The correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yang ¹ , LIU Junru ² , MENG Xiangcai ¹ , LI Lulu ² , ZHAO Yajing ³ ,  WANG Yimin ¹

1. Department of General Surgery, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei 066000, P. R. China;
2. Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei 066000, P. R. China;
3. Department of General Internal Medicine, The Fourth Hospital of Qinhuangdao, Qinhuangdao, Hebei 066000, P. R. China;

Corresponding author：

WANG Yimin, Email: qhddrwym@163.com

Keywords：

colon cancer; 25 hydroxyvitamin D3; body mass index

DOI：

10.7507/1007-9424.201905048

Video：

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Objective To explore the correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer.Methods A total of 100 cases who underwent colonoscopy and were excluded from bowel diseases at the physical examination center of the First Hospital of Qinhuangdao from March 2017 to October 2017 were retrospectively selected as the control group. A total of 100 patients who underwent colonoscopy at general surgery or physical examination center and were confirmed to have colon cancer by pathological examination were included in the colon cancer group. The height, weight and body mass index (BMI) were measured in the morning, and the level of 25 hydroxyvitamin D3 (25(OH)D3) was determined by fasting blood sampling.Results ① There was no statistical significance in age and 25(OH)D3 level between the two groups (P>0.05), and BMI of the colon cancer group was significantly higher than that of the control group (P<0.05). ② The proportion of overweight and obesity in the colon cancer group was significantly higher than that in the control group (P<0.05), and the proportion of vitamin D deficiency was significantly higher as well (P<0.05). ③ Logistic regression analysis showed that the incidence of colon cancer in patients with vitamin D deficiency was 12.263 times higher than that in patients without vitamin D deficiency, and the incidence of colon cancer in patients with overweight and obesity was 2.215 times higher than that in patients with normal BMI, with statistically significant differences (P<0.05).Conclusion The incidence of colon cancer in patients with vitamin D deficiency and those with BMI of overweight or obesity is significantly increased.

Citation： LIU Yang, LIU Junru, MENG Xiangcai, LI Lulu, ZHAO Yajing, WANG Yimin. The correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(11): 1289-1292. doi: 10.7507/1007-9424.201905048 Copy

