Vitamin D insufficiency in a multiethnic cohort of breast cancer survivors 1 – 3

Background: Little is known about vitamin D status in breast cancer survivors. This issue is important because vitamin D influences pathways related to carcinogenesis. Objective: The objective of this report was to describe and understand vitamin D status in a breast cancer survivor cohort. Design: Data are from the Health, Eating, Activity, and Lifestyle study. With the use of a cross-sectional design, we examined serum concentrations of 25-hydroxyvitamin D [25(OH)D] in 790 breast cancer survivors from western Washington state, New Mexico, and Los Angeles County. Cancer treatment data were obtained from Surveillance, Epidemiology, and End Results registries and medical records. Fasting blood, anthropometry, and lifestyle habits were collected after diagnosis and treatment. We examined distributions of 25(OH)D by race-ethnicity, season, geography, and clinical characteristics. Multivariate regression tested associations between 25(OH)D and stage of disease. Results: Five hundred ninety-seven (75.6%) of the women had low serum 25(OH)D, suggesting vitamin D insufficiency or frank deficiency. The overall mean ( SD) was 24.8 10.4 ng/mL, but it was lower for African Americans (18.1 8.7 ng/mL) and Hispanics (22.1 9.2 ng/mL). Women with localized (n 424) or regional (n 182) breast cancer had lower serum 25(OH)D than did women with in situ disease (n 184) (P 0.05 and P 0.03, respectively). Multivariate regression models controlled for age, body mass index (in kg/m), race-ethnicity, geography, season, physical activity, diet, and cancer treatments showed that stage of disease independently predicted serum 25(OH)D (P 0.02). Conclusions: In these breast cancer survivors, the prevalence of vitamin D insufficiency was high. Clinicians might consider monitoring vitamin D status in breast cancer patients, together with appropriate treatments, if necessary. Am J Clin Nutr 2008;88:

[1]  Pamela A Shaw,et al.  Use of recovery biomarkers to calibrate nutrient consumption self-reports in the Women's Health Initiative. , 2008, American journal of epidemiology.

[2]  G. Schwartz,et al.  1 a , 25-Dihydroxyvitamin D ( Calcitriol ) Inhibits the Invasiveness of Human Prostate Cancer Cells 1 , 2008 .

[3]  M. Holick.  Vitamin D deficiency. , 2007, The New England journal of medicine.

[4]  J. Berry,et al.  Observations from the UK Supra-Regional Assay Service laboratory for the measurement of Vitamin D metabolites , 2007, The Journal of Steroid Biochemistry and Molecular Biology.

[5]  D. Alberts,et al.  Serum 25(OH)D levels, dietary intake of vitamin D, and colorectal adenoma recurrence , 2007, The Journal of Steroid Biochemistry and Molecular Biology.

[6]  Sungtae Kim,et al.  Perspectives on mechanisms of gene regulation by 1,25-dihydroxyvitamin D3 and its receptor , 2007, The Journal of Steroid Biochemistry and Molecular Biology.

[7]  J. Knight,et al.  Vitamin D and Reduced Risk of Breast Cancer: A Population-Based Case-Control Study , 2007, Cancer Epidemiology Biomarkers & Prevention.

[8]  Y. Helfrich,et al.  Injury enhances TLR2 function and antimicrobial peptide expression through a vitamin D-dependent mechanism. , 2007, The Journal of clinical investigation.

[9]  E. Giovannucci,et al.  Vitamin D and prevention of breast cancer: Pooled analysis , 2007, The Journal of Steroid Biochemistry and Molecular Biology.

[10]  D. Neuberg,et al.  Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small-cell lung cancer patients. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  Jennifer Lin,et al.  Intakes of calcium and vitamin D and breast cancer risk in women. , 2006, Archives of internal medicine.

[12]  M. Thun,et al.  Vitamin D pathway gene polymorphisms, diet, and risk of postmenopausal breast cancer: a nested case-control study , 2007, Breast Cancer Research.

[13]  M. Visser,et al.  Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission. , 2006, The American journal of clinical nutrition.

[14]  T. Rohan,et al.  Vitamin D, Calcium, and Breast Cancer Risk: A Review , 2006, Cancer Epidemiology Biomarkers & Prevention.

[15]  W. Willett,et al.  Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. , 2006, American Journal of Clinical Nutrition.

