Clinically sufficient vitamin D levels at breast cancer diagnosis and survival outcomes in a prospective cohort of 3,995 patients after a median follow-up of 10 years.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10510-10510
Author(s):  
Song Yao ◽  
Haiyang Sheng ◽  
Marilyn L. Kwan ◽  
Qianqian Zhu ◽  
Janise M. Roh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Prospective Cohort ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Vitamin D Supplementation ◽  
Stage Disease ◽  
Vitamin D Levels ◽  
Sufficient Vitamin

10510 Background: There have been suggestive findings for better cancer survival with vitamin D supplementation in the recent VITAL trial. The findings are consistent with meta-analyses based on earlier randomized trials testing daily supplement vitamin D intake. As there is no ongoing or planned randomized trial of vitamin D supplementation in sight for women after breast cancer diagnosis, we evaluated relationships between serum levels of vitamin D and breast cancer outcomes in a large prospective cohort of breast cancer survivors. Methods: We measured 25-hydroxyvitamin D (25OHD) levels in serum samples collected at the time of diagnosis from 3,995 women with incident breast cancer enrolled in the Pathways Study, a large prospective cohort established in 2006 at Kaiser Permanente Northern California with active follow-up (FU). Potential determinants of 25OHD levels, including a polygenic score, were examined. Vitamin D levels were categorized based on clinical cutoffs as deficient ( < 20 ng/ml), insufficient (20 to < 30 ng/ml), or sufficient (≥30 ng/ml). These levels were then evaluated in relation to overall survival (OS), breast cancer-specific survival (BCSS), recurrence-free survival (RFS), and invasive disease-free survival (IDFS). Cox proportional hazards models were adjusted for non-clinical, clinical, and treatment factors and were further stratified by stage, estrogen receptor (ER) status, and body mass index (BMI). Results: Vitamin D supplement use, lower BMI, and self-reported white race were the strongest determinants of higher 25OHD levels. The polygenic score was significantly associated with 25OHD levels but explained only 0.3% of the variance. The median FU was 9.6 years (range: 0.3-13). Compared to those with deficient vitamin D levels, patients with sufficient levels had significantly better survival outcomes, which remained after controlling for various covariates (OS: HR [95% CI] = 0.73 [0.58-0.91]; BCSS: HR = 0.78 [0.56-1.09]; RFS: HR = 0.79 [0.65-0.97]; IDFS: HR = 0.82 [0.68-0.99]). Associations were similar by ER status, but stronger among patients with more advanced stage disease and those with under-weight or normal BMI. Black patients had the lowest 25OHD levels, which contributed to their poorer survival compared to white patients. Adding 25OHD levels to the Cox model of OS lowered the HR associated with Black vs. white race from 2.03 (1.57-2.62) to 1.79 (1.37-2.32). Conclusions: Sufficient vitamin D levels at the time of diagnosis were associated with improved breast cancer prognosis. Consistent with results from randomized trials, our findings from a large observational cohort of breast cancer survivors with long FU provide the strongest evidence to date for maintaining sufficient vitamin D levels in breast cancer patients, including among Black women and those with more advanced stage disease.

Prospective change in 25-OH vitamin D levels over long-term follow-up and health outcomes in breast cancer survivors.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 6111-6111
Author(s):  
S. K. Taylor ◽  
M. Ennis ◽  
N. S. Hood ◽  
M. Graham ◽  
K. I. Pritchard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Vitamin D Levels ◽  
Long Term Follow Up ◽  
25 Oh Vitamin D

scholarly journals Assessment the effect of vitamin D supplementation on plasma vitamin D levels, inflammation, and oxidative stress biomarkers based on vitamin D receptor genetic variation in breast cancer survivors: a protocol for clinical trial