1.	Feskanich D, Ma J, Fuchs CS, et al. Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev, 2004, 13(9): 1502-1508.
2.	Lee JE, Li H, Chan AT, et al. Circulating levels of vitamin D and colon and rectal cancer: the Physicians' Health Study and a meta-analysis of prospective studies. Cancer Prev Res (Phila), 2011, 4(5): 735-743.
3.	Ma Y, Zhang P, Wang F, et al. Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol, 2011, 29(28): 3775-3782.
4.	Yehuda-Shnaidman E, Schwartz B. Mechanisms linking obesity, inflammation and altered metabolism to colon carcinogenesis. Obes Rev, 2012, 13(12): 1083-1095.
5.	Aspray TJ, Bowring C, Fraser W, et al. National Osteoporosis Society vitamin D guideline summary. Age Ageing, 2014, 43(5): 592-595.
6.	中华人民共和国卫生部疾病控制司. 中国成人超重和肥胖症预防控制指南. 北京: 人民卫生出版社, 2006: 12.
7.	Bosen CJ. Vitamin D insufficiency. N Engl J Med, 2011, 364(1): 248-254.
8.	Braun MM, Helzlsouer KJ, Hollis BW, et al. Colon cancer and serum vitamin D metabolite levels 10-17 years prior to diagnosis. Am J Epidemiol, 1995, 142(6): 608-611.
9.	Grant WB. Ecological studies of the UVB-vitamin D-cancer hypothesis. Anticancer Res, 2012, 32(1): 223-236.
10.	Maalmi H, Ordóñez-Mena JM, Schöttker B, et al. Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: systematic review and meta-analysis of prospective cohort studies. Eur J Cancer, 2014, 50(8): 1510-1521.
11.	Irving AA, Duchow EG, Plum LA, et al. Vitamin D deficiency in the Apc^Pirc/+ rat does not exacerbate colonic tumorigenesis, while low dietary calcium might be protective. Dis Model Mech, 2018, 11(3): pii: dmm032300.
12.	Shabahang M, Buras RR, Davoodi, et al. Growth inhibition of HT-29 human colon cancer cells by analogues 1, 25-dihydroxyvitamin D3. Cancer Res, 1994, 54(15): 4057-4064.
13.	Eisman JA, Barkla DH, Tutton PJ. Suppression of in vivo growth of human cancer solid tumor xenografts by 1, 25-dihydroxyvitamin D3. Cancer Res, 1987, 47(1): 21-25.
14.	Huerta S, Irwin RW, Heber D, et al. 1alpha, 25-(OH)(2)-D(3) and its synthetic analogue decrease tumor load in the Apc(min) Mouse. Cancer Res, 2002, 62(3): 741-746.
15.	Díaz GD, Paraskeva C, Thomas MG, et al. Apoptosis is induced by the active metabolite of vitamin D3 and its analogue EB1089 in colorectal adenoma and carcinoma cells: possible implications for prevention and therapy. Cancer Res, 2000, 60(8): 2304-2312.
16.	Feldman D, Krishnan AV, Swami S, et al. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer, 2014, 14(5): 342-357.
17.	Mathieu C, Adorini L. The coming of age of 1, 25-dihydroxyvitamin D₃ analogs as immunomodulatory agents. Trends Mol Med, 2002, 8(4): 174-179.
18.	Scaglione-Sewell BA, Bissonnette M, Skarosi S, et al. A vitamin D3 analog induces a G1-phase arrest in CaCo-2 cells by inhibiting cdk2 and cdk6: roles of cyclin E, p21Waf1, and p27Kip1. Endocrinology, 2000, 141(11): 3931-3939.
19.	Iseki K, Tatsuta M, Uehara H, et al. Inhibition of angiogenesis as a mechanism for inhibition by 1alpha-hydroxyvitamin D3 and 1, 25-hydroxyvitamin D3 of colon carcinogenesis induced by azoxymethane in Wistar rats. Int J Cancer, 1999, 821(5): 730-733.
