Association between Circulating Vitamin D,the Taq1 Vitamin D Receptor Gene Polymorphism and Colorectal Cancer Risk among Jordanians

Background: The physiological role of vitamin D extends beyond bone health and calcium-phosphate homeostasis to effects on cancer risk, mainly for colorectal cancer. Vitamin D may have an anticancer effect in colorectal cancer mediated by binding of the active form 1,25(OH)2D to the vitamin D receptor (VDR). The Taq1 VDR gene polymorphism, a C-to-T base substitution (rs731236) in exon 9 may influence its expression and function. The aim of this study wass to determine the 25(OH)D vitamin D level and to investigate the association between circulating vitamin D level and Taq1VDR gene polymorphism among Jordanian colorectal cancer patients. Materials and Methods: This case control study enrolled ninety-three patients and one hundred and two healthy Jordanian volunteers from AL-Basheer Hospital/Amman (2012-2013). Ethical approval and signed consent forms were obtained from all participants before sample collection. 25(OH)D levels were determined by competitive immunoassay Elecsys (Roche Diagnostic, France). DNA was extracted (Promega, USA) and amplified by PCR followed by VDR Taq1 restriction enzyme digestion. The genotype distribution was evaluated by pairedt-test and chi-square. Comparison between vitamin D levels among CRC and control were assessed by odds ratio with 95% confidence interval. Results: The vitamin D serum level was significantly lower among colorectal cancerpatients (8.34 ng/ml) compared to the healthy control group (21.02ng/ml). Patients deficient in vitamin D (less than 10.0 ng/ml) had increased colorectal cancer risk 19.2 fold compared to control. Only 2.2% of CRC patients had optimal vitamin D compared to 23.5% among healthy control. TT, Tt and tt Taq1 genotype frequencies among CRC cases was 35.5%, 50.5% and 14% compared to 43.1%, 41.2% and 15.7% among healthy control; respectively. CRC patients had lower mean vitamin D level among TT (8.91±4.31) and Tt (9.15±5.25) genotypescompared to control ((21.3±8.31) and (19.3±7.68); respectively. Conclusions: There is significant association between low 25(OH)D serum level and colorectal cancer risk. The VDRTaq1 polymorphism was associated with increased colorectal cancer risk among patient with VDRTaq1 TT and Tt genotypes. Understanding the functional mechanism of VDRTaq1 TT and Tt may provide a strategy for colorectal cancer prevention and treatment.     

Serum 25-hydroxy Vitamin D Status is Not Related to Osteopenia/Osteoporosis Risk in Colorectal Cancer Survivors

Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recentlypublished studies. In addition, prospective investigations have indicated that low vitamin D levels may beassociated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exactincidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis isstill not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors ofosteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancersurvivors treated with surgery and/or chemotherapy ± radiotherapy were recruited from medical oncologyoutpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed,and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients wasdivided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: Themedian age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male.The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); milddeficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency(<10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17(15.0%) . Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma,chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis.Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). Infemale patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients(p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5%and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopeniaand osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first toevaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.     

甲状腺肿瘤患者外周血CD+4 CDHi25 CDLo127 调节性T细胞的检测及其临床意义

 目的　分析甲状腺肿瘤患者外周血CD+4 CDHi25 CDLo127 调节性T细胞（Treg）比例及其变化规律,初步探讨甲状腺肿瘤免疫抑制机制,以及分化型甲状腺癌和结节性甲状腺肿发病机制之间可能存在的相关性。方法　采用流式细胞技术联合标记CD4、CD25、CD127,检测43例初治分化型甲状腺癌患者（分化型甲状腺癌组）、132例初治结节性甲状腺肿患者（结节性甲状腺肿组）及153名健康者（健康对照组）的外周血T细胞各亚群和Treg 的比例。结果　分化型甲状腺癌组[（6.48±1.49）%]及结节性甲状腺肿组[（6.23±1.67）%]患者CD+4 CDHi25 CDLo127 Treg 比例均高于健康对照组[（5.62±1.48）%],差异有统计学意义（P＜0.05）,而分化型甲状腺癌组及结节性甲状腺肿组之间,差异无统计学意义（P＞0.05）。结论　结节性甲状腺肿与分化型甲状腺癌患者外周血CD+4 CDHi25 CDLo127 Treg 比例较健康者均显著升高,提示CD+4 CDHi25 CDLo127 Treg 可能是甲状腺肿瘤患者免疫抑制的重要原因之一。     

