Appears that IBD lowers vitamin D, which increases risk of cancer by 80 percent – Oct 2013

Association Between Reduced Plasma 25-hydroxy Vitamin D and Increased Risk of Cancer in Patients with Inflammatory Bowel Diseases

Clinical Gastroenterology and Hepatology
Ashwin N. Ananthakrishnan1, 2, Corresponding author contact information, E-mail the corresponding author,
Su-Chun Cheng3, Tianxi Cai3, Andrew Cagan4, Vivian S. Gainer4, Peter Szolovits6, Stanley Y. Shaw2, 8, Susanne Churchill9, Elizabeth W. Karlson2, 10, Shawn N. Murphy2, 4, 11, Isaac Kohane2, 5, 9, Katherine P. Liao2, 10
1 Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
2 Harvard Medical School, Boston, MA
3 Department of Biostatistics, Harvard School of Public Health, Boston, MA
4 Research Computing, Partners HealthCare, Charlestown, MA
5 Children’s Hospital Boston, Boston, MA
6 Massachusetts Institute of Technology, Cambridge, MA, 7 Department of Neurology, Brigham and Women’s Hospital, Boston, MA
8 Center for Systems Biology, Massachusetts General Hospital, Boston, MA
9 i2b2 National Center for Biomedical Computing, Brigham and Women’s Hospital, Boston, MA
10 Division of Rheumatology, Brigham and Women’s Hospital, Boston, MA
11 Department of Neurology, Massachusetts General Hospital, Boston, MA

Background & Aims: Vitamin D deficiency is common among patients with inflammatory bowel diseases (IBD) (Crohn’s disease or ulcerative colitis). The effects of low plasma 25-hydroxy vitamin D (25[OH]D) on outcomes other than bone health are understudied in patients with IBD. We examined the association between plasma level of 25(OH)D and risk of cancers in patients with IBD.

Methods: From a multi-institutional cohort of patients with IBD, we identified those with at least 1 measurement of plasma 25(OH)D. The primary outcome was development of any cancer. We examined the association between plasma 25(OH)D and risk of specific subtypes of cancer, adjusting for potential confounders in a multivariate regression model.

Results: We analyzed data from 2809 patients with IBD and a median plasma level of 25(OH)D of 26 ng/mL. Nearly one-third had deficient levels of vitamin D (<20 ng/mL). During a median follow-up period of 11 y, 196 patients (7%) developed cancer, excluding non-melanoma skin cancer (41 cases of colorectal cancer). Patients with vitamin D deficiency had an increased risk of cancer (adjusted odds ratio=1.82; 95% CI, 1.25–2.65) compared to those with sufficient levels.

Each 1 ng/mL increase in plasma 25(OH)D was associated with an 8% reduction in risk of colorectal cancer (odds ratio=0.92; 95% CI, 0.88–0.96). A weaker inverse association was also identified for lung cancer.

Conclusion: In a study of from 2809 patients with IBD, low plasma level of 25(OH)D was associated with an increased risk of cancer—especially colorectal cancer.

Corresponding author: Ashwin N Ananthakrishnan, MD, MPH, Crohn’s and Colitis center, Massachusetts General Hospital, 165 Cambridge Street, 9th Floor, Boston, MA 02114, Phone: 617-724-9953, Fax: 617-726-3080. aananthakrishnan@partners.org

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Appears that IBD lowers vitamin D, which increases risk of cancer by 80 percent – Oct 2013

Association Between Reduced Plasma 25-hydroxy Vitamin D and Increased Risk of Cancer in Patients with Inflammatory Bowel Diseases

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