Abstract
Introduction: In the field of cancer, vitamin D has emerged as the most creative research connecting it with risk reduction in various epithelial cancers. Aside from calcium homeostasis, vitamin D exerts a wide range of immunogenic and antiproliferative activities in the human body.
Vitamin D exerts its antiproliferative outcome by binding to vitamin D receptor (VDR) found in various tissues and cells of the body. Several human genes contain vitamin D response elements (specific DNA sequences) that encode for proteins important in regulation of cell proliferation, differentiation, apoptosis, and angiogenesis. When the serum vitamin D levels are suboptimal these activities are impaired and as a result enhanced cellular growth, neo-angiogenesis, and cancer development takes place. The breast cells have VDRs in their nuclei and it is postulated that polymorphism of genes for these VDRs results in increased risk for breast cancer.
Serum concentration of 25(OH) 2 D are more sensitive to exogenous sources like: dietary and supplemental intake and endogenous production through synthesis in the skin of vitamin D which is the best indicator of vitamin D status of the body. There are data showing that locally advanced breast cancer patients had more severe vitamin D deficiency than those with early stage disease.
The aim of the study was to determine serum vitamin D levels in breast cancer patients related with grade and stage of the tumor and to assess its risk prediction to improve health.
Materials and Methods: Study samples: The study was conducted on indoor and outdoor patients for a period of one year (January to December), and an equal number of age and sex matched controls were taken which included total of 500 adults.
Clinical Aassessment: Body mass index (BMI) was categorized as normal weight (<24 kg/m2), overweight (24-28 kg/m2) and obese (>28 kg/m2), fasting blood glucose (60 to 100 mg/dl) and Glycosylated Hemoglobin (controlled<7% and >7% uncontrolled). Vitamin D nutritional status was based on 25(OH) D levels, which were assessed as mild/sufficient (30-50 nmol/L), moderate/insufficient (12.5-29.9 nmol/L), and severe/deficient (<12.5 nmol/L).
Results: The mean age was 42±1.5 years. Age, marital status, menopausal, residential area and BMI were similar in distribution among cases and controls. The mean serum vitamin D level in the breast cancer patients was <12.5 nmol/L and in the control group was 36.9 nmol/L (P value <0.001). Vitamin D deficiency was seen in 97.6% breast cancer patients and in 69.3% of the control group (P value <0.001). Among the breast cancer patients the tumor characteristics (histology, grade, stage, and receptor status) did not show any significant associations with serum levels of vitamin D. Premenopausal breast cancer females had a mean serum vitamin D level of 11.1 nmol/L and postmenopausal females had a mean value of 15.65 nmol/L (P value 0.015). Low BMI did not correlate significantly with vitamin D deficiency (P value 0.787).
Conclusion: Invariably almost all patients with breast cancer were vitamin D deficient. Tumor characteristics and BMI did not show any significant associations with serum levels of vitamin D.
Note: This abstract was not presented at the conference.
Citation Format: Vinit Mehrotra, Ashutosh Sharma. Serum vitamin D levels in breast cancer patients to assess its risk prediction to improve health. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection; Nov 16-19, 2016; Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(5 Suppl):Abstract nr B09.