Plasma vitamin D levels, menopause, and risk of breast cancer: dose-response meta-analysis of prospective studies
Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL
Medicine · 133 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- American Diabetes Association
- Organización sin fines de lucro
- American Heart Association
- Gobierno
- National Institutes of Health
- Gobierno
- National Cancer Institute
- Gobierno
- NCI NIH HHS
- Subvenciones
- National Cancer Institute (CA-49449); National Cancer Institute (CA67262); National Cancer Institute (U01 CA067262); National Cancer Institute (R01‐CA049449); National Cancer Institute (R01‐CA067262); National Cancer Institute (U01CA049449); National Institutes of Health (CA67262)
Según 5 financiadores declarados.
Publicación
- Publicado
- 2013-04-25 · Medicine (Baltimore) · vol. 92 · número 3 · págs. 123–131
- Editorial
- Wolters Kluwer
- Citado
- 183 citas · más que el 99% de estudios similares · 13.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 71 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Vitamin D Research Studies · Cancer Risks and Factors · Nutritional Studies and Diet
- Palabras clave
- 25-hydroxyvitamin D, vitamin D, menopause, postmenopausal women, premenopausal women, circulating vitamin D levels, breast cancer risk, dose-response relationship, nonlinear relationship, effect modification, hormone replacement therapy, body mass index, breast cancer subtypes, vitamin D supplementation, vitamin D deficiency, vitamin D toxicity
- MeSH
- humans, breast neoplasms, vitamin d, risk assessment, prospective studies, postmenopause, premenopause, dose-response relationship, drug, female
4 autores
- Scott R. Bauer🇺🇸Brigham and Women's Hospital; Harvard University; University of Massachusetts Amherst
- Susan E. Hankinson🇺🇸Brigham and Women's Hospital; Harvard University; University of Massachusetts Amherst
- Elizabeth R. Bertone‐Johnson🇺🇸Brigham and Women's Hospital; Harvard University; University of Massachusetts Amherst
- Eric L. Ding🇺🇸Brigham and Women's Hospital; Harvard University; University of Massachusetts Amherst
Resumen
El texto original del estudio, en el idioma en que se publicó.
Previous evidence suggests that higher circulating 25-hydroxyvitamin D (25[OH]D) levels are variably associated with lower breast cancer risk; however, prospective studies and clinical trials have been inconsistent, particularly between older and younger women of differing menopausal status. We conducted a quantitative nonlinear dose-response meta-analysis of prospective studies evaluating the association between circulating 25(OH)D and breast cancer risk, stratified by menopause. A systematic search of MEDLINE and EMBASE included studies published through May 2011. We reviewed references from retrieved articles and contacted relevant investigators for additional data from prospective studies on circulating 25(OH)D levels and incident breast cancers. Prospective studies of circulating vitamin D and breast cancer risk were reviewed, and no language restrictions were imposed. Information on study population, menopausal status, 25(OH)D levels, and relative risk (RR) estimates were extracted using a standardized protocol.A total of 9 prospective studies were included, comprising 5206 cases and 6450 controls. Data were pooled using dose-response random-effects meta-regression models. Identifying nonlinear effects, spline models were optimized for thresholds. The relationship between circulating 25(OH)D and breast cancer risk differed by menopausal status (p = 0.05 for effect modification). While no association was found in premenopausal women, dose-response modeling revealed a nonlinear inverse association among postmenopausal women. Notably, a flat association was observed in the lowest range of 25(OH)D levels 35 ng/mL. The significant inverse association did not appear to vary across strata of invasive/in-situ cases, body mass index adjustment, region, postmenopausal hormone use, or assay method.In summary, this dose-response meta-analysis of prospective studies of plasma 25(OH)D suggested a breast cancer risk differential by menopause, whereby a step-wise inverse association was observed beyond a threshold of 27 ng/mL, but with flattening of effects above 35 ng/mL, in postmenopausal women. These findings help resolve prior inconsistent findings and may carry important clinical and public health implications.
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