Correlation between Serum 25-Hydroxyvitamin D Levels and Gastric Cancer: A Systematic Review and Meta-Analysis

The purpose of this meta-analysis was to evaluate the relationship between serum 25-hydroxyvitamin D[25(OH)D] levels and gastric cancer. PubMed, Embase, Cochrane Library, Web of Science, The China Academic Journals full-text database, Wanfang Database of Chinese Academic Journals, VIP Chinese Science and Technology Periodicals database, and Chinese Biomedical Literature database were systematically searched. Case-control studies on the correlation between serum 25-hydroxyvitamin D levels and gastric cancer were retrieved, and the data extracted were analyzed. The results of 9 case-control studies containing 671 patients showed that serum 25(OH)D levels in the gastric cancer group were lower than those in the control group (weighted mean difference (WMD) = −8.90, 95% confidence interval (CI): −11.5, −6.32, p < 0.01); the risk of vitamin D deficiency in the gastric cancer group was higher than that in the control group (Odds ratio = 3.09, 95% CI: 1.96, 4.87, p < 0.01). The serum 25(OH)D levels in patients with well and moderately differentiated gastric cancer were higher than those in patients with poorly differentiated gastric cancer (WMD = −3.58, 95% CI: −6.41, −0.74, p = 0.01). Thus, low levels of vitamin D may increase the risk of gastric cancer. Systematic review registration: PROSPERO CRD42022327942.     

Low Levels of Vitamin D in a Cohort of Women with Impalpable Breast Lesions from Rio de Janeiro/Brazil

Background: Low levels of vitamin D have been described as a risk factor for the development of breast cancer.The aim of this study was to evaluate the serum levels of vitamin D (25OHD) in patients with impalpable breast lesionscomparing with a control group. Methods: Vitamin D quantification (25OHD) was assessed in the plasma of 65 patientswith impalpable breast lesions and from 20 health controls using a chemiluminescent microparticle immunoassay.Pearson’s chi-square test and nonparametric t-Student were used to evaluate statistical significance between the clinicalvariables and the means of quantification of vitamin D. The receiver operating characteristic (ROC) curve was used toevaluate the correlation between age and vitamin sufficiency for the cases and the controls. Results: The prevalence ofvitamin D deficiency and/or insufficiency in women with malignant lesions was 84% and 60% for the control group.Using the chi-square or Fisher’s exact test, the relationship between vitamin D levels and age presented significantassociation only for the control group (P=0.002). Using ROC curve, the plot area (0.778) for the control group defineda cut-off value of 45 years to age, with specificity and sensitivity of 60% and 50%, respectively. Thus, the odds ratiofor vitamin D insufficiency in women over 45 years was 1.37 (P=0.011). For the case group, clinical characteristics,histological grade, and lymph node involvement did not show any significant association. Conclusion: The prevalence ofvitamin D deficiency/insufficiency is high in women with impalpable breast lesions, as well as in the control group,even in a tropical city. According to the results the age advancement may be involved with the decrease in vitamin Dlevels in plasma, but there was no statistical association between low levels of Vitamin D and breast cancer.     

Effect of Vitamin D Deficiency on Liver Cancer Risk: A Systematic Review and Meta-Analysis

