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血浆25-羟维生素D水平与结直肠肿瘤关系的病例对照研究
帅群1,2△,张永镇1,2△,王华1,2,于恩达3,李桂香1,2,李兆申1,2,蔡全才1,2*
0
(1. 第二军医大学长海医院消化内科, 上海 200433;
2. 第二军医大学临床流行病学与循证医学中心, 上海 200433;
3. 第二军医大学长海医院肛肠外科, 上海 200433
共同第一作者
*通信作者)
摘要:
目的 探讨血浆25-羟维生素D水平与结直肠肿瘤发生的关系。方法 采用病例对照研究,对结直肠癌、进展期腺瘤、腺瘤和增生性息肉患者及健康人群血浆25-羟维生素D水平进行比较,并将结直肠癌患者按照病变部位(近端结肠、远端结肠)进行分层分析。结果 将25-羟维生素D水平分为≤13.39、13.39~18.23和≥18.23 ng/mL 3个等级,结直肠癌(P<0.001)、进展期腺瘤(P<0.001)、腺瘤(Ptrend<0.001)和增生性息肉(Ptrend=0.013)患者血浆25-羟维生素D均低于健康对照人群,其维生素D最高值与最低值比较OR(95%CI)依次为0.33(0.21,0.53)、0.18(0.09,0.38)、0.09(0.01,0.41)、0.25(0.08,0.77)。按发病部位进行分层后,近端结直肠癌(Ptrend=0.001)和远端结直肠癌(P<0.001)患者血浆25-羟维生素D水平均低于健康对照人群,其维生素D最高值与最低值比较OR(95%CI)依次为0.26(0.12,0.56)和0.33(0.20,0.56)。结论 血浆25-羟维生素D可降低结直肠肿瘤发病风险,且与病变部位无关。
关键词:  25-羟维生素D  饮食习惯  结直肠肿瘤  病例-对照研究
DOI:10.16781/j.0258-879x.2016.05.0536
投稿时间:2016-04-15修订日期:2016-05-11
基金项目:国家自然科学基金(81473045).
Association between plasma 25-hydroxy vitamin D levels and risk of colorectal neoplasms: a case-control study
SHUAI Qun1,2△,ZHANG Yong-zhen1,2△,WANG Hua1,2,YU En-da3,LI Gui-xiang1,2,LI Zhao-shen1,2,CAI Quan-cai1,2*
(1. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Center of Clinical Epidemiology and Evidence-Based Medicine, Second Military Medical University, Shanghai 200433, China;
3. Department of Anorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Co-first authors
*Corresponding author)
Abstract:
Objective To investigate the relationship between 25-hydroxy vitamin D and colorectal neoplasms. Methods A case control study was designed to compare the plasma 25-hydroxy vitamin D levels of participants with colorectal cancer, progressive adenoma, adenoma, hyperplastic polyposis and healthy controls. Meanwhile, stratified analysis was carried out according to the lesion sites (proximal colon and distal colon). Results The plasma 25-hydroxy vitamin D was divided into three levels: ≤13.39, 13.39-18.23 and ≥18.23 ng/mL. The levels in colorectal cancer group (P<0.001), progressive adenoma group (P<0.001), adenoma group (Ptrend<0.001), and hyperplastic polyposis group (Ptrend=0.013) were all significantly lower compared to that in the healthy control group, with the OR (95%CI) values of highest value and the lowest value of vitamin D as follows: 0.33(0.21, 0.53), 0.18(0.09, 0.38), 0.09(0.01, 0.41), and 0.25(0.08, 0.77), respectively. After stratified according to the lesion sites, the plasma 25-hydroxy vitamin D levels of proximal colorectal cancer group (Ptrend=0.001) and distal colorectal cancer group (P<0.001) were significantly lower than that of the healthy control group. The OR (95%CI) of highest value and the lowest value of vitamin D were 0.26(0.12, 0.56) and 0.33(0.20, 0.56), respectively. Conclusion Plasma 25-hydroxy vitamin D can reduce the risk of colorectal cancer regardless of the lesion locations.
Key words:  25-hydroxy vitamin D  food habits  colorectal neoplasms  case-control studies