血浆25-羟维生素D水平与结直肠肿瘤关系的病例对照研究

Association between plasma 25-hydroxy vitamin D levels and risk of colorectal neoplasms:a case-control study

目的探讨血浆25-羟维生素D水平与结直肠肿瘤发生的关系。方法采用病例对照研究，对结直肠癌、进展期腺瘤、腺瘤和增生性息肉患者及健康人群血浆25-羟维生素D水平进行比较，并将结直肠癌患者按照病变部位（近端结肠、远端结肠）进行分层分析。结果将25-羟维生素D水平分为≤13．39、13．39～18．23和≥18．23ng／mL3个等级，结直肠癌（P〈O．001）、进展期腺瘤（P〈O．001）、腺瘤（Ptrenddo．001）和增生性息肉（Ptrend=0．013）患者血浆25-羟维生素D均低于健康对照人群，其维生素D最高值与最低值比较OR（95％CI）依次为0．33（0．21，0．53）、0．18（O．09，0．38）、0．09（O．01，0．41）、0．25（O．08，0．77）。按发病部位进行分层后，近端结直肠癌（Ptrend-O．001）和远端结直肠癌（P〈O．001）患者血浆25-羟维生素D水平均低于健康对照人群，其维生素D最高值与最低值比较OR（95％CI）依次为0．26（0．12，0．56）和0．33（o．20，0．56）。结论血浆25-羟维生素D可降低结直肠肿瘤发病风险，且与病变部位无关。

Objective To investigate the relationship between 25-hydroxy vitamin D and colorectal neoplasms.Methods A case control study was designed to compare the plasma 25-hydroxy vitamin D levels of participants with colorectal cancer,progressive adenoma,adenoma,hyperplastic polyposis and healthy controls.Meanwhile,stratified analysis was carried out according to the lesion sites(proximal colon and distal colon).Results The plasma 25-hydroxy vitamin D was divided into three levels:≤13.39,13.39-18.23 and ≥18.23ng/mL.The levels in colorectal cancer group(P<0.001),progressive adenoma group(P<0.001),adenoma group(Ptrend<0.001),and hyperplastic polyposis group(Ptrend=0.013)were all significantly lower compared to that in the healthy control group,with the OR(95%CI)values of highest value and the lowest value of vitamin D as follows:0.33(0.21,0.53),0.18(0.09,0.38),0.09(0.01,0.41),and 0.25(0.08,0.77),respectively.After stratified according to the lesion sites,the plasma 25-hydroxy vitamin D levels of proximal colorectal cancer group(Ptrend=0.001)and distal colorectal cancer group(P<0.001)were significantly lower than that of the healthy control group.The OR(95%CI)of highest value and the lowest value of vitamin D were 0.26(0.12,0.56)and 0.33(0.20,0.56),respectively.Conclusion Plasma 25-hydroxy vitamin D can reduce the risk of colorectal cancer regardless of the lesion locations.