Clinical outcomes of vitamin D deficiency and supplementation in cancer patients
Nutrition Reviews Vol. 71 Issue 8 DOI: 10.1111/nure.12047
Laisa Teleni1,2,
Jacqueline Baker3,
Bogda Koczwara4,
Michael G. Kimlin5,
Euan Walpole6,
Kathy Tsai3,
Elizabeth A Isenring3,7,*
1 School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
2 Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
3 School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia
4 Department of Medical Oncology, Flinders Medical Centre, Adelaide, South Australia, Australia
5 NHMRC Centre for Research Excellence in Sun and Health and AusSun Research Lab, Queensland University of Technology, Brisbane, Australia
6 Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
7 Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
*Correspondence: EA Isenring, School of Human Movements Studies, Connell Building, University of Queensland, St Lucia, Qld 4072, Australia. E-mail: e.isenring@uq.edu.au. Phone: +61-3-07-3365-6982.
Results of recent studies suggest that circulating levels of vitamin D may play an important role in cancer-specific outcomes. The present systematic review was undertaken to determine the prevalence of vitamin D deficiency (<25 nmol/L) and insufficiency (25–50 nmol/L) in cancer patients and to evaluate the association between circulating calcidiol (the indicator of vitamin D status) and clinical outcomes. A systematic search of original, peer-reviewed studies on calcidiol at cancer diagnosis, and throughout treatment and survival, was conducted yielding 4,706 studies.
A total of 37 studies met the inclusion criteria for this review. Reported mean blood calcidiol levels ranged from 24.7 to 87.4 nmol/L, with up to 31% of patients identified as deficient and 67% as insufficient.
The efficacy of cholecalciferol supplementation for raising the concentration of circulating calcidiol is unclear; standard supplement regimens of <1,000 IU/D3 day may not be sufficient to maintain adequate concentrations or prevent decreasing calcidiol. Dose-response studies linking vitamin D status to musculoskeletal and survival outcomes in cancer patients are lacking.