Relationship of very low serum 25-hydroxyvitamin D 3 levels with long-term survival in a large cohort of colorectal cancer patients from Germany

AbstractTo investigate the association of serum 25-hydroxyvitamin D (25(OH)D3) with survival in a large prospective cohort study of colorectal cancer (CRC) patients. The study population consisted of 2,910 patients diagnosed with CRC between 2003 and 2010 who participated in the DACHS study, a multicenter study from Germany with comprehensive long-term follow-up. 25(OH)D3 was determined in serum samples collected shortly after cancer diagnosis by High Performance Liquid Chromatography-Electro Spray Ionization-Mass Spectrometry. Analyses of survival outcomes were performed using Cox regression with comprehensive adjustment for relevant confounders. The majority (59%) of CRC patients were vitamin D deficient (serum 25(OH)D3 levels<30  nmol/L). During a median follow-up of 4.8 years, 787 deaths occurred, 573 of which were due to CRC. Compared to patients in the highest 25(OH)D3 quintile (>45.20  nmol/L), those in the lowest 25(OH)D3 quintile (<11.83  nmol/L) had a strongly increased mortality. Adjusted hazard ratios (95% Confidence Interval) were 1.78 (1.39–2.27), 1.65 (1.24–2.21), 1.32 (1.03–1.71) and 1.48 (1.18–1.85) for all-cause mortality, CRC-specific mortality, recurrence-free and disease-free survival, respectively. Subgroup an alyses did not show any significant effect modification across strata defined by sex, age, stage, body mass index, or the late entry. Dose–response analyses showed a strong inverse relationship between serum 25(OH)D3 levels ...
Source: European Journal of Epidemiology - Category: Epidemiology Source Type: research