- 作者：Ashwin N. Ananthakrishnan&lowast ; ; &Dagger ; ; aananthakrishnan@partners.org" class="auth_mail ; Su&ndash ; Chun Cheng§ ; ; Tianxi Cai§ ; ; Andrew Cagan鈥?/sup> ; Vivian S. Gainer鈥?/sup> ; Peter Szolovits# ; Stanley Y. Shaw&Dagger ; ; &lowast ; &lowast ; ; Susanne Churchill&Dagger ; &Dagger ; ; Elizabeth W. Karlson&Dagger ; ; § ; § ; ; Shawn N. Murphy&Dagger ; ; 鈥?/sup> ; 鈥栤€?/sup> ; Isaac Kohane&Dagger ; ; ¶ ; ; &Dagger ; &Dagger ; ; Katherine P. Liao&Dagger ; ; § ; § ;
- 关键词：Crohn&rsquo ; s Disease ; Ulcerative Colitis ; Vitamin D ; Malignancy ; Colorectal Cancer
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：May, 2014
- 年：2014
- 卷：12
- 期：5
- 页码：821-827
- 全文大小：274 K
Background & Aims
Vitamin D deficiency is common among patients with inflammatory bowel diseases (IBD) (Crohn鈥檚 disease or ulcerative colitis). The effects of low plasma 25-hydroxy vitamin D (25[OH]D) on outcomes other than bone health are understudied in patients with IBD. We examined the association between plasma level of 25(OH)D and risk of cancers in patients with IBD.Methods
From a multi-institutional cohort of patients with IBD, we identified those with at least 1聽measurement of plasma 25(OH)D. The primary outcome was development of any cancer. We examined the association between plasma 25(OH)D and risk of specific subtypes of cancer, adjusting for potential confounders in a multivariate regression model.
Results
We analyzed data from 2809 patients with IBD and a median plasma level of 25(OH)D of 26聽ng/mL. Nearly one-third had deficient levels of vitamin D (<20 ng/mL). During a median follow-up period of 11 years, 196 patients (7%) developed cancer, excluding nonmelanoma skin cancer (41 cases of colorectal cancer). Patients with vitamin D deficiency had an increased risk of cancer (adjusted odds ratio, 1.82; 95% confidence interval, 1.25-2.65) compared with those with sufficient levels. Each 1-ng/mL increase in plasma 25(OH)D was associated with an 8% reduction in risk of colorectal cancer (odds ratio, 0.92; 95% confidence interval, 0.88-0.96). A聽weaker inverse association was also identified for lung cancer.
Conclusions
In a large multi-institutional IBD cohort, a low plasma level of 25(OH)D was associated with an increased risk of cancer, especially colorectal cancer.