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Circulating Vitamin D and Colorectal Adenoma in Asymptomatic Average-Risk Individuals Who Underwent First Screening Colonoscopy: A Case–Control Study

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Abstract

Background

A higher circulating vitamin D level is inversely associated with the risk of colorectal cancer, but the association with adenoma risk is less clear.

Aims

We examined the association between the circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration and colorectal adenoma in asymptomatic average-risk participants undergoing initial screening colonoscopy.

Methods

The study subjects were comprised of 143 cases of colorectal adenomas and 143 age- and gender-matched controls with normal colonoscopy among the 586 asymptomatic average-risk subjects (median age, 58 years; range, 50–73 years) who underwent first screening colonoscopy and measurement of the serum 25(OH)D3 between December 2009 and April 2010, consistent with winter months of the region.

Results

The mean concentration of serum 25(OH)D3 in the adenoma and control groups was 20.0 ± 11.0 ng/ml and 25.0 ± 20.0 ng/ml, respectively (P = 0.009). Using multivariate analysis, higher levels of 25(OH)D3 were associated with a statistically significant decreased risk of colorectal adenoma after multivariable adjustment (highest vs. lowest quartile OR 0.38, 95% CI 0.18–0.80, P trend = 0.012). The inverse association of circulating 25(OH)D3 with colorectal adenoma was stronger among the patients with proximal adenoma than that among the patients without proximal adenoma (highest vs. lowest quartile OR 0.29, 95% CI 0.13–0.66, P trend = 0.001).

Conclusions

The present study suggests that high levels of circulating vitamin D are associated with a decreased risk of colorectal adenoma, and especially adenoma located in the proximal colon.

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References

  1. Garland CF, Garland FC. Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol. 1980;9:227–231.

    Article  PubMed  CAS  Google Scholar 

  2. Matusiak D, Murillo G, Carroll RE, Mehta RG, Benya RV. Expression of vitamin D receptor and 25-hydroxyvitamin D3–1{alpha}-hydroxylase in normal and malignant human colon. Cancer Epidemiol Biomarkers Prev. 2005;14:2370–2376.

    Article  PubMed  CAS  Google Scholar 

  3. Tangpricha V, Flanagan JN, Whitlatch LW, et al. 25-hydroxyvitamin D-1alpha-hydroxylase in normal and malignant colon tissue. Lancet. 2001;357:1673–1674.

    Article  PubMed  CAS  Google Scholar 

  4. Miller EA, Keku TO, Satia JA, Martin CF, Galanko JA, Sandler RS. Calcium, vitamin D, and apoptosis in the rectal epithelium. Cancer Epidemiol Biomarkers Prev. 2005;14:525–528.

    Article  PubMed  CAS  Google Scholar 

  5. Diaz GD, Paraskeva C, Thomas MG, Binderup L, Hague A. Apoptosis is induced by the active metabolite of vitamin D3 and its analogue eb1089 in colorectal adenoma and carcinoma cells: possible implications for prevention and therapy. Cancer Res. 2000;60:2304–2312.

    PubMed  CAS  Google Scholar 

  6. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–1086S.

    PubMed  CAS  Google Scholar 

  7. Hanley DA, Davison KS. Vitamin D insufficiency in North America. J Nutr. 2005;135:332–337.

    PubMed  CAS  Google Scholar 

  8. Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88:500S–506S.

    PubMed  CAS  Google Scholar 

  9. Wei MY, Garland CF, Gorham ED, Mohr SB, Giovannucci E. Vitamin D and prevention of colorectal adenoma: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2008;17:2958–2969.

    Article  PubMed  CAS  Google Scholar 

  10. Whelan RL, Horvath KD, Gleason NR, et al. Vitamin and calcium supplement use is associated with decreased adenoma recurrence in patients with a previous history of neoplasia. Dis Colon Rectum. 1999;42:212–217.