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Elham kazemian ◽  
Mohammad Esmaeil Akbari ◽  
Nariman Moradi ◽  
Safoora Gharibzadeh ◽  
Atieh Amouzegar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Cell Proliferation ◽  
Genetic Variation ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Vitamin D Supplementation ◽  
Plasma Vitamin ◽  
Environmental Aspects ◽  
Vitamin D Levels

Abstract Background Both human genes and environmental exposures, due to complex interplay, play important role in the cancer etiology. Vitamin D is associated with a reduced risk of incidence and mortality of several human cancers. This study will aim to investigate the possible effects of individual polymorphisms in vitamin D receptor (VDR) as well as effects of VDR haplotypes on response to vitamin D supplementation in breast cancer survivors. Methods This is an interventional study in which the effects of vitamin D supplementation on plasma vitamin D levels, inflammatory and antioxidant biomarkers and factors associated with cell proliferation, differentiation, damage, and apoptosis will be investigated stratified by variations in VDR genotype. The present study will be conducted on breast cancer survivors referred to the Shohadaye Tajrish hospital and its associated clinics. One hundred ninety-eight breast cancer survivors will receive 4000 IU of vitamin D3 daily for 12 weeks. VDR Fok1, ApaI, TaqI, BsmI, and Cdx-2 genotype will be determined at the end of the study and responses to vitamin D supplements (inflammatory, antioxidant, cell proliferation, differentiation, damage, and apoptosis biomarkers) will be compared between the three subgroups of each VDR polymorphism as well as different VDR haplotype categories. Discussion Genetic variation is a fundamental factor influencing individuals’ divergent responses to diet, nutritional status, metabolic response, and diet-related health disorders. Furthermore, studies of gene and environment interactions will provide a precise and accurate assessments of individuals’ dietary requirements by considering both the genetic and environmental aspects simultaneously. The results of the current study, to some extent, will highlight the discrepancies existing in the findings of different studies regarding vitamin D, VDR, and cancer by considering both the genetic and environmental aspects simultaneously. If responses to vitamin D supplementation could be modified by VDR SNPs, determining the distribution of VDR polymorphisms in both breast cancer survivors and healthy populations will provide a new insight into the vitamin D requirements of individuals to prevent cancer and its related mortality based on their genotypes. Trial registration This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT2017091736244N1, registration date: 2017-11-10, http://www.irct.ir/trial/27153

Evidence of a possible therapeutic role of vitamin D in a cohort of adult Caucasian vitiligo patients

2020 ◽  
Vol 90 (3-4) ◽  
pp. 200-204 ◽  
Author(s):  
Roberta Colucci ◽  
Rossana Conti ◽  
Federica Dragoni ◽  
Allegra Cammi ◽  
Luisella Cianferotti ◽  
...  
Keyword(s):  
Vitamin D ◽  
Positive Association ◽  
Vitamin D Supplementation ◽  
Significant Positive Association ◽  
Vitamin D Levels ◽  
The Stability ◽  
Sufficient Vitamin

Abstract. Reduced serum 25(OH)D levels have been largely reported in vitiligo, which is an autoimmune skin disorder characterized by the appearance of achromic macules. Since vitamin D can positively modulate immune function and stimulate melanogenesis in vitro, a possible role of sufficient vitamin D levels in promoting the stability of the disease and repigmentation process might be hypothesized in vitiligo. Hence, we conducted an observational study on medical records related to 101 vitiligo patients, in order to correlate baseline 25(OH)D levels with the baseline vitiligo activity and repigmentation of vitiligo macules on a 6-month follow-up. According to our results, at baseline we found that active vitiligo was significantly associated with 25(OH)D deficiency (≤20 ng/mL) (P = 0.036) or insufficiency (21–29 ng/mL) (P = 0.041), while stable disease was significantly associated with sufficient 25(OH)D levels (30–100 ng/mL) (P = 0.043). After 6 months, vitiligo patients with sufficient 25(OH)D levels (30–100 ng/mL) achieved a significantly higher degree of repigmentation. In conclusion, our study provides a novel evidence of a significant positive association of sufficient 25(OH)D levels with the stability of the disease and a satisfactory repigmentation process in Caucasian adult vitiligo patients and strengthen the need to assess vitamin D status in vitiligo. The correlation between sufficient vitamin D levels and a satisfactory course of the disease opens the way for future randomized controlled trials assessing a possible beneficial role of vitamin D supplementation on vitiligo.

Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hatice Sarıdemir ◽  
Ozge Surmeli Onay ◽  
Ozge Aydemir ◽  
Ayse Neslihan Tekin
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Prospective Cohort ◽  
Very Low Birth Weight ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Vlbw Infants ◽  
Vitamin D Levels

Abstract Objectives Preterm infants are at increased risk for vitamin D deficiency (VDD). We aimed to assess the adequacy of standardized vitamin D supplementation protocol in very low birth weight (VLBW) infants. Additionally, vitamin D status of mother/infant couples and the associations between vitamin D status at birth and morbidities of the infants were investigated. Methods In this single-center, prospective cohort study blood samples were collected from 55 mothers just before delivery and from their infants at birth and on the 30th day of life (DOL) for 25 hydroxy vitamin D (25OHD) measurements. Vitamin D was initiated in dose of 160 IU/kg by parenteral nutrition on the first DOL and oral vitamin D supplementation (400 IU/day) was administered when enteral feedings reached 50% of total intake or on the 15th DOL. Results The median 25OHD levels of the infants were 16.12 (9.14–20.50) in cord blood and 36.32 (31.10–44.44) in venous blood on the 30th DOL (p<0.01). In 98% of the VLBW infants 25OHD reached sufficient levels on the 30th DOL. None of the mothers had sufficient vitamin D levels (25OHD >30 ng/mL). Maternal 25OHD levels were correlated with the 25OHD levels of the infants in cord blood (r=0.665, p<0.001). There was a significant difference in mean cord 25OHD levels between winter (13.65 ± 5.69 ng/mL) and summer seasons (19.58 ± 11.67 ng/mL) (p=0.021). No association was found between neonatal morbidity and vitamin D status. Conclusions The results clearly show that by utilizing the current supplementation protocol, the majority of VLBW infants with deficient/insufficient serum 25OHD levels reached sufficient levels on the 30th DOL. Furthermore, vitamin D levels in mother/infant couples were found to be highly correlated.

scholarly journals High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

2009 ◽  
Vol 27 (13) ◽  
pp. 2151-2156 ◽  
Author(s):  
Katherine D. Crew ◽  
Elizabeth Shane ◽  
Serge Cremers ◽  
Donald J. McMahon ◽  
Dinaz Irani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Black Women ◽  
Adjuvant Chemotherapy ◽  
Vitamin D Deficiency ◽  
White Women ◽  
Premenopausal Women ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Vitamin D Levels

Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation. Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater. Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use. Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined.

scholarly journals Evaluation of efficacy of a nanoparticle based vitamin D formulation in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D

2017 ◽  
Vol 3 (3) ◽  
pp. 486
Author(s):  
Kishore A. Manek
Keyword(s):  
Vitamin D ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Open Label ◽  
Baseline Serum ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Post Marketing ◽  
Sufficient Vitamin ◽  
To Receive