Epidemiological studies have showed that vitamin D deficiency can increase the risk of liver cancers. Hence, we conducted a meta-analysis to explore the relationship between 25-hydroxyvitamin D [25(OH)D] levels and liver cancer risk. Methods: Cochrane Library, Medline, Web of Science, and Embase were searched up to Mar. 2020, and the references of those studies were also searched by hand. A meta-analysis of 11 studies was performed which met the inclusion criteria. Six case–control studies and five cohort studies were included. Results: A total of 11 studies (6 case–control and 5 cohort studies) with 12,895 incident cases were included in the meta-analysis. The meta-analysis showed that liver cancer risk was significantly increased for vitamin D deficiency, and the pooled RR and its 95% CIs was 2.16 (1.2, 3.88; P = 0.01). In comparative analyses between 25(OH)D levels in patients with hepatocellular carcinoma(HCC) and those in the control group individuals, the summary RR of liver cancer was -1.11 (95% CI=-1.96 to -0.25). The subgroup analysis of the different geographical region of the population showed that the risk of liver cancer in Asian subgroup, European subgroup and Egyptian subgroup increased for vitamin D deficiency (RR=1.34,95% CI 0.72 to 2.48, p <0.00001; RR=2.53,95% CI 1.62 to 3.93,p <0.0001;RR=29.5,95% CI 4.14 to 209.93, P=0.88). Conclusion: The results of this meta-analysis indicate that vitamin D deficiency is associated with increased risk of liver cancer. The 25(OH)D3 levels are lower in HCC patients than those in health controls. Maintenance of sufficient serum vitamin D levels would be beneficial for prevention of liver cancer.     

术前血清促甲状腺激素水平与甲状腺结节相关性的研究

目的:探讨术前血清促甲状腺激素( TSH)水平与甲状腺结节良恶性的关系.方法:回顾性分析了1499例甲状腺结节手术切除患者术前血清TSH、甲状腺B超,手术记录、术后病理诊断报告.根据术后病理报告判定甲状腺结节良恶性,分析术前血清TSH水平在甲状腺良恶性结节中的不同分布.结果:分化型甲状腺癌(DTC)患者术前血清TSH水平明显高于甲状腺良性结节组(2.179 ±2.017vs1.259 ±0.884) μIU/ml,P＜0.001;在DTC患者中,有淋巴结转移较无淋巴结转移、TNM分期Ⅲ、Ⅳ期较Ⅰ、Ⅱ期以及肿瘤直径≥1cm较＜1cm的患者术前血清TSH明显升高(均P＜0.001).结论:术前血清TSH水平是预测甲状腺结节良恶性的重要指标.     

The Fok1 Vitamin D Receptor Gene Polymorphism and 25(OH) D Serum Levels and Prostate Cancer among Jordanian Men

Background: Prostate cancer (PCa) is one of the most commonly diagnosed neoplasms and the second leadingcause of cancer death in men in the Western world. Vitamin D (1,25dihydroxy vitamin D) is linked to manybiological processes that influence oncogenesis but data on relations between its genetic variants and cancerrisk have been inconsistent. The aim of this study was to determine associations between a vitamin D geneticpolymorphism and 25-hydroxyvitamin D [25(OH)D] levels and prostate cancer. Materials and Methods: GenomicDNA was extracted from 124 Jordanian prostate cancer patients and 100 healthy volunteers. Ethical approvalwas granted from the ethical committee at Hashemite University and written consent was given by all patients.PCR was used to amplify the vitamin D receptor Fok1 polymorphism fragment. 25(OH)D serum levels weremeasured by competitive immunoassay. Results: All genotypes were in Hardy-Weinberg equilibrium. Genotypefrequency for Fok1 genotypes FF, Ff and ff was 30.7%, 61.3% and 8.06%, for prostate cancer patients, whilefrequencies for the control group was 28.0%, 66.0% and 6.0%, respectively, with no significant differences.Vitamin D serum level was significantly lower in prostate cancer patients (mean 7.7 ng/ml) compared to the controlgroup (21.8 ng/ml). No significant association was noted between 25(OH)D and VDR Fok1 gene polymorphismamong Jordanians overall, but significant associations were evident among prostate cancer patients (FF, Ff andff : 25(OH)D levels of 6.2, 8.2 and 9.9) and controls (19.0, 22.5 and 26.3, respectively). An inverse associationwas noted between 25(OH)D serum level less than 10ng/ml and prostate cancer risk (OR 35.5 and 95% CI 14.3-88.0). Conclusions: There is strong inverse association between 25(OH)D serum level less than 10ng/ml leveland prostate cancer risk.     