    Article  PubMed  CAS  Google Scholar 

  11. Boutron MC, Faivre J, Marteau P, Couillault C, Senesse P, Quipourt V. Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case–control study. Br J Cancer. 1996;74:145–151.

    Article  PubMed  CAS  Google Scholar 

  12. Peters U, McGlynn KA, Chatterjee N, et al. Vitamin D, calcium, and vitamin D receptor polymorphism in colorectal adenomas. Cancer Epidemiol Biomarkers Prev. 2001;10:1267–1274.

    PubMed  CAS  Google Scholar 

  13. Levine AJ, Harper JM, Ervin CM, et al. Serum 25-hydroxyvitamin D, dietary calcium intake, and distal colorectal adenoma risk. Nutr Cancer. 2001;39:35–41.

    Article  PubMed  CAS  Google Scholar 

  14. Boyapati SM, Bostick RM, McGlynn KA, et al. Calcium, vitamin D, and risk for colorectal adenoma: dependency on vitamin D receptor Bsmi polymorphism and nonsteroidal anti-inflammatory drug use? Cancer Epidemiol Biomarkers Prev. 2003;12:631–637.

    PubMed  CAS  Google Scholar 

  15. Kampman E, Giovannucci E, van’t Veer P, et al. Calcium, vitamin D, dairy foods, and the occurrence of colorectal adenomas among men and women in two prospective studies. Am J Epidemiol. 1994;139:16–29.

    PubMed  CAS  Google Scholar 

  16. Martinez ME, Marshall JR, Sampliner R, Wilkinson J, Alberts DS. Calcium, vitamin D, and risk of adenoma recurrence (United States). Cancer Causes Control. 2002;13:213–220.

    Article  PubMed  Google Scholar 

  17. Lieberman DA, Prindiville S, Weiss DG, Willett W. Risk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals. JAMA. 2003;290:2959–2967.

    Article  PubMed  Google Scholar 

  18. Kesse E, Boutron-Ruault MC, Norat T, Riboli E, Clavel-Chapelon F. Dietary calcium, phosphorus, vitamin D, dairy products and the risk of colorectal adenoma and cancer among French women of the e3n-epic prospective study. Int J Cancer. 2005;117:137–144.

    Article  PubMed  CAS  Google Scholar 

  19. Hartman TJ, Albert PS, Snyder K, et al. The association of calcium and vitamin D with risk of colorectal adenomas. J Nutr. 2005;135:252–259.

    PubMed  CAS  Google Scholar 

  20. Jacobs ET, Alberts DS, Benuzillo J, Hollis BW, Thompson PA, Martinez ME. Serum 25(oh)d levels, dietary intake of vitamin D, and colorectal adenoma recurrence. J Steroid Biochem Mol Biol. 2007;103:752–756.

    Article  PubMed  CAS  Google Scholar 

  21. Oh K, Willett WC, Wu K, Fuchs CS, Giovannucci EL. Calcium and vitamin D intakes in relation to risk of distal colorectal adenoma in women. Am J Epidemiol. 2007;165:1178–1186.

    Article  PubMed  Google Scholar 

  22. Platz EA, Hankinson SE, Hollis BW, et al. Plasma 1, 25-dihydroxy- and 25-hydroxyvitamin D and adenomatous polyps of the distal colorectum. Cancer Epidemiol Biomarkers Prev. 2000;9:1059–1065.

    PubMed  CAS  Google Scholar 

  23. Peters U, Hayes RB, Chatterjee N, et al. Circulating vitamin D metabolites, polymorphism in vitamin D receptor, and colorectal adenoma risk. Cancer Epidemiol Biomarkers Prev. 2004;13:546–552.

    PubMed  CAS  Google Scholar 

  24. Grau MV, Baron JA, Sandler RS, et al. Vitamin D, calcium supplementation, and colorectal adenomas: results of a randomized trial. J Natl Cancer Inst. 2003;95:1765–1771.

