Association of 25-hydroxyvitamin D with liver cancer incidence and chronic liver disease mortality in Finnish male smokers of the ATBC study.
Cancer Epidemiol Biomarkers Prev. 2018 May 2. pii: cebp.0877.2017. doi: 10.1158/1055-9965.EPI-17-0877. [Epub ahead of print]
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Lai GY1, Wang JB2, Weinstein SJ3, Parisi D4, Horst RL5, McGlynn KA3, Männistö S6, Albanes D3, Freedman ND7.
1 Environmental Epidemiology Branch, National Cancer Institute, NIH, DHHS laigy at mail.nih.gov.
2 Department of Epidemiology and Health Statistics, Zhejiang University.
3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH.
4 Information Management Services, Inc.
5 Heartland Assays, Inc.
6 Department of Health, National Institute for Health and Welfare.
7 Department of Cancer Epidemiology and Genetics, National Cancer Institute.
Although circulating 25-hydroxyvitamin D [25(OH)D] concentrations were linked to liver cancer and chronic liver disease (CLD) in laboratory studies, few epidemiologic studies have addressed the associations.
Within the ATBC Study, we measured 25(OH)D in baseline serum of 202 incident liver cancer cases and 225 CLD deaths that occurred during nearly 25 years of follow-up, and 427 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. We examined pre-determined clinically defined cut-points, and season-specific and season-standardized quartiles.
Low serum 25(OH)D concentrations were associated with higher risk of liver cancer (<25 nmol/L versus ≥50 nmol/L: 1.98, 95% CI: 1.22-3.20; p-trend across categories=0.003) and CLD mortality (1.93, 1.23-3.03; p-trend=0.006) in models adjusted for age and date of blood draw. After additional adjustment for BMI, diabetes, smoking, and other potential confounders, the association remained statistically significant for liver cancer (1.91, 1.16-3.15, p-trend=0.008), but was somewhat attenuated for CLD mortality (1.67, 1.02-2.75; p-trend=0.05). Associations were similar for analyses using season-specific and season-standardized quartiles, and after excluding participants with diabetes, or hepatitis B or C.
Our results suggest a possible preventive role for vitamin D against liver cancer and CLD, although the importance of the liver for vitamin D metabolism and the lack of information about underlying liver disease makes reverse causality a concern.
Future studies are needed to evaluate associations of vitamin D with liver cancer and disease in other populations, particularly those with a different constellation of risk factors.
PMID: 29720370 DOI: 10.1158/1055-9965.EPI-17-0877