Genetic Variations in VDR could Modulate the Efficacy of Vitamin D3 Supplementation on Inflammatory Markers and Total Antioxidant Capacity among Breast Cancer Women: A Randomized Double Blind Controlled Trial

Background: Low levels of vitamin D are found in a great part of breast cancer women. Study subjects using vitaminD3 supplement had lower rates of cancers and fewer markers of inflammation. Additionally, recent studies demonstratethe power of vitamin D supplementation to lower inflammation and oxidative stress biomarkers associate with VDRpolymorphism to reduce inflammation. This study was aimed to assess the impact of vitamin D3 supplementation onthe serum concentration of inflammatory markers and antioxidant capacity with regard to VDR polymorphism in theVDR gene in breast cancer women. Methods: A randomized, double-blind, placebo-controlled trial was conducted on 56breast cancer women. Participants were assigned to 2 treatment arms: placebo and vitamin D3 for 2 months intervention.Supplementation group received 50,000 IU of vitamin weekly. Blood samples were collected at baseline and afterthe intervention to measure the 25(OH) D3, TNF-α, TGF- β and TAC. Genotyping was performed for FokI, BsmI, ApaI,and TaqI polymorphism. Results: After eight weeks supplementation, the intervention group showed a significant increasein the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004 and TAC (48.9±13.3 to 63.5±13.3; p= 0.017).Changes in TNF-α, TGF- β1 were not significant. Serum TAC levels of participants with the TT/Tt, Ff genotypes weremore responsive to supplementation. Conclusions: Supplementation with a vitamin D3 increased the TAC in breastcancer women, although it had no effect on inflammatory markers. Serum TAC in the TT/Tt, Ff were more responsive tovitamin D supplement compared with those with the FF/ff and tt genotypes.     

Epidemiologic Analysis of the Tehran Cancer Institute Data System Registry (TCIDSR)

Objective: To review epidemiological data on thyroid cancer in Iran. ‍Methods: The Tehran Cancer Institute Data System Registry (TCIDSR) was used to identify patients with different ‍histological types of thyroid cancer (TC) in Iran. Data were analysed from 438 thyroid cancer cases identified by the ‍TCIDSR in 1998-99. Disease prevalence was calculated with reference to age, time and place. ‍Results: The TCIDSR recorded 438 primary malignancies of the thyroid gland: papillary, follicular, medullary, ‍and anaplastic carcinomas accounted for 67.1%, 10.7%, 5.3% and 4.3% of cases, respectively. The remaining ‍12.6% were classified as OD (other diagnoses). The prevalence of TC was highest in ethnic Farsis. The age range of ‍patients was 8-85 years. Mean patient age was 44.52±17.03 years (mean ± SD) overall, 47.74±18.10 years in female ‍patients and 43.04±16.34 years in male patients. Anaplastic (6.5% vs. 3.3%) and medullary (10.0% vs. 3.0%) cancers ‍were more common in men than women. ‍Conclusion: This study was undertaken to define the epidemiological aspects of thyroid carcinoma in Iran, an ‍area of endemic iodine deficiency until fairly recently. Against expectation for an iodine-deficient area, the frequency ‍distribution of tumours in our study was closer to that seen in iodine-rich areas. Additional research on the risk ‍factors for thyroid cancer – genetic, ethnic, geographic and environmental – is needed to explain the high incidence ‍of PTC overall, and among ethnic Farsis in particular, in Iran. ‍     

