Plasma 25-Hydroxyvitamin D
Concentration, VDR polymorphisms
and their Interaction are Associated
with Survival in Colorect...
Vitamin D and Colorectal Cancer 2
Garland CF, Garland FC. Do sunlight
and vitamin D reduce the likelihood of
colon cancer?...
The SOCCS study (1999-2006)
Study of Colorectal Cancer in Scotland
3
Case-Control
Study
1,598
CRC patients
AJCC stages 1-3...
Colorectal Cancer-Specific and Overall Survival
according to Tertile of Circulating Vitamin D
(A) Colorectal cancer-specif...
Unadjusted and Multivariate Adjusted Hazard Ratios of Death
According to May-Adjusted 25-HydroxyVitamin D Tertile.
Vitamin...
Meta-Analyses 6
Overall (I-squared = 0.0%, p = 0.544)
Fedirko V (2012)
Study
Tretli S (2012)
Ng K (2008)
ID
Zgaga L (2013)...
Vitamin D Polymorphisms and
Colorectal Cancer Mortality
SNP model SNP
vit D
raw interaction SNP
vit D
May-adj interaction
...
 Thank you for your attention.
Contact: zgagal@tcd.ie
8
Most recent Meta-Analyses
(incidence)
1. Breast cancer
2. Kidney cancer
3. Non-Hodgkin Lymphoma
4. Non-Hodgkin Lymphoma
5....
UVB Irradiation 10
UVB
Ozone layer
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Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interaction are Associated with Survival in Colorectal Cancer Patients - Lina Zgaga

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A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.

Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interaction are Associated with Survival in Colorectal Cancer Patients - Lina Zgaga

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Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interaction are Associated with Survival in Colorectal Cancer Patients - Lina Zgaga

