Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Serum 25-hydroxy Vitamin D Status is Not Related to Osteopenia/Osteoporosis Risk in Colorectal Cancer Survivors

  • Akinci, Muhammed Bulent (Department of Medical Oncology, Yildirim Beyazit University) ;
  • Sendur, Mehmet Ali Nahit (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Aksoy, Sercan (Department of Medical Oncology, Hacettepe University Institute of Oncology) ;
  • Yazici, Ozan (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Ozdemir, Nuriye Yildirim (Department of Medical Oncology, Yildirim Beyazit University) ;
  • Kos, Tugba (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Yaman, Sebnem (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Altundag, Kadri (Department of Medical Oncology, Hacettepe University Institute of Oncology) ;
  • Zengin, Nurullah (Department of Medical Oncology, Ankara Numune Education and Research Hospital)
  • Published : 2014.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recently published studies. In addition, prospective investigations have indicated that low vitamin D levels may be associated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exact incidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis is still not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors of osteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancer survivors treated with surgery and/or chemotherapy ${\pm}$ radiotherapy were recruited from medical oncology outpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed, and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients was divided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: The median age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male. The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); mild deficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency (<10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17 (15.0%). Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma, chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis. Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). In female patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients (p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5% and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopenia and osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first to evaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.

Keywords

References

  1. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006). Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr, 84, 18-28.
  2. Boyce SP, Mincey BA, Duh M, et al (2005). Risk of osteoporosis/osteopenia among women with breast cancer receivin anticancer theapy (ACT). J Clin Oncol, 23, 665. https://doi.org/10.1200/JCO.2005.09.922
  3. Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA (2011). Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the US Preventive Services Task Force. Ann Intern Med, 155, 827-38. https://doi.org/10.7326/0003-4819-155-12-201112200-00005
  4. Deeb KK, Trump DL, Johnson CS (2007). Vitamin D signalling pathways in cancer: potential for anticancer therapeutics. Nat Rev Cancer, 7, 684-700. https://doi.org/10.1038/nrc2196
  5. Eastell R, Adams JE, Coleman RE, et al (2008). Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230. J Clin Oncol, 26, 1051-7. https://doi.org/10.1200/JCO.2007.11.0726
  6. Fakih MG, Trump DL, Johnson CS, et al (2009). Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer. Int J Colorectal Dis, 24, 219-24. https://doi.org/10.1007/s00384-008-0593-y
  7. Feskanich D, Ma J, Fuchs CS, et al (2004). Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev, 13, 1502-8.
  8. Garland CF, Garland FC, Gorham ED, et al (2006). The role of vitamin D in cancer prevention. Am J Public Health, 96, 252-61. https://doi.org/10.2105/AJPH.2004.045260
  9. Giovannucci E, Liu Y, Rimm EB, et al (2006). Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst, 98, 451-9. https://doi.org/10.1093/jnci/djj101
  10. Gorham ED, Garland CF, Garland FC, et al (2005). Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol, 97, 179-94. https://doi.org/10.1016/j.jsbmb.2005.06.018
  11. Gorham ED, Garland CF, Garland FC, et al (2007). Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. Am J Prev Med, 32, 210-6. https://doi.org/10.1016/j.amepre.2006.11.004
  12. Hershberger PA, Yu WD, Modzelewski RA, et al (2001). Calcitriol (1,25-dihydroxycholecalciferol) enhances paclitaxel antitumor activity in vitro and in vivo and accelerates paclitaxel-induced apoptosis. Clin Cancer Res, 7, 1043-51.
  13. Holick MF (2007). Vitamin D deficiency. N Engl J Med, 357, 266-81. https://doi.org/10.1056/NEJMra070553
  14. Jenab M, Bueno-de-Mesquita HB, Ferrari P, et al (2010). Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ, 340, 5500. https://doi.org/10.1136/bmj.b5500
  15. Kanis JA (1994). Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int, 4, 368-81. https://doi.org/10.1007/BF01622200
  16. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008). FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int, 19, 385-97. https://doi.org/10.1007/s00198-007-0543-5
  17. Lee JE, Li H, Chan AT, et al (2011). Circulating levels of vitamin D and colon and rectal cancer: the Physicians’ Health Study and a meta-analysis of prospective studies. Cancer Prev Res, 4, 735-43. https://doi.org/10.1158/1940-6207.CAPR-10-0289
  18. Lonning PE, Geisler J, Krag LE, et al (2005). Effects of exemestane administered for 2 years versus placebo on bone mineral density, bone biomarkers, and plasma lipids in patients with surgically resected early breast cancer. J Clin Oncol, 23, 5126-37. https://doi.org/10.1200/JCO.2005.07.097
  19. Ma Y, Yu WD, Hershberger PA, et al (2008). 1alpha,25-Dihydroxyvitamin D3 potentiates cisplatin antitumor activity by p73 induction in a squamous cell carcinoma model. Mol Cancer Ther, 7, 3047-55. https://doi.org/10.1158/1535-7163.MCT-08-0243
  20. Ma Y, Zhang P, Wang F, et al (2011). Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol, 29, 3775-82. https://doi.org/10.1200/JCO.2011.35.7566
  21. Maddipatla S, Tan W, Wilding GE, et al (2007). Vitamin D status in patients with colorectal cancer. 2007 Gastrointestinal Cancers Symposium Abstract 260.
  22. Moffatt KA, Johannes WU, Miller GJ (1999). 1Alpha, 25dihydroxyvitamin D3 and platinum drugs act synergistically to inhibit the growth of prostate cancer cell lines. Clin Cancer Res, 5, 695-703.
  23. Ng K, Meyerhardt JA, Wu K, et al (2008). Circulating 25-hydroxyvitamin d levels and survival in patients with colorectal cancer. J Clin Oncol, 26, 2984-91. https://doi.org/10.1200/JCO.2007.15.1027
  24. Ng K, Sargent DJ, Goldberg RM, et al (2011). Vitamin D status in patients with stage IV colorectal cancer: findings from Intergroup trial N9741. J Clin Oncol, 29, 1599-606. https://doi.org/10.1200/JCO.2010.31.7255
  25. Ng K, Wolpin BM, Meyerhardt JA, et al (2009). Prospective study of predictors of vitamin D status and survival in patients with colorectal cancer. Br J Cancer, 101, 916-23. https://doi.org/10.1038/sj.bjc.6605262
  26. Perez EA, Josse RG, Pritchard KI, et al (2006). Effect of letrozole versus placebo on bone mineral density in women with primary breast cancer completing 5 or more years of adjuvant tamoxifen: a companion study to NCIC CTG MA.17. J Clin Oncol, 24, 3629-35. https://doi.org/10.1200/JCO.2005.05.4882
  27. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics, 2013. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  28. Siegel R, Ward E, Brawley O, Jemal A (2011). Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin, 61, 212-36. https://doi.org/10.3322/caac.20121
  29. Trump DL, Deeb KK, Johnson CS (2010). Vitamin D: considerations in the continued development as an agent for cancer prevention and therapy. Cancer J, 16, 1-9. https://doi.org/10.1097/PPO.0b013e3181c51ee6
  30. Wu K, Feskanich D, Fuchs CS, et al (2007). A nested case control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. J Natl Cancer Inst, 99, 1120-9. https://doi.org/10.1093/jnci/djm038