Circulating 25-Hydroxyvitamin-D and Risk of Colorectal Adenomas and Hyperplastic Polyps

Abstract

Colorectal adenomas are clear precursors of cancer; hyperplastic polyps may also have malignant potential. An inverse association between circulating vitamin D metabolites and adenoma risk has been reported, but less is known about vitamin D and hyperplastic polyps. We conducted a case-control study of adenomas and hyperplastic polyps among 459 members of an integrated health plan evaluated via colonoscopy. Questionnaires provided information on colorectal polyp risk factors, and plasma samples were assayed for 25-hydroxyvitamin-D (25(OH)D). Polytomous regression was used to estimate odds ratios for adenomas (N=149) and hyperplastic polyps (N=85) compared to polyp-free controls (N=225) by tertile of 25(OH)D. An inverse association between 25(OH)D and adenomas was suggested after adjustment for potential confounding factors (comparing upper to lower tertiles, OR[95%CI]: 0.71 [0.38–1.30]). After restriction of the analyses to study participants with no history of polyps, this OR estimate was reduced further (adjusted OR [95%CI]: 0.52 [0.23–1.20]). In comparison, no inverse association between hyperplastic polyps and 25(OH)D was observed among the full study participants (adjusted OR [95%CI]: 1.17 [0.55–2.51]) or among those without prior polyps (adjusted OR [95%CI]: 1.42 [0.55–3.65]). Our study suggests that the established inverse association between circulating 25(OH)D and adenoma may not apply to hyperplastic polyps.

Lifestyle Risk Factors for Serrated Colorectal Polyps: A Systematic Review and Meta-analysis

“…Reduced SP risks were detected for individuals consuming the highest compared with the lowest intakes of calcium, fiber and folate, although only the latter was significant (RR, 0.65; 95% CI, 0.49-0.85) and all estimates had moderate heterogeneity. Vitamin D intake was not associated with SP risk (Figure 7), which is in agreement with another study measuring circulating 25-hydroxyvitamin D status 63 .…”

“…Fifteen articles published on a range of dietary factors and SP risk 25,28,32,38,40,42,44,54,55,[63][64][65][66][67][68] , only one of which reported SSA/P risk separately 55 , as shown in Supplementary .…”

No Evidence for Human Papillomavirus in the Etiology of Colorectal Polyps

“…Prior to colonoscopy, a sequential sample of individuals were invited to take part in a study of colorectal cancer screening markers (39, 40). All study protocols were approved by Institutional Review Boards at GH and the Fred Hutchinson Cancer Research Center (FHCRC).…”

Decreased preoperative serum 25-Hydroxyvitamin D levels in colorectal cancer are associated with systemic inflammation and serrated morphology

“…These associations suggest that vitamin D deficiency might be related to the serrated pathway of CRC. Earlier studies have reported that vitamin D deficiency is not a risk factor for colorectal hyperplastic polyps25, but to our knowledge, little is known of the association between vitamin D deficiency and sessile and traditional serrated adenomas, which is an important subject for further investigation, since hyperplastic polyps are very common, and the risk of neoplastic progression has not been attributed to hyperplastic polyps but sessile and traditional serrated adenomas6.…”