<p><strong>Background:</strong> In India more than 90% of apparently healthy Indians have subnormal 25(OH) D levels. To maintain sufficient vitamin D level, apart from sunlight and food containing vitamin D, supplementation with vitamin D is also required. The objective of this study was to find out effectiveness of nanoparticle based vitamin D formulations in patient of vitamin D deficiency and insufficiency</p><p><strong>Methods:</strong> This was a prospective, open label, single arm, non-comparative, dose response post-marketing efficacy study (PMS) – phase-4 study to find the effectiveness of a nanoparticle based vitamin D formulation in adult patients between 18 to 65 years of either gender, attending/visiting the study site with documented deficiency or insufficiency of vitamin D (&lt;30 ng/ml) or sign and symptoms of deficiency or insufficiency of vitamin D. Each subject planned to receive 60,000 IU of nanoparticle based vitamin D, once weekly, for 8 weeks orally. Serum 25(OH) D levels were measured at baseline, 4 and 8 week.</p><p><strong>Results:</strong> The mean baseline serum 25[OH] D levels were 15.90. After treatment with nanoparticle based vitamin D there was a significant increase in the serum vitamin D levels at 4 weeks (41.03) and 8 weeks (31.38) (p&lt;0.0001). Patients who have received treatment for at least 4 weeks’ period (n=38), the improvement (serum 25[OH] D &gt;30 ng/ml) was seen in 84.2% patients (n=32) at the end of 4 weeks itself. There is significant increased (&lt;0.0001) in the physical component scores of the SF-12 QOL questionnaire after 8 weeks of therapy.</p><p><strong>Conclusions:</strong> Nanoparticle based formulation of vitamin D<sub>3</sub> is effective and safe in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D. Also the safety and tolerability is well accepted and reported good to excellent by patients and physician.</p><p> </p>

scholarly journals Impact of Vitamin D Therapy on the Progress COVID-19: Six Weeks Follow-Up Study of Vitamin D Deficient Elderly Diabetes Patients

2021 ◽  
pp. 201010582110414
Author(s):  
Amin R. Soliman ◽  
Tarek Samy Abdelaziz ◽  
Ahmed Fathy
Keyword(s):  
Vitamin D ◽  
Large Scale ◽  
Clinical Laboratory ◽  
Vitamin D Supplementation ◽  
Chronic Obstructive ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Diabetes Patients

Background Coronavirus disease-19 (COVID-19) is an ongoing pandemic causing considerable fatalities worldwide. Vitamin D modulates the immune response through effects on various cells, such as: macrophages, B and T lymphocytes, neutrophils, and dendritic cells. Aim To explore whether supplementation of vitamin D, in the form of a single intramuscular cholecalciferol injection, to patients with diabetes, COVID-19, and low vitamin D levels could improve the prognosis of those patients. Methods This was a placebo-controlled randomized prospective study. The study has two arms as follows: the intervention arm (40 vitamin D deficient diabetes elderly patients that acquired SARS-CoV-2), compared to the control arm (16 elderly diabetes patients, with deficient vitamin D with SARS-CoV-2). Patients in the intervention arm were given vitamin D as a single intramuscular injection (200,000 IU); patients in the control arm were given placebo. The primary outcome was mortality within 6 weeks of the diagnosis of COVID-19. Clinical, laboratory, treatment, and outcome data were recorded after 6 weeks of follow-up. Results No significant difference in 6 weeks mortality was observed between patients who received vitamin D and patients who received placebo (17.5% vs 18.8%, p = 0.838). Age, presence of hypertension, and chronic obstructive pulmonary disease were independent predictors of mortality at 6 weeks. Conclusion Vitamin D supplementation did not reduce the severity or mortality of COVID-19 at 6 weeks. Further large scale studies are required to explore the effect of vitamin D therapy on survival in patients with diabetes mellitus who acquire COVID-19.

scholarly journals Effects of Vitamin D Use on Health-Related Quality of Life of Breast Cancer Patients in Early Survivorship

2019 ◽  
Vol 18 ◽  
pp. 153473541882205 ◽  
Author(s):  
M. Robyn Andersen ◽  
Erin Sweet ◽  
Shelly Hager ◽  
Marcia Gaul ◽  
Fred Dowd ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Cancer Patients ◽  
Vitamin D Supplementation ◽  
Blood Levels ◽  
Breast Cancer Patients ◽  
Supplement Use ◽  
Related Quality ◽  
Vitamin D Supplements

