血清 25-羟维生素 D 与原发性结肠癌患者的五年生存率:一项回顾性队列研究

IF 2 4区 医学 Q3 NUTRITION & DIETETICS Nutrition and Cancer-An International Journal Pub Date : 2024-01-01 Epub Date: 2024-08-09 DOI:10.1080/01635581.2024.2389580
Raphael E Cuomo
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引用次数: 0

摘要

本研究探讨了结肠癌患者血清 25- 羟维生素 D (25(OH)D) 与死亡率之间的关系。利用加利福尼亚大学的临床数据库,对确诊后至死亡前或 5 年内的血清 25(OH)D 测量值进行了平均。分析方法包括使用广义相加模型(GAM)、逻辑回归和考克斯比例危险模型来检验非线性关系以及 25(OH)D 对 5 年死亡率的影响。这项研究对1602名结肠癌患者进行了评估,其中25(OH)D的中位数为31.8纳克/毫升,5年死亡率为22.7%。研究发现,诊断后维生素 D 水平升高与 5 年死亡率降低之间存在明显联系。在调整了疾病严重程度和重要的人口混杂因素后,这种关联在 5 年死亡率的逻辑回归模型中仍然存在(OR = 0.79,95% CI:0.66-0.92,P = 0.048)。GAM 表明生存概率会急剧增加,直至达到一个高点,这表明在大约 50.0 纳克/毫升以上会产生阈值效应。这项研究发现,维生素 D 对结肠癌患者的生存具有潜在的保护作用,支持纠正低于 25 纳克/毫升但最好高于 50 纳克/毫升的水平。
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Serum 25-Hydroxyvitamin D and Five-Year Survival in Primary Colon Cancer: A Retrospective Cohort Study.

This study examined the link between serum 25-hydroxyvitamin D (25(OH)D) and mortality in patients with colon cancer. Using a clinical database from the University of California, serum 25(OH)D measures were averaged for the time following diagnosis until either the time of death or 5 years had elapsed. Analytical methods included the use of Generalized Additive Models (GAM), logistic regression, and Cox proportional hazards models to examine non-linear relationships and the impact of 25(OH)D on 5-year mortality. This study assessed 1,602 patients with colon cancer having a median 25(OH)D of 31.8 ng/mL and a 5-year mortality rate of 22.7%. A significant association between higher post-diagnosis vitamin D levels and decreased 5-year mortality was observed. This association persisted after adjusting for disease severity and significant demographic confounders, in both a logistic regression model for 5-year mortality (OR = 0.79, 95% CI: 0.66-0.92, p < 0.001) and a cox proportional hazards model for survival (HR = 0.94, CI: 0.88-0.99, p = 0.048). GAM illustrated a steep increase in survival probability up to a plateau, suggesting a threshold effect beyond roughly 50.0 ng/mL. This study found a potential protective role of vitamin D in the survival of colon cancer patients, supporting the correction of levels below 25 ng/mL but ideally above 50 ng/mL.

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来源期刊
CiteScore
5.80
自引率
3.40%
发文量
172
审稿时长
3 months
期刊介绍: This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.
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