[16]  Yan Liu,et al.  Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. , 2006, Journal of the National Cancer Institute.

[17]  Glenville Jones,et al.  Promise of vitamin D analogues in the treatment of hyperproliferative conditions , 2006, Molecular Cancer Therapeutics.

[18]  A. Norman,et al.  A perspective on how the Vitamin D sterol/Vitamin D receptor (VDR) conformational ensemble model can potentially be used to understand the structure–function results of A-ring modified Vitamin D sterols , 2005, The Journal of Steroid Biochemistry and Molecular Biology.

[19]  D. Neuberg,et al.  Vitamin D Is Associated with Improved Survival in Early-Stage Non–Small Cell Lung Cancer Patients , 2005, Cancer Epidemiology Biomarkers & Prevention.

[20]  Srinivasan Vijayakumar,et al.  Clinical trials involving vitamin D analogs in prostate cancer. , 2005, Cancer journal.

[21]  W. Willett,et al.  Plasma 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D and Risk of Breast Cancer , 2005, Cancer Epidemiology Biomarkers & Prevention.

[22]  B. Hollis.  Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. , 2005, The Journal of nutrition.

[23]  D. Black,et al.  Serum 25-hydroxyvitamin D is unaffected by multiple freeze-thaw cycles. , 2005, Clinical chemistry.

[24]  S. Kato,et al.  1 alpha,25-Dihydroxyvitamin D(3) is a preventive factor in the metastasis of lung cancer. , 2005, Carcinogenesis.

[25]  S. Kato,et al.  1 a , 25-Dihydroxyvitamin D 3 is a preventive factor in the metastasis of lung cancer , 2005 .

[26]  Roy Armstrong,et al.  UV dose determines key characteristics of nonmelanoma skin cancer. , 2004, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[27]  A. Kristal,et al.  Melanoma and lifetime UV radiation , 2004, Cancer Causes & Control.

[28]  P. Hershberger,et al.  Anti-tumor activity of calcitriol: pre-clinical and clinical studies , 2004, The Journal of Steroid Biochemistry and Molecular Biology.

[29]  Johan Moan,et al.  Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway) , 2004, Cancer Causes & Control.

[30]  M. Holick,et al.  Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. , 2004, The American journal of clinical nutrition.

[31]  Kelly Smith,et al.  Vitamin D-3 receptor as a target for breast cancer prevention. , 2003, The Journal of nutrition.

[32]  F. Gilliland,et al.  Adiposity and sex hormones in postmenopausal breast cancer survivors. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[33]  K. Malone,et al.  Differences in breast cancer stage, treatment, and survival by race and ethnicity. , 2003, Archives of internal medicine.

[34]  J. Welsh,et al.  Impact of the Vitamin D3 receptor on growth-regulatory pathways in mammary gland and breast cancer , 2002, The Journal of Steroid Biochemistry and Molecular Biology.

[35]  H. Adlercreutz.  Can rye intake decrease risk of human breast cancer? , 2010, Food & nutrition research.

[36]  M. Cogswell,et al.  Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. , 2002, The American journal of clinical nutrition.

[37]  G. Pirianov,et al.  Interaction of vitamin D analogs with signaling pathways leading to active cell death in breast cancer cells , 2001, Steroids.

[38]  M. Stipanuk,et al.  Biochemical and Physiological Aspects of Human Nutrition , 2000 .

[39]  A. Kristal,et al.  Measurement characteristics of the Women's Health Initiative food frequency questionnaire. , 1999, Annals of epidemiology.

[40]  C. Rock,et al.  Demographic, dietary and lifestyle factors differentially explain variability in serum carotenoids and fat-soluble vitamins: baseline results from the sentinel site of the Olestra Post-Marketing Surveillance Study. , 1999, The Journal of nutrition.

[41]  B. Dawson-Hughes,et al.  Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. , 1998, The American journal of clinical nutrition.

[42]  R. Mehta,et al.  Prevention of preneoplastic mammary lesion development by a novel vitamin D analogue, 1alpha-hydroxyvitamin D5. , 1997, Journal of the National Cancer Institute.

[43]  R. Coombes,et al.  POSSIBLE ROLE FOR VITAMIN D IN CONTROLLING BREAST CANCER CELL PROLIFERATION , 1989, The Lancet.