RAGE、sRAGE在结肠癌中的表达及其临床意义

目的：本研究通过检测结肠癌组织晚期糖基化终末产物受体（ the receptor for advanced glycation end product,RAGE）和血清可溶性RAGE（ soluble RAGE,sRAGE）的表达水平,探讨其在结肠癌发生、发展过程中的作用及其临床意义。方法：本研究纳入49例非糖尿病结肠癌（ I、II、III期）患者,以免疫组织化学评分法（ immunohistochemical score,IHS）评价结肠癌RAGE表达水平,以ELISA法检测患者外周血血清sRAGE浓度。结果：结肠癌组织RAGE表达水平（IHS为1.24±0.48）显著高于癌周组织（IHS为0.50±0.25）（P﹤0.05）, III期（IHS为1.42±0.51）显著性高于I期（IHS为1.01±0.35）（P﹤0.05）和II期（IHS为1.11±0.42）（P﹤0.05）;低分化结肠癌组织（IHS为1.58±0.49）显著高于中分化（IHS为1.08±0.45）（P﹤0.05）和高分化结肠癌组织（IHS为1.02±0.27）（P﹤0.05）。结肠癌患者血清sRAGE表达水平术前、术后分别为（344.77±68.06）ng/L、（265.43±76.85）ng/L,二者相比有显著性差异（ P ﹤0.05）,而且分别与健康志愿者 sRAGE （149.97±30.12）ng/L相比有显著性差异（ P﹤0.05）,但sRAGE表达水平与TNM分期、结肠癌组织分化程度没有关联。结肠癌组织RAGE高表达患者术前血清sRAGE浓度（415.02±85.08）ng/L高于中表达（334.26±44.56）ng/L和低表达（335.95±78.48）ng/L患者（P﹤0.05）。结论：结肠癌组织RAGE表达水平与分化程度呈负相关趋势,与TNM分期呈正相关趋势,作为术后诊断指标有一定的临床意义。血清sRAGE浓度与结肠癌组织RAGE表达水平呈正相关趋势,但与TNM分期和结肠癌组织分化程度没有关联,作为术前诊断指标仅能代表结肠癌风险,但无法考量结肠癌的恶性程度和进展情况。     

Vitamin D - An Elixir for Recurrent Upper Respiratory Tract Infection

AIMThe aim of this study was to assess and compare the level of serum vitamin-D in participants affected with recurrent upper respiratory tract infections and in healthy population and to know whether vitamin-D deficiency is factor contributing to recurrent upper respiratory tract infections (URTI).Materials and MethodsA case control study was conducted on 52 subjects with recurrent URTI and 52 controls. Frequency and severity of infections in the previous 6 months were assessed and documented among the case group. Vitamin D level was assessed in all the participants among case and control group and statistical analysis was done.ResultsMean serum vitamin D was 10.67 ± 3.58 ng/mL in the study group and 20.10 ± 7.73 ng/mL in the control group, the difference in value was statistically significant. None of the study group participants belonged to vitamin D sufficient group, and majority (98%) were in vitamin D deficient, except for 2% who were in insufficient group. In the control group, 10%,29%,61% were in sufficient, insufficient and deficient group respectively. Mean serum vitamin D was not significantly associated with severity and type of infection.ConclusionSignificant number of participants in both study and control had serum vitamin D deficiency. This study also observed that a significant number of participants with recurrent URTI had serum vitamin D deficiency than the control group which suggest that hypovitaminosis D is a factor contributing to recurrent URTI.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12070-022-03220-z.     

Preliminary report: vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia

Background.

Vitamin D deficiency in noncancer patients is associated with symptoms of fatigue, muscle weakness, and depression. These symptoms are common among advanced cancer patients. We investigated the prevalence of low serum vitamin D levels in cancer patients with fatigue or poor appetite and their association with symptom burden and other correctable endocrine abnormalities.

Methods.

This was a retrospective review of 100 consecutive cancer patients with appetite or fatigue scores of ≥4 of 10 referred to a supportive care clinic. We investigated serum levels of 25(OH) vitamin D, cortisol, thyroid-stimulating hormone, and bioavailable testosterone. Symptoms were measured by the Edmonton Symptom Assessment Scale. Serum 25(OH) vitamin D <20 ng/mL was considered deficient; ≥20 ng/mL and <30 ng/mL were considered insufficient.

Results.

Patients were predominantly male (68%) and white (66%), with a median age of 60 years (range, 27–91 years). Gastrointestinal (30%) and lung (22%) cancers were predominant. Forty-seven patients (47%) were vitamin D deficient and 70 (70%) were insufficient. Thirteen of 70 patients (19%) with vitamin D insufficiency were on supplementation. Vitamin D deficiency was more common among nonwhites (82% versus 36%) and females. No significant association was found between vitamin D and symptoms. Hypogonadic males had a significantly lower mean 25(OH) vitamin D level than eugonadic males.

Conclusions.

Low vitamin D levels were highly prevalent among advanced cancer patients with cachexia or fatigue. Vitamin D deficiency was more frequent among nonwhite and female patients. Vitamin D levels were also significantly lower in male patients with hypogonadism.     

Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to 131I treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ≤1.628 points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ≥1.817 points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.     

Evaluation of vitamin D deficiency in breast cancer patients on bisphosphonates

BACKGROUND: Bisphosphonates are very effective in treating osteoporosis and metastatic bone disease; however, unfavorable outcomes can occur when they are given to patients with occult vitamin D deficiency. No clear consensus exists on the assessment of vitamin D status in cancer patients undergoing bisphosphonate therapy. This study examines the prevalence of vitamin D deficiency among breast cancer patients treated with bisphosphonates for osteoporosis or metastatic bone disease, and observes the use of calcium and vitamin D supplementation in these patients. METHODS: This retrospective study reviewed the electronic records of 321 breast cancer patients treated with bisphosphonates. Information on age, race, and serum levels of 25-hydroxyvitamin D (25-OHD), parathyroid hormone, and calcium were collected, and intakes of calcium and vitamin D supplements were queried in an outpatient pharmacy database. RESULTS: Of the 321 patients treated with bisphosphonates, 209 (65.1%) had their 25-OHD levels checked at least once. Of these patients, 57 (27.3%) had a serum 25-OHD level <20 ng/ml. Of the 209 patients with a known 25-OHD level, only eight (3.8%) received >600 IU of vitamin D per day, and 41 (19.6%) patients received 400-600 IU of vitamin D daily. CONCLUSION: Especially in the setting of metastatic bone disease in breast cancer patients, we advocate routine 25-OHD concentration screening for vitamin D deficiency in general. Clear guidelines for the diagnosis of vitamin D deficiency in cancer patients would be extremely beneficial to have, as would identification of the proper dose of vitamin D supplementation. We recommend 1,000 IU daily to our metastatic cancer patients.     

Circulating 25-Hydroxy Vitamin D Relative to Vitamin D Receptor Polymorphism after Vitamin D3 Supplementation in Breast Cancer Women: A Randomized,Double-Blind Controlled Clinical Trial

Objective: The influence of vitamin D receptor (VDR) genetic variation on serum 25-hydroxyvitamin D levels [25(OH)D] after vitamin D3 supplementation remains unclear. We aimed to investigate changes of 25(OH)D in a randomized, double-blind, placebo-controlled clinical trial, according to VDR genotype, after provision of vitamin D3 to breast cancer cases for a 2-month period. Methods: Participants were assigned to two treatment arms: placebo (n = 28) and vitamin D3 supplementation (n =28). The supplementation group received 50,000 IU of vitamin D every week for 2 months. Blood samples were collected at baseline and after intervention to measure serum 25(OH) D3. Genotypes were assessed for FokI, BsmI, ApaI, and TaqI polymorphisms. Results: After eight weeks supplementation, the rvention group showed a significant increase in the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004). Subjects were then classified into twelve subgroups according to different VDR genotypes. Subjects with ff/Ff, TT/Tt, and Bb genotypes had significantly higher increases in serum 25(OH)D compared to those with FF, tt, and BB/bb genotypes post-intervention. Serum vitamin D3 levels with the AA genotype were lower than with aa/ Aa. No differences were found among other subgroups. Conclusion: Vitamin D3 supplementation increases serum 25(OH)D in women with breast cancer. Serum vitamin D3 in TT/Tt, ff/Ff, and Bb carriers was more responsive to vitamin D supplementation than in those with FF/ff and tt genotypes. Other subgroups might gain less from vitamin D3 supplementation.     

Racial disparity in death from colorectal cancer

BACKGROUND:

The reasons blacks have higher mortality rates from colorectal cancer (CRC) than non‐Hispanic whites are not fully understood. Blacks have higher rates of vitamin D deficiency than non‐Hispanic whites, and vitamin D deficiency has been associated with CRC. The authors of this report investigated the association of vitamin D deficiency with excess risk for CRC mortality for blacks in the Third National Health and Nutrition Examination Survey (NHANES III) that was conducted from 1988 to 1994.

METHODS:

The association between serum 25(OH)D levels and CRC mortality and its contribution to elevated risk among blacks were studied using baseline data from NHANES III and CRC mortality data through 2006 from the National Death Index. By using survival models, the adjusted risk of death from CRC for African Americans was examined with and without adjusting for vitamin D deficiency, which was defined as an 25(OH)D level <20 ng/dL.

