Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.
Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.
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DOI：
10.1136/bmj.k671
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发表时间：
2018-03-07
期刊：
影响因子：
--
通讯作者：
Japan Public Health Center-based Prospective Study Group
中科院分区：
文献类型：
--
作者：
Budhathoki S;Hidaka A;Yamaji T;Sawada N;Tanaka-Mizuno S;Kuchiba A;Charvat H;Goto A;Kojima S;Sudo N;Shimazu T;Sasazuki S;Inoue M;Tsugane S;Iwasaki M;Japan Public Health Center-based Prospective Study Group
在一项大型队列研究中评价诊断前循环维生素D浓度与随后总体和部位特异性癌症风险之间的相关性。基于日本公共卫生中心的前瞻性研究队列中的巢式病例队列研究。日本全国有9个公共卫生中心。3301例癌症病例和4044例随机选择的子队列参与者。酶免疫法测定血浆25-羟基维生素D浓度。参与者被分为四分之一的基础上，性别和季节的具体分布的25-羟基维生素D的亚队列。使用加权考克斯比例风险模型计算25-羟基维生素D浓度类别中总体和部位特异性癌症的多变量校正风险比，以最低四分之一作为参考。总体或部位特异性癌症的发病率。血浆25-羟基维生素D浓度与总癌症风险呈负相关，第二至第四季度的多变量校正风险比与最低季度的0.81相比（95%置信区间0.70 - 0.94）、0.75（0.65 - 0.87）和0.78（0.67 - 0.91）（趋势P =0.001）。在特定部位癌症的研究结果中，发现肝癌呈负相关，相应的风险比为0.70（0.44至1.13），0.65（0.40至1.06）和0.45（0.26至0.79）（趋势P =0.006）。一项敏感性分析显示，从总癌症病例中交替删除一个特定部位的癌症病例并没有实质性改变总体风险比。在这项大型前瞻性研究中，较高的维生素D浓度与较低的总癌症风险相关。这些发现支持了维生素D在许多部位对癌症具有保护作用的假设。
To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Nine public health centre areas across Japan. 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Incidence of overall or site specific cancer. Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites.
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