Vitamin D, calcium supplementation, and colorectal adenomas: results of a randomized trial
Grau MV, Baron JA, Sandler RS, Haile RW, Beach ML, Church TR, Heber D
Journal of the National Cancer Institute · 239 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Cancer Institute
- Gobierno
- NCI NIH HHS
- Subvenciones
- National Cancer Institute (P01 CA-042710); National Cancer Institute (CA42710); National Cancer Institute (CA 23 108); National Cancer Institute (CA 37287)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2003-12-03 · J Natl Cancer Inst · vol. 95 · número 23 · págs. 1765–1771
- Editorial
- Oxford University Press
- Citado
- 373 citas · más que el 100% de estudios similares · 15.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 46 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Colorectal Cancer Screening and Detection · Nutritional Studies and Diet
- Palabras clave
- vitamin D, calcium supplementation, colorectal adenoma, adenoma recurrence, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, VDR polymorphisms, TaqI polymorphism, FokI polymorphism, colorectal cancer prevention, gene-nutrient interactions
- MeSH
- humans, adenoma, colorectal neoplasms, calcium compounds, vitamin d, receptors, calcitriol, anticarcinogenic agents, colonoscopy, treatment outcome, risk assessment, genotype, polymorphism, genetic, dietary supplements, aged, middle aged, female, male
1 autor
- Maria V. Grau · autor de correspondencia
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Calcium and vitamin D both appear to have antineoplastic effects in the large bowel. Although these nutrients are inter-related metabolically in bone and in the normal intestine, their potential interactions in large-bowel carcinogenesis are not well understood.
Methods
We assessed independent and joint effects of calcium supplementation and vitamin D status on adenoma recurrence in 803 subjects in a multi-center, placebo-controlled randomized clinical trial of calcium supplementation for the prevention of colorectal adenoma recurrence. Serum levels of 25-hydroxy [25-(OH)] vitamin D and 1,25-dihydroxy [1,25-(OH)2] vitamin D levels were determined, and the Taq I and Fok I polymorphisms in the vitamin D receptor (VDR) gene were analyzed by polymerase chain reaction. Risk ratios (RRs) for any adenoma recurrence were computed for calcium supplementation within groups defined by serum vitamin D levels and for serum vitamin D levels within treatment groups. Associations of VDR polymorphisms with recurrence risk were also evaluated. All statistical tests were two-sided.
Results
Among subjects with baseline 25-(OH) vitamin D levels at or below the median (29.1 ng/mL), calcium supplementation was not associated with adenoma recurrence, whereas among those with levels above the median, calcium supplementation was associated with a reduced risk (RR = 0.71, 95 % confidence interval [CI] = 0.57 to 0.89, P for interaction =.012). Conversely, serum 25-(OH) vitamin D levels were associated with a reduced risk only among subjects receiving calcium supplements (RR per 12 ng/mL increase of vitamin D = 0.88, 95% CI = 0.77 to 0.99, P for interaction =.006). VDR polymorphisms were not related to adenoma recurrence and did not modify the associations with vitamin D or calcium.
Conclusions
Calcium supplementation and vitamin D status appear to act largely together, not separately, to reduce the risk of colorectal adenoma recurrence. VDR genotype does not appear to be associated with risk.
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