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

Abstract

Deficiency of vitamin D is associated with increased risk of several types of cancer including colorectal cancer (CRC). However, factors contributing to low levels of 25-hydroxyvitamin D [25(OH)D] in CRC are not clear. Therefore, in this study serum 25(OH)D levels in 117 CRC patients and 86 controls were analyzed and correlated with the clinicopathological data including morphological subtype (serrated or conventional), quantity of tumor infiltrating immune cells, levels of systemic inflammatory markers, and disease outcome. We found that the patients had lower serum 25(OH)D levels compared to the controls. Interestingly, among the patients mismatch repair deficiency, serrated morphology, and high body mass index associated with lowest serum 25(OH)D levels. In addition, patients operated in summer or autumn had higher serum 25(OH)D levels. Furthermore, serum 25(OH)D levels inversely correlated with several systemic inflammatory markers, e.g. serum C reactive protein, but did not associate with prognosis. Mechanism leading to vitamin D deficiency in these patients are not clear but could be related to the effects of systemic inflammation. Longitudinal studies are warranted to assess vitamin D deficiency as a potential risk factor for serrated colorectal polyps and adenocarcinoma.

Circulating 25-Hydroxyvitamin D Concentration and Risk of Breast, Prostate, and Colorectal Cancers: The Melbourne Collaborative Cohort Study

“…In a randomized controlled trial of adjuvant therapy for stage III colorectal cancer, BRAF mutations were less common in patients with high predicted baseline 25(OH)D, and KRAS mutations were not associated with predicted 25(OH)D (33). Varynen and colleagues reported a small case-control study of colorectal cancer (34). Cases with BRAF mutations had the lowest mean 25(OH)D, those with KRAS mutations had intermediate mean, and patients with neither mutation had the highest mean, although the numbers of patients were small (n ¼ 117) and the differences were not significant (P ¼ 0.51).…”

Preoperative anemia in colorectal cancer: relationships with tumor characteristics, systemic inflammation, and survival

“…The study includes two independent, consecutive, prospectively recruited cohorts of CRC patients. Cohort 1 is an earlier described cohort of 148 CRC patients operated in Oulu University Hospital in 2006–2010 (Table 1 ) 29 , 42 , 43 , with up to 120-month follow-up data (Time to recurrence, TTR; cancer specific survival, CSS; overall survival, OS) collected from the clinical records and from Statistics Finland 44 – 46 . Cohort 2 consists of 208 CRC patients operated in Oulu University Hospital in 2010–2014, with up to 60-month follow-up data (TTR, CSS, OS) collected from the clinical records and from Statistics Finland (Table 1 ).…”

Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis

“…Basic information concerning the eligible studies is listed in Table 1 . A total of 18 prospective cohort studies were included in the meta-analysis of OS (5579 events and 17,770 participants) [ 18 , 27 , 35–49 ], and 10 of them showed the outcome of CSS (2411 events and 9128 participants) [ 18 , 35 , 36 , 39–42 , 45 , 46 ]. Nine studies were conducted in the Europe [ 18 , 39 , 40 , 42 , 44–46 , 48 ], six were performed in US [ 35 , 36 , 38 , 41 , 43 , 49 ], and the remaining studies were executed in Asia [ 37 , 47 ] and Australia [ 27 ].…”

“…The sample size of the included studies ranged from 52 to 3818 participants. Five studies investigated stage I-III patients [ 18 , 42 , 47 , 48 ], nine studies investigated stage I-IV patients [ 27 , 35–37 , 39–41 , 45 , 46 ] and four studies investigated exclusively stage IV patients [ 38 , 43 , 44 , 49 ]. The level of covariate adjustment in the individual studies differed, but most studies adjusted for age, sex, and some indicators relating to tumor spreading.…”