JNCI：血浆25-羟维生素D浓度影响肾细胞癌发病风险

虽然肾脏是Vit D代谢的主要器官，但是目前为止我们并不知道Vit D和肾细胞癌发病率之间存在怎样的联系。为了试图回答上述问题，来自韩国首尔国立大学医学院的Hee‑Kyung Joh等进行了相关研究并将其研究结果发表在JNCI 4月最新的在线期刊上。

研究者在本研究中前瞻性的评估了血浆25-羟Vit D和肾细胞癌发病风险之间所存在的联系。在1986至2008年期间，研究者纳入了72051名女性受试者和46380名男性受试者。采用验证回归模型计算了血浆25(OH)D评分，验证回归模型包括了决定Vit D状态的主要决定因子，如种族、中波紫外线、一般状态、体重指数、估计Vit D摄入量、酒精摄入量和女性绝经后激素应用情况。研究者应用Cox风险比例模型计算了风险比（HR）和95%可信区间。所有的统计检验都在双侧进行。

在长达22年的随访之后，研究者记录到在女性中有201名肾细胞癌患者，而在男性中则有207人。多变量风险比提示女性中25(OH)D评分为0.50，男性中则为0.59，集群队列中为0.54。25(OH)D评分递增10 ng/mL，肾细胞癌发病风险降低44%。研究者同时指出调查问卷调查的结果提示饮食中Vit D的摄入和肾细胞癌发病率之间不存在显著联系。

本研究结果提示，无论是在男性还是女性人群中，血浆高Vit D水平能显著降低肾细胞癌的发病风险。研究者同时指出，还需要设计前瞻性的研究来证实本研究的结果，采用能够代表Vit D长期状态的特异性指标来进一步验证本研究的结论。

与肾细胞相关的拓展阅读：

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Predicted Plasma 25-Hydroxyvitamin D and Risk of Renal Cell Cancer
Background
Although the kidney is a primary organ for vitamin D metabolism, the association between vitamin D and renal cell cancer (RCC) remains unclear.
Methods
We prospectively evaluated the association between predicted plasma 25-hydroxyvitamin D [25(OH)D] and RCC risk among 72 051 women and 46 380 men in the period from 1986 to 2008. Predicted plasma 25(OH)D scores were computed using validated regression models that included major determinants of vitamin D status (race, ultraviolet B flux, physical activity, body mass index, estimated vitamin D intake, alcohol consumption, and postmenopausal hormone use in women). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. All statistical tests were two-sided.
Results
During 22 years of follow-up, we documented 201 cases of incident RCC in women and 207 cases in men. The multivariable hazard ratios between extreme quintiles of predicted 25(OH)D score were 0.50 (95% CI = 0.32 to 0.80) in women, 0.59 (95% CI = 0.37 to 0.94) in men, and 0.54 (95% CI = 0.39 to 0.75; P trend < .001) in the pooled cohorts. An increment of 10ng/mL in predicted 25(OH)D score was associated with a 44% lower incidence of RCC (pooled HR = 0.56, 95% CI = 0.42 to 0.74). We found no statistically significant association between vitamin D intake estimated from food-frequency questionnaires and RCC incidence.
Conclusion
Higher predicted plasma 25(OH)D levels were associated with a statistically significantly lower risk of RCC in men and women. Our findings need to be confirmed by other prospective studies using valid markers of long-term vitamin D status.