH）D≥100 nmol/L的受试者中未观察到风险增加。在亚组分析中，25（OH）D的上四分位数与下四分位数的OR分别为女性0.72（0.48-1.08）、男性0.73（0.40-1.31）和白人0.73（0.51-1.03）。在五个大型前瞻性队列的参与者中，血浆25（OH）D水平较高与胰腺癌风险较低相关。低循环25（OH）D可能使个体易于发生胰腺癌。
Laboratory studies suggest vitamin D may inhibit pancreatic cancer cell growth. However, epidemiologic studies of vitamin D and pancreatic cancer risk have been conflicting. To determine whether prediagnostic levels of plasma 25-hydroxyvitamin D (25[OH]D) (IDS Inc. enzymeimuunoassay) were associated with risk of pancreatic cancer, we performed a pooled analysis of nested case-control studies with 451 cases and 1167 controls from five cohorts through 2008. Median follow-up among controls was 14.1 years in HPFS, 18.3 years in NHS, 25.3 years in PHS, 12.2 years in WHI, and 14.4 years in WHS. Logistic regression was used to compare the odds of pancreatic cancer by plasma level of 25(OH)D. Mean plasma 25(OH)D was lower in cases versus controls (61.3 vs. 64.5 nmol/L, P=0.005). In logistic regression models, plasma 25(OH)D was inversely associated with odds of pancreatic cancer. Participants in quintiles two through five had multivariable-adjusted odds ratios (OR [95% confidence intervals]) of 0.79 (0.56–1.10), 0.75 (0.53–1.06), 0.68 (0.48–0.97), and 0.67 (0.46–0.97); P-trend=0.03), respectively, compared to the bottom quintile. Compared to those with insufficient levels (25[OH]D<50 nmol/L), ORs were 0.75 (0.58–0.98) for subjects with relative insufficiency (25[OH]D 50–<75 nmol/L) and 0.71 (0.52–0.97) for those with sufficient levels (25[OH]D≥75 nmol/L). No increased risk was noted in subjects with 25(OH)D≥100 nmol/L, as suggested in a prior study. In subgroup analyses, ORs for the top versus bottom quartile of 25(OH)D were 0.72 (0.48–1.08) for women, 0.73 (0.40–1.31) for men, and 0.73 (0.51–1.03) for Whites. Among participants in five large prospective cohorts, higher plasma levels of 25(OH)D were associated with a lower risk for pancreatic cancer. Low circulating 25(OH)D may predispose individuals to the development of pancreatic cancer.