20.	Lamprecht SA, Lipkin M. Cellular mechanisms of calcium and vitamin D in the inhibition of colorectal carcinogenesis. Ann N Y Acad Sci, 2001, 952: 73-87.
21.	Aggarwal A, Hoebaus J, Tennakoon, et al. Active vitamin D potentiates the anti-neoplastic effects of calcium in the colon: a cross-talk through the calcium-sensing receptor. J Steroid Biochem Mol Biol, 2016, 155(Pt B): 231-238.
22.	Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: A meta-analysis of 31 studies with 70 000 events. Cancer Epidemiol Biomarkers Prev, 2007, 16(12): 2533-2547.
23.	Sinicrope FA, Foster NR, Sargent DJ, et al. Obesity is an independent prognostic variable in colon cancer survivors. Clin Cancer Res, 2010, 16(6): 1884-1893.
24.	Jain SS, Bird RP. Elevated expression of tumor necrosis factor-α signaling molecules in colonic tumors of Zucker obese (fa/fa) rats. Int J Cancer, 2010, 127(9): 2042-2050.
25.	Teraoka N, Mutoh M, Takasu S, et al. High susceptibility to azoxymethane-induced colorectal carcinogenesis in obese KK-Ay mice. Int J Cancer, 2011, 129(3): 528-535.
26.	Campbell PT, Newton CC, Dehal AN, et al. Impact of body mass index on survival after colorectal cancer diagnosis: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol, 2012, 30(1): 42-52.
27.	Meyerhardt JA, Tepper JE, Niedzwiecki D, et al. Impact of body mass index on outcomes and treatment-related toxicity in patients with stage II and III rectal cancer: findings from Intergroup Trial 0114. J Clin Oncol, 2004, 22(4): 648-657.
28.	Endo H, Hosono K, Uchiyama T, et al. Leptin acts as a growth factor for colorectal tumours at stages subsequent to tumour initiation in murine colon carcinogenesis. Gut, 2011, 60(10): 1363-1371.
29.	Wei EK, Giovannucci E, Fuchs CS, et al. Low plasma adiponectin levels and risk of colorectal cancer in men: a prospective study. J Natl Cancer Inst, 2005, 97(22): 1688-1694.
30.	Otake S, Takeda H, Fujishima S, et al. Decreased levels of plasma adiponectin associated with increased risk of colorectal cancer. World J Gastroenterol, 2010, 16(10): 1252-1257.
31.	Gallagher EJ, LeRoith D. Diabetes, antihyperglycemic medications and cancer risk: smoke or fire? Curr Opin Endocrinol Diabetes Obes, 2013, 20(5): 485-494.
32.	Berster JM, Göke B. Type 2 diabetes mellitus as risk factor for colorectal cancer. Arch Physiol Biochem, 2008, 114(1): 84-98.
33.	Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients. Gastroenterology, 2004, 127(4): 1044-1050.
34.	Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr, 2001, 131(11 Suppl): 3109S-3120S.
35.	Mar AC, Chu CH, Lee HJ, et al. Interleukin-1 receptor type 2 acts with c-Fos to enhance the expression of interleukin-6 and vascular endothelial growth factor a in colon cancer cells and induce angiogenesis. J Biol Chem, 2015, 290(36): 22212-22224.
36.	Flores MBS, Rocha GZ, Damas-Souza DM, et al. Obesity-induced increase in tumor necrosis factor-α leads to development of colon cancer in mice. Gastroenterology, 2012, 143(3): 741-753. e1-e4.

