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Serum 25-Hydroxyvitamin D Levels and the Risk of Dysplasia and Esophageal Adenocarcinoma in Patients with Barrett’s Esophagus

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Abstract

Background

To date, there are no studies reporting an association between vitamin D and Barrett’s esophagus (BE), the precursor for esophageal adenocarcinoma (EAC).

Aims

Our aim was to study the association between serum 25-hydroxyvitamin D (25(OH)D) levels and prevalence and incidence of dysplasia/EAC in BE.

Methods

Patients from our BE Registry cohort seen between 2000 and 2012 who had serum 25(OH)D levels measured were included. Age, gender, race, BE length, hiatal hernia size, and histological findings were recorded. Patients without high-grade dysplasia (HGD)/EAC at or within 1 year of index biopsy and who had follow-up endoscopies and 25(OH)D levels were studied for incidence of dysplasia/EAC.

Results

Among 429 patients with BE, the mean 25(OH)D level was 72 ± 31.2 nmol/L. Hundred and one (23.6 %) patients had deficiency (<50 nmol/L), 149 (34.7 %) had insufficiency (50–74.9 nmol/L), and 179 (41.7 %) had normal levels of 25(OH)D. There was no association between serum 25(OH)D levels and dysplasia (p = 0.90). In the incidence cohort of 246 patients with median follow-up of 46 months, there were 34 cases of low-grade dysplasia, 12 of HGD, and 5 of EAC. Change in 25(OH)D levels did not impact progression to dysplasia/EAC (every 5 nmol/L increase from baseline, hazard ratio 0.98; p = 0.62).

Conclusions

Serum 25(OH)D levels were low in 58.3 % of our BE cohort. There was no association between 25(OH)D levels and prevalence or incidence of HGD/EAC in patients with BE. Further long-term studies are needed to study the association between vitamin D status and progression of dysplasia in BE.

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Author Contributions

Prashanthi N. Thota MD, FACG: Study design, data collection, data analysis and interpretation, and drafting the manuscript. Gaurav Kistangari MD, MPH: Data analysis and interpretation, and drafting the manuscript. Prabhdeep Singh, MD: Data collection and reviewing the manuscript. Linda Cummings, MD: Study design, data analysis and interpretation, and drafting the manuscript. Kaveh Hajifathalian, MD: Data Collection and reviewing the manuscript. Rocio Lopez MS: Study design, data analysis and interpretation, and reviewing the manuscript. Madhusudhan R. Sanaka MD, FACG: Study design, data analysis and interpretation, and reviewing the manuscript. The final draft submitted has been approved by all authors.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Prashanthi N. Thota, Prabhdeep Singh & Madhusudhan R. Sanaka

  2. Department of Internal Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Gaurav Kistangari & Kaveh Hajifathalian

  3. Department of Gastroenterology and Hepatology, University Hospitals, 11100 Euclid Avenue, Mailstop 5066, Cleveland, OH, 44106-5066, USA

    Linda Cummings

  4. Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Rocio Lopez

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  1. Prashanthi N. Thota
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Correspondence to Prashanthi N. Thota.

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Prashanthi N. Thota, MD, FACG.

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Thota, P.N., Kistangari, G., Singh, P. et al. Serum 25-Hydroxyvitamin D Levels and the Risk of Dysplasia and Esophageal Adenocarcinoma in Patients with Barrett’s Esophagus. Dig Dis Sci 61, 247–254 (2016). https://doi.org/10.1007/s10620-015-3823-5

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  • DOI: https://doi.org/10.1007/s10620-015-3823-5

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