Background: Vitamin D supplements may prevent recurrence, prolong survival, and improve mood for women with breast cancer, although evidence for these effects is preliminary. Methods: This report describes vitamin D supplement use by 553 breast cancer patient/survivors (193 who used a naturopathic oncology [NO] provider and 360 who did not) participating in a matched cohort study of breast cancer outcomes. Results: We found that more than half of breast cancer patients reported using vitamin D supplements. Women who received care from NO providers in early survivorship may be more likely to use vitamin D supplements ( P < .05). Approximately 30% of breast cancer patients with blood levels recorded in their medical chart were potentially vitamin D deficient (<30 ng/mL). Vitamin D supplement use at study enrollment was associated with higher levels of self-reported health-related quality of life (HRQOL) at enrollment ( P < .05) and predicted better HRQOL at 6-month follow-up ( P < .05). Sufficient blood levels of vitamin D recorded between enrollment and follow-up were also associated with better HRQOL at follow-up ( P < .05). Conclusions: Vitamin D supplementation by breast cancer patients is common both during and after treatment for breast cancer, but deficiency may also be common. NO and conventional providers may be able to promote vitamin D sufficiency through vitamin D supplementation and by encouraging healthy solar exposure. Further studies should be undertaken examining whether vitamin D supplementation and higher blood levels might improve HRQOL among women with breast cancer in early survivorship.

scholarly journals Inflammatory activity and vitamin D levels in an MS population treated with rituximab

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982659 ◽  
Author(s):  
Johan Linden ◽  
Gabriel Granåsen ◽  
Jonatan Salzer ◽  
Anders Svenningsson ◽  
Peter Sundström
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Magnetic Resonance ◽  
Vitamin D Supplementation ◽  
Inflammatory Activity ◽  
T2 Lesions ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Multiple Sclerosis Patients

Background Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed. Objective To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels. Methods Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health. Results In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects. Conclusion The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.

scholarly journals Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1400
Author(s):  
Niv Ben-Shabat ◽  
Abdulla Watad ◽  
Aviv Shabat ◽  
Nicola Luigi Bragazzi ◽  
Doron Comaneshter ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Health Maintenance ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
All Cause Mortality

In this study, we aimed to examine the effect of vitamin D deficiency on all-cause mortality in ankylosing spondylitis (AS) patients and in the general population. This is a retrospective-cohort study based on the electronic database of the largest health-maintenance organization in Israel. AS patients who were first diagnosed between 2002–2007 were included. Controls were matched by age, gender and enrollment-time. Follow-up continued until death or end of study follow-up on 1 July 2019. Laboratory measures of serum 25-hydroxyvitamin-D levels during the entire follow-up period were obtained. A total of 919 AS patients and 4519 controls with a mean time of follow-up of 14.3 years were included. The mean age at the time of enrollment was 52 years, and 22% of them were females. AS was associated with a higher proportion of vitamin D deficiency (odds ratio 1.27 [95% confidence-interval (CI) 1.03–1.58]). In AS patients, insufficient levels of vitamin D (<30 ng/mL) were significantly associated with increased incidence of all-cause mortality (hazard ratio (HR) 1.59 [95% CI 1.02–2.50]). This association was more prominent with the decrease in vitamin D levels (< 20 ng/mL, HR 1.63 [95% CI 1.03–2.60]; <10 ng/mL, HR 1.79 [95% CI 1.01–3.20]) and among male patients (<30 ng/mL, HR 2.11 [95% CI 1.20–3.72]; <20 ng/mL, HR 2.12 [95% CI 1.19–3.80]; <10 ng/mL, HR 2.23 [95% CI 1.12–4.43]). However, inadequate levels of vitamin D among controls were not associated with an increased all-cause mortality. Our study has shown that vitamin D deficiency is more common in AS patients than controls and is linked to an increased risk for all-cause mortality. These results emphasize the need for randomized-controlled trials to evaluate the benefits of vitamin D supplementation as a secondary prevention of mortality in patients with chronic inflammatory rheumatic disease.

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