1. Feskanich D, Ma J, Fuchs CS, et al. Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev, 2004, 13(9): 1502-1508.
2. Lee JE, Li H, Chan AT, et al. Circulating levels of vitamin D and colon and rectal cancer: the Physicians' Health Study and a meta-analysis of prospective studies. Cancer Prev Res (Phila), 2011, 4(5): 735-743.
3. Ma Y, Zhang P, Wang F, et al. Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol, 2011, 29(28): 3775-3782.
4. Yehuda-Shnaidman E, Schwartz B. Mechanisms linking obesity, inflammation and altered metabolism to colon carcinogenesis. Obes Rev, 2012, 13(12): 1083-1095.
5. Aspray TJ, Bowring C, Fraser W, et al. National Osteoporosis Society vitamin D guideline summary. Age Ageing, 2014, 43(5): 592-595.
6. 中华人民共和国卫生部疾病控制司. 中国成人超重和肥胖症预防控制指南. 北京: 人民卫生出版社, 2006: 12.
7. Bosen CJ. Vitamin D insufficiency. N Engl J Med, 2011, 364(1): 248-254.
8. Braun MM, Helzlsouer KJ, Hollis BW, et al. Colon cancer and serum vitamin D metabolite levels 10-17 years prior to diagnosis. Am J Epidemiol, 1995, 142(6): 608-611.
9. Grant WB. Ecological studies of the UVB-vitamin D-cancer hypothesis. Anticancer Res, 2012, 32(1): 223-236.
10. Maalmi H, Ordóñez-Mena JM, Schöttker B, et al. Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: systematic review and meta-analysis of prospective cohort studies. Eur J Cancer, 2014, 50(8): 1510-1521.
11. Irving AA, Duchow EG, Plum LA, et al. Vitamin D deficiency in the Apc^Pirc/+ rat does not exacerbate colonic tumorigenesis, while low dietary calcium might be protective. Dis Model Mech, 2018, 11(3): pii: dmm032300.
12. Shabahang M, Buras RR, Davoodi, et al. Growth inhibition of HT-29 human colon cancer cells by analogues 1, 25-dihydroxyvitamin D3. Cancer Res, 1994, 54(15): 4057-4064.
13. Eisman JA, Barkla DH, Tutton PJ. Suppression of in vivo growth of human cancer solid tumor xenografts by 1, 25-dihydroxyvitamin D3. Cancer Res, 1987, 47(1): 21-25.
14. Huerta S, Irwin RW, Heber D, et al. 1alpha, 25-(OH)(2)-D(3) and its synthetic analogue decrease tumor load in the Apc(min) Mouse. Cancer Res, 2002, 62(3): 741-746.
15. Díaz GD, Paraskeva C, Thomas MG, et al. Apoptosis is induced by the active metabolite of vitamin D3 and its analogue EB1089 in colorectal adenoma and carcinoma cells: possible implications for prevention and therapy. Cancer Res, 2000, 60(8): 2304-2312.
16. Feldman D, Krishnan AV, Swami S, et al. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer, 2014, 14(5): 342-357.
17. Mathieu C, Adorini L. The coming of age of 1, 25-dihydroxyvitamin D₃ analogs as immunomodulatory agents. Trends Mol Med, 2002, 8(4): 174-179.
18. Scaglione-Sewell BA, Bissonnette M, Skarosi S, et al. A vitamin D3 analog induces a G1-phase arrest in CaCo-2 cells by inhibiting cdk2 and cdk6: roles of cyclin E, p21Waf1, and p27Kip1. Endocrinology, 2000, 141(11): 3931-3939.
19. Iseki K, Tatsuta M, Uehara H, et al. Inhibition of angiogenesis as a mechanism for inhibition by 1alpha-hydroxyvitamin D3 and 1, 25-hydroxyvitamin D3 of colon carcinogenesis induced by azoxymethane in Wistar rats. Int J Cancer, 1999, 821(5): 730-733.
20. Lamprecht SA, Lipkin M. Cellular mechanisms of calcium and vitamin D in the inhibition of colorectal carcinogenesis. Ann N Y Acad Sci, 2001, 952: 73-87.
21. Aggarwal A, Hoebaus J, Tennakoon, et al. Active vitamin D potentiates the anti-neoplastic effects of calcium in the colon: a cross-talk through the calcium-sensing receptor. J Steroid Biochem Mol Biol, 2016, 155(Pt B): 231-238.
22. Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: A meta-analysis of 31 studies with 70 000 events. Cancer Epidemiol Biomarkers Prev, 2007, 16(12): 2533-2547.
23. Sinicrope FA, Foster NR, Sargent DJ, et al. Obesity is an independent prognostic variable in colon cancer survivors. Clin Cancer Res, 2010, 16(6): 1884-1893.
24. Jain SS, Bird RP. Elevated expression of tumor necrosis factor-α signaling molecules in colonic tumors of Zucker obese (fa/fa) rats. Int J Cancer, 2010, 127(9): 2042-2050.
25. Teraoka N, Mutoh M, Takasu S, et al. High susceptibility to azoxymethane-induced colorectal carcinogenesis in obese KK-Ay mice. Int J Cancer, 2011, 129(3): 528-535.
26. Campbell PT, Newton CC, Dehal AN, et al. Impact of body mass index on survival after colorectal cancer diagnosis: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol, 2012, 30(1): 42-52.
27. Meyerhardt JA, Tepper JE, Niedzwiecki D, et al. Impact of body mass index on outcomes and treatment-related toxicity in patients with stage II and III rectal cancer: findings from Intergroup Trial 0114. J Clin Oncol, 2004, 22(4): 648-657.
28. Endo H, Hosono K, Uchiyama T, et al. Leptin acts as a growth factor for colorectal tumours at stages subsequent to tumour initiation in murine colon carcinogenesis. Gut, 2011, 60(10): 1363-1371.
29. Wei EK, Giovannucci E, Fuchs CS, et al. Low plasma adiponectin levels and risk of colorectal cancer in men: a prospective study. J Natl Cancer Inst, 2005, 97(22): 1688-1694.
30. Otake S, Takeda H, Fujishima S, et al. Decreased levels of plasma adiponectin associated with increased risk of colorectal cancer. World J Gastroenterol, 2010, 16(10): 1252-1257.
31. Gallagher EJ, LeRoith D. Diabetes, antihyperglycemic medications and cancer risk: smoke or fire? Curr Opin Endocrinol Diabetes Obes, 2013, 20(5): 485-494.
32. Berster JM, Göke B. Type 2 diabetes mellitus as risk factor for colorectal cancer. Arch Physiol Biochem, 2008, 114(1): 84-98.
33. Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients. Gastroenterology, 2004, 127(4): 1044-1050.
34. Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr, 2001, 131(11 Suppl): 3109S-3120S.
35. Mar AC, Chu CH, Lee HJ, et al. Interleukin-1 receptor type 2 acts with c-Fos to enhance the expression of interleukin-6 and vascular endothelial growth factor a in colon cancer cells and induce angiogenesis. J Biol Chem, 2015, 290(36): 22212-22224.
36. Flores MBS, Rocha GZ, Damas-Souza DM, et al. Obesity-induced increase in tumor necrosis factor-α leads to development of colon cancer in mice. Gastroenterology, 2012, 143(3): 741-753. e1-e4.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer

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