The Journal of Clinical Endocrinology and Metabolism Journal Article

Vitamin D and Risk of Cancer in the D2d Study

September 13, 2021
 

Ranee Chatterjee, Paul Fuss, Ellen M Vickery, Erin S LeBlanc, Patricia R Sheehan, Michael R Lewis, Rowena J Dolor, Karen C Johnson, Sangeeta R Kashyap, Jason Nelson, Anastassios G Pittas, D2d Research Group
The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 9, September 2021, Pages 2767–2778
https://doi.org/10.1210/clinem/dgab153

Abstract

Context

Observational studies suggest that low vitamin D status may be a risk factor for cancer.

Objective

In a population with prediabetes and overweight/obesity that is at higher risk of cancer than the general population, we sought to determine if vitamin D supplementation lowers the risk of cancer and precancers.

Methods

The Vitamin D and type 2 diabetes (D2d) cancer outcomes study (D2dCA) is an ancillary study to the D2d study, which was conducted at 22 academic medical centers in the United States. Participants had prediabetes and overweight/obesity and were free of cancer for the previous 5 years. Participants were randomized to receive vitamin D3 4000 IU daily or placebo. At scheduled study visits (4 times/year), cancer and precancer events were identified by questionnaires. Clinical data were collected and adjudicated for all reported events. Cox proportional hazard models compared the hazard ratio (HR) of incident cancers and precancers between groups.

Results

Over a median follow-up period of 2.9 years, among 2385 participants (mean age 60 years and 25-hydroxyvitamin D 28 ng/mL), there were 89 cases of cancer. The HR of incident cancer for vitamin D vs placebo was 1.07 (95% CI 0.70, 1.62). Of 241 participants with incident precancers, 239 had colorectal adenomatous polyps. The HR for colorectal polyps for vitamin D vs placebo was 0.83 (95% CI 0.64, 1.07).

Conclusion

In the D2d population of participants with prediabetes and overweight/obesity, not selected for vitamin D insufficiency, vitamin D supplementation did not have a significant effect on risk of incident cancer or colorectal polyps.

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