RESULTS:

Black race (hazard ratio [HR], 2.03; 95% confidence interval [95% CI], 1.04‐3.95), age (HR, 1.12; 95% CI, 1.09‐1.15), not having health insurance (HR, 2.45; 95% CI, 1.12‐5.36), and a history of CRC (HR, 7.22; 95% CI, 2.12‐24.6) predicted CRC mortality. When added to the model, vitamin D deficiency was associated significantly with CRC mortality (HR, 2.11; 95% CI, 1.11‐4.00), and the effect of race was decreased (HR, 1.60; 95% CI, 0.87‐2.93); the 40% attenuation was statistically significant (F_1,49 = 4.85; P = .03). Similar results were observed when participants who had a history of CRC were excluded from the analysis.

CONCLUSIONS:

The current findings were consistent with the hypothesis that vitamin D deficiency contributes to excess African‐American mortality from CRC. Cancer 2011. © 2010 American Cancer Society.     

Association Between Alterations in the Serum 25-Hydroxyvitamin D Status During Follow-Up and Breast Cancer Patient Prognosis

Background: Serum vitamin D status can affect the prognosis of breast cancer patients. Our aim was todetermine the association between alterations in the 25-hydroxyvitamin D [25(OH)D] status during follow-upand the prognosis of breast cancer patients. Additionally, we evaluated the association between the 25(OH)Dstatus at the time of diagnosis and the prognosis using a detailed age and stage categorization. Materials andMethods: Four hundred and sixty-nine Korean breast cancer patients were included. We collected patientclinicopathological data, including their serum 25(OH)D concentration at diagnosis and at the annual followupuntil 4 years after diagnosis. The patients were divided according to their 25(OH)D status at diagnosis intoa deficient (<20 ng/ml) and a non-deficient (≥20 ng/ml) group. At follow-up, patients were categorized into thefour following groups according to 25(OH)D status alterations: persistently deficient, improved, deterioratedand persistently non-deficient. Results: At diagnosis, 118 patients were classified into the deficient group and 351into the non-deficient group. After a median follow-up period of 85.8±31.0 months, the patients with advancedstagedisease or an older age in the non-deficient group showed a significantly better survival compared with thedeficient group. Furthermore, at the 1-year follow-up of 25(OH)D status, the persistently non-deficient group andthe improved group had better survival compared with the other two groups. Conclusions: Our results suggestthat maintaining an optimal 25(OH)D status at diagnosis and during the 1-year follow-up period is importantfor improving breast cancer patient survival.     

Blood levels of vitamin D and early stage breast cancer prognosis: a systematic review and meta-analysis

Vitamin D regulates expression of genes important in development and progression of breast cancer. The association of vitamin D with breast cancer outcomes among breast cancer patients is controversial. We conducted a systematic review and meta-analysis of this association in early stage breast cancer outcome. We searched MEDLINE (1982–May 1, 2013), the American Society of Clinical Oncology (2009–2012), and the San Antonio Breast Cancer Symposium (2010–2012) for abstracts, using the following keywords: “breast cancer” and “prognosis” or “survival”, and “vitamin D” or” calcitriol” to identify studies reporting the associations of blood vitamin D levels (drawn close to diagnosis) with breast cancer outcomes. Meta-analyses were performed using an inverse-variance weighted fixed-effects model with Stata Version 12. Eight studies including 5,691 patients were identified. Vitamin D deficiency was variably categorized across studies; a median of 36.8 % of patients were classified as deficient. Low vitamin D levels were associated with a pooled hazard ratio of 2.13 (95 % CI 1.64–2.78) and 1.76 (95 % CIs 1.35–2.30) for recurrence (six studies) and death (four studies), respectively, with no evidence of significant heterogeneity across studies. There was potential evidence of a publication bias in studies examining associations with death (but not in those examining associations with recurrence). These findings support an association of low levels of vitamin D with increased risk of recurrence and death in early stage breast cancer patients. Given the observational nature of the included studies, it cannot be concluded that this association is causal. Further research is warranted to investigate the potential beneficial effects of vitamin D in breast cancer.