  1. 1. Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interaction are Associated with Survival in Colorectal Cancer Patients LINA ZGAGA Associate Professor of Epidemiology Trinity College Dublin
  2. 2. Vitamin D and Colorectal Cancer 2 Garland CF, Garland FC. Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol. 1980 Sep;9(3):227-31. 1. Incidence 2. Survival
  3. 3. The SOCCS study (1999-2006) Study of Colorectal Cancer in Scotland 3 Case-Control Study 1,598 CRC patients AJCC stages 1-3 Median Follow-Up: 9 years diagnosis treatment recruitment & sampling DNA Vitamin D Receptor Polymorphisms Circulating 25-HydroxyVitamin D (25-OHD) liquid chromatography-tandem mass spectrometry, LC-MS/MS DEFICIENT SUFFICIENTAT RISK OF DEFICIENCY HIGH LOW Deeb, K. K., D. L. Trump and C. S. Johnson (2007). "Vitamin D signalling pathways in cancer: potential for anticancer therapeutics." Nat Rev Cancer 7(9): 684-700.
  4. 4. Colorectal Cancer-Specific and Overall Survival according to Tertile of Circulating Vitamin D (A) Colorectal cancer-specific and (B) overall survival (after sampling) according to tertile of post-operative 25-hydroxyvitamin D levels in patients with colorectal cancer: (A) CRC AJCC stage 1, (B) CRC AJCC stage 2, (C) CRC AJCC stage 3, and (D) CRC AJCC stages 1-3. T1 median: 4.80 ng/mL; T2 median: 10.11 ng/mL; T3 median 18.26 ng/mL A. B. 4 P=0.22 P=0.002 P=0.24 P=0.001 P=0.00001 P=0.00001 P=0.16 P=0.072
  5. 5. Unadjusted and Multivariate Adjusted Hazard Ratios of Death According to May-Adjusted 25-HydroxyVitamin D Tertile. Vitamin D tertiles (May-adjusted 25-OHD) Model 1 tertile 1 < 7.25 ng/mL tertile 2 7.25-13.25 ng/mL tertile 3 > 13.25ng/mL P 4HR 95% CI P HR 95% CI P CRC Mortality Unadjusted ref 0.8 0.63-1.02 0.08 0.66 0.51-0.85 0.001 0.012 Partially adjusted 2 ref 0.83 0.65-1.06 0.14 0.69 0.53-0.89 0.004 0.074 Fully adjusted 3 ref 0.81 0.63-1.03 0.09 0.67 0.52-0.87 0.002 0.040 All-Cause Mortality Unadjusted ref 0.78 0.64-0.95 0.01 0.62 0.5-0.77 0.00001 0.00007 Partially adjusted 2 ref 0.78 0.64-0.96 0.02 0.67 0.54-0.83 0.0002 0.0036 Fully adjusted 3 ref 0.77 0.63-0.94 0.01 0.66 0.53-0.81 0.0001 0.0015 Footnote: 1 Follow-Up from time of sampling until death or censor date. 2 Multivariate model adjusted for age at diagnosis, sex and AJCC stage. 3 Multivariate model additionally adjusted for tumor site (colon/rectum), surgery (yes/no), time between definitive treatment and sampling and season of blood collection. 4 p-value was calculated using May-adjusted 25-OHD as a continuous variable Abbreviations: N, number of patients; 25-OHD, 25-hydroxyvitamin D; CRC, colorectal cancer; HR, hazard ratio; CI, confidence interval. 5
  6. 6. Meta-Analyses 6 Overall (I-squared = 0.0%, p = 0.544) Fedirko V (2012) Study Tretli S (2012) Ng K (2008) ID Zgaga L (2013) 0.66 (0.55, 0.80) 0.69 (0.50, 0.93) 0.20 (0.04, 1.10) 0.61 (0.31, 1.19) ES (95% CI) 0.67 (0.52, 0.87) 100.00 37.01 % 1.30 7.88 Weight 53.81 0.66 (0.55, 0.80) 0.69 (0.50, 0.93) 0.20 (0.04, 1.10) 0.61 (0.31, 1.19) ES (95% CI) 0.67 (0.52, 0.87) 100.00 37.01 % 1.30 7.88 Weight 53.81 11 Overall (I-squared = 19.6%, p = 0.290) Fedirko V (2012) Tretli S (2012) Ng K (2008) Zgaga L (2013) ID Mezawa H (2010) Study 0.63 (0.54, 0.75) 0.67 (0.50, 0.88) 0.40 (0.10, 1.60) 0.52 (0.29, 0.94) 0.66 (0.53, 0.81) ES (95% CI) 0.16 (0.04, 0.63) 100.00 32.35 1.34 7.48 57.47 Weight 1.36 % 0.63 (0.54, 0.75) 0.67 (0.50, 0.88) 0.40 (0.10, 1.60) 0.52 (0.29, 0.94) 0.66 (0.53, 0.81) ES (95% CI) 0.16 (0.04, 0.63) 100.00 32.35 1.34 7.48 57.47 Weight 1.36 % 11 A. Colorectal-Cancer Specific Mortality A. All-Cause Mortality Fixed-Effects Meta-Analyses of Adjusted Models.
  7. 7. Vitamin D Polymorphisms and Colorectal Cancer Mortality SNP model SNP vit D raw interaction SNP vit D May-adj interaction rs7975232 simple 0.80 0.04 0.81 0.06 with interaction 0.71 0.37 0.79 0.72 0.43 0.78 rs1544410 simple 0.87 0.03 0.86 0.04 with interaction 0.76 0.14 0.63 0.94 0.22 0.83 rs10735810 simple 0.57 0.03 0.55 0.04 with interaction 0.48 0.14 0.64 0.34 0.10 0.46 rs11568820 (AA+AG vs. GG) simple 0.96 0.04 0.96 0.05 with interaction 0.05 0.08 0.013 0.06 0.08 0.016 protective alleles (<=2 vs. 2+) simple 0.45 0.03 0.43 0.04 with interaction 0.02 0.004 0.016 0.01 0.001 0.005 7 Vitamin D VDR Cancer Progression ? VDR Biological Effects
  8. 8.  Thank you for your attention. Contact: zgagal@tcd.ie 8
  9. 9. Most recent Meta-Analyses (incidence) 1. Breast cancer 2. Kidney cancer 3. Non-Hodgkin Lymphoma 4. Non-Hodgkin Lymphoma 5. ovarian cancer 6. Pancreatic cancer 7. colorectal cancer 8. colon 9. rectum 10. sporadic colorectal adenoma 11. sporadic colorectal adenoma recurrence 1. Prostate cancer 2. aggressive prostate cancer 9
  10. 10. UVB Irradiation 10 UVB Ozone layer

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