Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival

Chen Yuan; Zhi Rong Qian; Ana Babic; Vicente Morales-Oyarvide; Douglas A Rubinson; Peter Kraft; Kimmie Ng; Ying Bao; Edward L Giovannucci; Shuji Ogino; Meir J Stampfer; John Michael Gaziano; Howard D Sesso; Julie E Buring; Barbara B Cochrane; Rowan T Chlebowski; Linda G Snetselaar; JoAnn E Manson; Charles S Fuchs; Brian M Wolpin

doi:10.1200/JCO.2015.66.3005

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Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival

Journal article

Open access

Peer reviewed

Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival

Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A Rubinson, Peter Kraft, Kimmie Ng, Ying Bao, Edward L Giovannucci, Shuji Ogino, …

Journal of clinical oncology, Vol.34(24), pp.2899-2905

08/20/2016

DOI: 10.1200/JCO.2015.66.3005

PMCID: PMC5012662

PMID: 27325858

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Abstract

Although vitamin D inhibits pancreatic cancer proliferation in laboratory models, the association of plasma 25-hydroxyvitamin D [25(OH)D] with patient survival is largely unexplored. We analyzed survival among 493 patients from five prospective US cohorts who were diagnosed with pancreatic cancer from 1984 to 2008. We estimated hazard ratios (HRs) for death by plasma level of 25(OH)D (insufficient, < 20 ng/mL; relative insufficiency, 20 to < 30 ng/mL; sufficient ≥ 30 ng/mL) by using Cox proportional hazards regression models adjusted for age, cohort, race and ethnicity, smoking, diagnosis year, stage, and blood collection month. We also evaluated 30 tagging single-nucleotide polymorphisms in the vitamin D receptor gene, requiring P < .002 (0.05 divided by 30 genotyped variants) for statistical significance. Mean prediagnostic plasma level of 25(OH)D was 24.6 ng/mL, and 165 patients (33%) were vitamin D insufficient. Compared with patients with insufficient levels, multivariable-adjusted HRs for death were 0.79 (95% CI, 0.48 to 1.29) for patients with relative insufficiency and 0.66 (95% CI, 0.49 to 0.90) for patients with sufficient levels (P trend = .01). These results were unchanged after further adjustment for body mass index and history of diabetes (P trend = .02). The association was strongest among patients with blood collected within 5 years of diagnosis, with an HR of 0.58 (95% CI, 0.35 to 0.98) comparing patients with sufficient to patients with insufficient 25(OH)D levels. No single-nucleotide polymorphism at the vitamin D receptor gene met our corrected significance threshold of P < .002; rs7299460 was most strongly associated with survival (HR per minor allele, 0.80; 95% CI, 0.68 to 0.95; P = .01). We observed longer overall survival in patients with pancreatic cancer who had sufficient prediagnostic plasma levels of 25(OH)D.

Aged

Biomarkers, Tumor - blood

Carcinoma, Pancreatic Ductal - blood

Carcinoma, Pancreatic Ductal - mortality

Cohort Studies

Female

Humans

Male

Pancreatic Neoplasms - blood

Pancreatic Neoplasms - mortality

Prognosis

Proportional Hazards Models

Prospective Studies

United States - epidemiology

Vitamin D - analogs & derivatives

Vitamin D - blood

Details

Title: Subtitle: Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival
Creators: Chen Yuan
Zhi Rong Qian
Ana Babic
Vicente Morales-Oyarvide
Douglas A Rubinson
Peter Kraft
Kimmie Ng
Ying Bao
Edward L Giovannucci
Shuji Ogino
Meir J Stampfer
John Michael Gaziano
Howard D Sesso
Julie E Buring
Barbara B Cochrane
Rowan T Chlebowski - Chen Yuan, Zhi Rong Qian, Ana Babic, Vicente Morales-Oyarvide, Douglas A. Rubinson, Kimmie Ng, Shuji Ogino, Charles S. Fuchs, and Brian M. Wolpin, Dana-Farber Cancer Institute and Harvard Medical School; Peter Kraft, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, Howard D. Sesso, Julie E. Buring, and JoAnn E. Manson, Harvard School of Public Health; Ying Bao, Edward L. Giovannucci, Shuji Ogino, Meir J. Stampfer, John Michael Gaziano, Howard D. Sesso, JoAnn E. Manson, and Charles S. Fuchs, Brigham and Women's Hospital and Harvard Medical School; John Michael Gaziano, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; Barbara B. Cochrane, University of Washington School of Nursing, Seattle, WA; Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Linda G. Snetselaar, University of Iowa College of Public Health, Iowa City, IA
Linda G Snetselaar - University of Iowa, College of Public Health
JoAnn E Manson
Charles S Fuchs
Brian M Wolpin
Resource Type: Journal article
Publication Details: Journal of clinical oncology, Vol.34(24), pp.2899-2905
DOI: 10.1200/JCO.2015.66.3005
PMID: 27325858
PMCID: PMC5012662
NLM abbreviation: J Clin Oncol
ISSN: 0732-183X
eISSN: 1527-7755
Grant note: UM1 CA167552 / NCI NIH HHS R01 CA040360 / NCI NIH HHS R01 HL102122 / NHLBI NIH HHS P50 CA127003 / NCI NIH HHS P01 CA087969 / NCI NIH HHS R01 CA124908 / NCI NIH HHS UM1 CA186107 / NCI NIH HHS R01 CA034944 / NCI NIH HHS R35 CA197735 / NCI NIH HHS K07 CA148894 / NCI NIH HHS UM1 CA182913 / NCI NIH HHS R01 CA049449 / NCI NIH HHS N01WH22110 / WHI NIH HHS R01 HL026490 / NHLBI NIH HHS R01 HL034595 / NHLBI NIH HHS R01 CA138962 / NCI NIH HHS
Language: English
Date published: 08/20/2016
Academic Unit: Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9983995130202771

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