Tengfei Lin1, Yun Song2, Xianglin Zhang3, Huiyuan Guo1, Lishun Liu1, Ziyi Zhou1, Binyan Wang4, Genfu Tang5, Chengzhang Liu6, Yan Yang7, Wenhua Ling8, Zhengqiang Yuan9, Jianping Li10, Yan Zhang10, Yong Huo10, Xiaobin Wang11, Hao Zhang12, Xianhui Qin13, Xiping Xu14. 1. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China. 2. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. 3. National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. 4. National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China. 5. Health Management College, Anhui Medical University, Hefei 230032, China. 6. Shenzhen Evergreen Medical Institute, Shenzhen 518057, China. 7. School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou 510006, China; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou 510080, China. 8. Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou 510080, China; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China. 9. Department of Cardiology, The First People's Hospital of Zunyi, Zunyi 563000, China. 10. Department of Cardiology, Peking University First Hospital, Beijing 100034, China. 11. Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA. 12. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China. Electronic address: zhanghaocau@cau.edu.cn. 13. National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China. Electronic address: pharmaqin@126.com. 14. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China. Electronic address: xipingxu126@126.com.
Abstract
BACKGROUND & AIMS: Evidence from epidemiologic studies on the association of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with the incident risk of cancer has been inconsistent. We aimed to investigate the prospective relationship of baseline plasma 25(OH)D concentrations with the risk of cancer, and to examine possible effect modifiers. METHODS: We employed a nested case-control study design, including 231 patients with incident cancer during a median 4.5 years of follow up, and 231 matched controls from the China Stroke Primary Prevention Trial (CSPPT). RESULTS: The prevalence of plasma 25(OH)D <15, <20 and <30 ng/mL was 23.6%, 47.4% and 85.5%, respectively. Overall, there was an inverse relation between risk of cancer and plasma 25(OH)D. The Odds ratios (95% CI) for participants in the second (15.1 to <20.6 ng/mL), third (20.6 to <26.4 ng/mL) and fourth quartiles (≥26.4 ng/mL) were 0.45 (95% CI: 0.25-0.80), 0.53 (95% CI: 0.27-1.06) and 0.55 (95% CI: 0.27-1.10), respectively, compared with those in quartile 1. Conversely, low 25(OH)D (<15.1 ng/mL) concentrations were associated with increased risk of cancer (OR, 2.08; 95% CI: 1.20-3.59) compared to higher concentrations. These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified, including plasma vitamin E concentrations and alcohol intake. CONCLUSIONS: Low plasma 25(OH)D concentrations (<15.1 ng/mL) were associated with increased total cancer risk among Chinese hypertensive adults, compared to higher 25(OH)D concentrations. This finding and the possible effect modifiers warrant additional investigation.
BACKGROUND & AIMS: Evidence from epidemiologic studies on the association of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with the incident risk of cancer has been inconsistent. We aimed to investigate the prospective relationship of baseline plasma 25(OH)D concentrations with the risk of cancer, and to examine possible effect modifiers. METHODS: We employed a nested case-control study design, including 231 patients with incident cancer during a median 4.5 years of follow up, and 231 matched controls from the China Stroke Primary Prevention Trial (CSPPT). RESULTS: The prevalence of plasma 25(OH)D <15, <20 and <30 ng/mL was 23.6%, 47.4% and 85.5%, respectively. Overall, there was an inverse relation between risk of cancer and plasma 25(OH)D. The Odds ratios (95% CI) for participants in the second (15.1 to <20.6 ng/mL), third (20.6 to <26.4 ng/mL) and fourth quartiles (≥26.4 ng/mL) were 0.45 (95% CI: 0.25-0.80), 0.53 (95% CI: 0.27-1.06) and 0.55 (95% CI: 0.27-1.10), respectively, compared with those in quartile 1. Conversely, low 25(OH)D (<15.1 ng/mL) concentrations were associated with increased risk of cancer (OR, 2.08; 95% CI: 1.20-3.59) compared to higher concentrations. These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified, including plasma vitamin E concentrations and alcohol intake. CONCLUSIONS: Low plasma 25(OH)D concentrations (<15.1 ng/mL) were associated with increased total cancer risk among Chinese hypertensive adults, compared to higher 25(OH)D concentrations. This finding and the possible effect modifiers warrant additional investigation.