    Article  PubMed  CAS  Google Scholar 

  25. Fedirko V, Bostick RM, Goodman M, Flanders WD, Gross MD. Blood 25-hydroxyvitamin D3 concentrations and incident sporadic colorectal adenoma risk: a pooled case–control study. Am J Epidemiol. 2010;172:489–500.

    Article  PubMed  Google Scholar 

  26. Takahashi R, Mizoue T, Otake T, et al. Circulating vitamin D and colorectal adenomas in Japanese men. Cancer Sci. 2010;101:1695–1700.

    Article  PubMed  CAS  Google Scholar 

  27. Miller EA, Keku TO, Satia JA, Martin CF, Galanko JA, Sandler RS. Calcium, dietary, and lifestyle factors in the prevention of colorectal adenomas. Cancer. 2007;109:510–517.

    Article  PubMed  CAS  Google Scholar 

  28. Hong SN, Kim JH, Choe WH, et al. Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age. Gastrointest Endosc. 2010;72:480–489.

    Article  PubMed  Google Scholar 

  29. Wagner D, Hanwell HE, Vieth R. An evaluation of automated methods for measurement of serum 25-hydroxyvitamin D. Clin Biochem. 2009;42:1549–1556.

    Article  PubMed  CAS  Google Scholar 

  30. Bushinsky DA, Monk RD. Electrolyte quintet: calcium. Lancet. 1998;352:306–311.

    Article  PubMed  CAS  Google Scholar 

  31. Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–1395.

    Article  PubMed  Google Scholar 

  32. Matusiak D, Benya RV. Cyp27a1 and cyp24 expression as a function of malignant transformation in the colon. J Histochem Cytochem. 2007;55:1257–1264.

    Article  PubMed  CAS  Google Scholar 

  33. Ahearn TU, McCullough ML, Flanders WD, Long Q, Sidelnikov E, Fedirko V, Daniel CR, Rutherford RE, Shaukat A, Bostick RM. A randomized clinical trial of the effects of supplemental calcium and vitamin D3 on markers of their metabolism in normal mucosa of colorectal adenoma patients. Cancer Res. 2011;71:413–423.

    Google Scholar 

  34. Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19:73–78.

    Article  PubMed  Google Scholar 

  35. Giovannucci E. Epidemiology of vitamin D and colorectal cancer: casual or causal link? J Steroid Biochem Mol Biol. 2010;121:349–354.

    Article  PubMed  CAS  Google Scholar 

  36. Wu K, Feskanich D, Fuchs CS, Willett WC, Hollis BW, Giovannucci EL. A nested case control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. J Natl Cancer Inst. 2007;99:1120–1129.

    Article  PubMed  CAS  Google Scholar 

  37. Houghton LA, Vieth R. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr. 2006;84:694–697.

    PubMed  CAS  Google Scholar 

  38. Gorham ED, Garland CF, Garland FC, et al. Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. Am J Prev Med. 2007;32:210–216.

    Article  PubMed  Google Scholar 

  39. Gorham ED, Garland CF, Garland FC, et al. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005;97:179–194.

    Article  PubMed  CAS  Google Scholar 

  40. Connelly AE, Satia-Abouta J, Martin CF, et al. Vitamin C intake and apoptosis in normal rectal epithelium. Cancer Epidemiol Biomarkers Prev. 2003;12:559–565.

    PubMed  CAS  Google Scholar 

  41. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1–8.

    PubMed  Google Scholar 

  42. Wactawski-Wende J, Kotchen JM, et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med. 2006;354:684–696.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by Konkuk University in 2011.

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Correspondence to In Kyung Sung.

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Hong, S.N., Kim, J.H., Choe, W.H. et al. Circulating Vitamin D and Colorectal Adenoma in Asymptomatic Average-Risk Individuals Who Underwent First Screening Colonoscopy: A Case–Control Study. Dig Dis Sci 57, 753–763 (2012). https://doi.org/10.1007/s10620-011-1926-1

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  • DOI: https://doi.org/10.1007/s10620-011-1926-1

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