VITAMIN-D STATUS AT BREAST CANCER DIAGNOSIS: CORRELATION WITH SOCIAL AND ENVIRONMENTAL FACTORS AND DIETRY INTAKE
Abstract
Background: Serum levels of vitamin-D are low in breast cancer patients. Vitamin-D levels have inverse correlations with postmenopausal state, obesity, poor sun exposure and low intake of vitamin-D rich diet. The objective of this study was to quantify levels of vitamin-D in serum to determine the degree of vitamin-D deficiency in breast cancer patients compared with age matched controls and to observe the association between serum 25-OH vitamin-D levels and personal and social parameters, BMI, amount of sun exposure and dietary intake. Methods: In this cross-sectional analytical study all newly diagnosed breast cancer female patients were recruited into the study over a period of 6 months. Age matched healthy females were also recruited as a control group. Personal and social data was documented on to a pro forma. Sun exposure was determined by mid-day exposure to direct sunlight. Serum 25-OHD levels were studied by ELISA technique on the blood samples. The dietary information was collected by recall over the last 1 year. Results: Vitamin-D deficiency was found in 99% breast cancer females and 90% in healthy females. Mean serum vitamin-D level was 9.6±5 ng/ml and 15.2±10 ng/ml for cases and control group respectively. All breast cancer and 95% healthy females with BMI >30 were found to be vitamin-D deficient. Menopausal state, parity, parda (veil) observation, area of living and sun exposure did not affect vitamin-D status in either group. Egg, fish and cheese intake revealed correlation with vitamin-D deficiency. Forty percent healthy females were found to have deficient serum vitamin-D levels despite being on supplement. Conclusion: Vitamin-D deficiency was highly prevalent among breast cancer females. Serum 25 OHD levels exhibited an inverse correlation with high body mass index and vitamin-D rich diet.
Keywords: Vitamin-D deficiency, breast cancer, 25-OHD, sun exposure, body mass indexReferences
Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res 2004;6:229-39.
Gilani GM, Kamal S, Akhter AS. A differential study of breast cancer patients in Punjab, Pakistan. J Pak Med Assoc 2003;53:478-81.
Khan KA, Akram J, Fazal M. Hormonal actions of vitamin-D and its role beyond just being a vitamin: A review article. Int J Med Sci 2011;3(3):65-72.
Garland CF, Gorham ED, Mohr SB, Garland FC. Vitamin-D for cancer prevention: global perspective. Ann Epidemiol 2009;19:468-83.
Sheikh A, Saeed Z, Jafri SAD, Yazdani I, Hussain SA. Vitamin-D levels in asymptomatic adults--a population survey in Karachi, Pakistan. PLoS One 2012;7:e33452.
Masood SH, Iqbal MP. Prevalence of vitamin-D deficiency in South Asia. Pak J Med Sci 2008;24:891-7.
Crew KD, Gammon MD, Steck SE, Hershman DL, Cremers S, Dworakowski E, et al. Association between plasma 25-hydroxyvitamin-D and breast cancer risk. Cancer Prev Res (Phila) 2009;2:598-604.
Bertone-Johnson ER, Chen WY, Holick MF, Hollis BW, Colditz GA, Willett WC,et al. Palsma 25-hydoxyvitamin-D and 1,25-hydroxyvitamin-D and risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2005;14:1991-7.
Hatse S, Lambrechts D, Verstuyf A, Smeets A, Brouwers B, Vandorpe T, et al. Vitamin-D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome, and genetic determinants of vitamin-D insufficiency. Carcinogenesis 2012;33:1319-26.
Vrieling A, Hein R, Abbas S, Schneeweiss A, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxy vitamin-D and postmenopausal breast cancer survival: a prospective patient cohort study. Breast Cancer Res 2011;13(4):R74.
Chen WY, Bertone-Johnson ER, Hunter DJ, Willett WC, Hankinson SE. Association between polymorphisms in the vitamin-D receptor and breast cancer risk. Cancer Epidemiol Biomarkers Prev 2005:14:2335-9.
Holick MF. Vitamin-D deficiency. N Engl J Med 2007;357:266-81.
Wolpowitz D, Gilchrest BA. The vitamin-D questions: how much do you need and how should you get it? J Am Acad Dermatol 2006;54:301-17.
Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM. Vitamin-D status in relation to obesity, bone mineral density, bone turnover markers and vitamin-D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int. 2011;22:463-75.
Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vázquez C, Escobar-Morreale HF. Vitamin-D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr 2007;26:573-80.
Robien K, Cutler GJ, Lazovich D. Vitamin-D intake and breast cancer risk in postmenopausal women: the Iowa Women's Health Study. Cancer Causes Control 2007; 18:775-82.
Khan QJ, Kimler BF, Fabian CJ. The Relationship between Vitamin-D and Breast Cancer Incidence and Natural History. Curr Oncol Rep 2010;12:136-42.
Carmichael AR, Bates T. Obesity and breast cancer: a review of the literature. Breast 2004;13(2):85-92.
Shin MH, Holmes MD, Hankinson SE, Wu K, Colditz GA, Willett WC. Intake of Dairy Products, Calcium, and Vitamin-D and Risk of Breast Cancer. J Natl Cancer Inst 2002; 94:1301-11.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.