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Association of serum 25-hydroxyvitamin D with the incidence of 16 cancers, cancer mortality, and all-cause mortality among individuals with metabolic syndrome: a prospective cohort study

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

The relationship between vitamin D levels and cancer incidence and mortality in individuals with metabolic syndrome (MetS) remains poorly explored. Herein, we aimed to determine the association between 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of 16 cancer incidence types and cancer/all-cause mortality in patients with MetS.

Methods

We enrolled 97,621 participants with MetS at recruitment from the UK Biobank cohort. The exposure factor was baseline serum 25(OH)D concentrations. The associations were examined using Cox proportional hazards models, which were displayed as hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

Over a median follow-up period of 10.92 years for cancer incidence outcomes, 12,137 new cancer cases were recorded. We observed that 25(OH)D concentrations were inversely related to the risk of colon, lung, and kidney cancer, and HRs (95% CI) for 25(OH)D ≥ 75.0 vs. < 25.0 nmol/L were 0.67 (0.45–0.98), 0.64 (0.45–0.91), and 0.54 (0.31–0.95), respectively. The fully adjusted model revealed a null correlation between 25(OH)D and the incidence of stomach, rectum, liver, pancreas, breast, ovary, bladder, brain, multiple myeloma, leukemia, non-Hodgkin lymphoma, esophagus, and corpus uteri cancer. Over a median follow-up period of 12.72 years for mortality outcomes, 8286 fatalities (including 3210 cancer mortalities) were documented. An “L-shaped” nonlinear dose–response correlation was detected between 25(OH)D and cancer/all-cause mortality; the respective HRs (95% CI) were 0.75 (0.64–0.89) and 0.65 (0.58–0.72).

Conclusion

These findings emphasize the importance of 25(OH)D in cancer prevention and longevity promotion among patients with MetS.

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Data availability

The UK Biobank datasets are openly available by submitting a data request proposal from https://www.ukbiobank.ac.uk/ (We accessed on 9 April 2022). We are authorized to access the database through the Access Management System (AMS) (Application number: 78563).

Abbreviations

MetS:

Metabolic syndrome

25(OH)D :

25-Hydroxyvitamin D

HR:

Hazard ratio

CI:

Confidence interval

VD:

Vitamin D

CVD:

Cardiovascular disease

BP:

Blood pressure

FG:

Fasting glucose

TG:

Triglycerides

HDL-C:

High-density lipoprotein cholesterol

ICD:

International classification of diseases

TDI:

Townsend deprivation index

BMI:

Body mass index

DM:

Diabetes mellitus

IQR:

Interquartile range

RCS:

Restricted cubic spline

PAR%:

Population-attributable risk percentage

NHL:

Non-Hodgkin lymphoma

MM:

Multiple myeloma

RCT:

Randomized controlled trial

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Acknowledgements

We thank the participants and staff of the UK Biobank for their dedication and contribution to the research. We appreciate the UK Biobank for giving us the opportunity to access the database through the Access Management System.

Funding

This research was funded by the High Level Talent Research Launch Project of Hangzhou Vocational & Technical College (RCXY202242) (to E Wu). The funding sources had no role in study design; in the collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Author information

Author notes

  1. E. Wu, Jun-Ping Guo, Kai Wang and Jun-Tao Ni are equal contributors.

Authors and Affiliations

  1. Rehabilitation and Nursing School, Hangzhou Vocational & Technical College, Hangzhou, 310018, Zhejiang, China

    E Wu & Jun-Ping Guo

  2. School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China

    E Wu, Hong-Quan Xu, Tian Xie & Lin Tao

  3. Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China

    E Wu, Hong-Quan Xu, Tian Xie & Lin Tao

  4. Department of acupuncture and massage, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China

    Kai Wang

  5. Women’s Hospital School of Medicine Zhejiang University, Hangzhou, 310006, Zhejiang, China

    Jun-Tao Ni

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  1. E Wu
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Contributions

EW: performed the statistical analysis and wrote the manuscript, J-PG and KW: provided consultation in their areas of expertise, H-QX: were responsible for technical support, TX and LT: designed the study, J-TN: revised the manuscript. All authors read and approved the final manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Tian Xie, Lin Tao or Jun-Tao Ni.

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Conflict of interest

The authors declare no conflict of interest.

Ethics approval

The UK Biobank was approved by the Research Ethics Committees of the North West Multi-Centre (reference no. 21/NW/0157). All the study participants signed an informed consent form.

Supplementary Information

Below is the link to the electronic supplementary material.

394_2023_3169_MOESM1_ESM.pdf

Table S1. Coding of outcomes. Table S2. HRs (95% CIs) for 16 site-specific cancer incidence according to serum 25(OH)D categories. Table S3. HRs (95% CIs) of all-cause mortality according to serum 25(OH)D categories stratified by baseline characteristics. Table S4. HRs (95% CIs) for cancer mortality and all-cause mortality according to serum 25(OH)D concentrations quartiles. Table S5. HRs (95% CIs) for 16 site-specific cancer incidence according to serum 25(OH)D concentrations quartiles. Fig. S1 Cohort exclusions of the study participants. 1. Assessment of covariates. 2. Assessment of missing values (PDF 515 KB)

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Wu, E., Guo, JP., Wang, K. et al. Association of serum 25-hydroxyvitamin D with the incidence of 16 cancers, cancer mortality, and all-cause mortality among individuals with metabolic syndrome: a prospective cohort study. Eur J Nutr 62, 2581–2592 (2023). https://doi.org/10.1007/s00394-023-03169-x

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