Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/116870
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Type: | Journal article |
Title: | Circulating Vitamin D and overall survival in breast cancer patients: a dose-response meta-analysis of cohort studies |
Author: | Hu, K. Callen, D. Li, J. Zheng, H. |
Citation: | Integrative Cancer Therapies, 2017; 17(2):1-9 |
Publisher: | SAGE Publications (UK and US) |
Issue Date: | 2017 |
ISSN: | 1534-7354 1552-695X |
Statement of Responsibility: | Kejia Hu, David Frederick Callen, Jiayuan Li and Hong Zheng |
Abstract: | Studies have shown that vitamin D could have a role in breast cancer survival; however, the evidence of the relationship between patients' vitamin D levels and their survival has been inconsistent. This meta-analysis explores possible dose-response relationships between vitamin D levels and overall survival by allowing for differences in vitamin D levels among populations of the various studies. Studies relating vitamin D (25-OH-D [25-hydroxyvitamin D]) levels in breast cancer patients with their survival were identified by searching PubMed and Embase. A pooled HR (hazard ratio) comparing the highest with the lowest category of circulating 25-OH-D levels were synthesized using the Mantel-Haenszel method under a fixed-effects model. A two-stage fixed-effects dose-response model including both linear (a log-linear dose-response regression) and nonlinear (a restricted cubic spline regression) models were used to further explore possible dose-response relationships. Six studies with a total number of 5984 patients were identified. A pooled HR comparing the highest with the lowest category of circulating 25-OH-D levels under a fixed-effects model was 0.67 (95% confidence interval = 0.56-0.79, P < .001). Utilizing a dose-response meta-analysis, the pooled HR for overall survival in breast cancer patients was 0.994 (per 1 nmol/L), Pfor linear trend < .001. At or above a 23.3 nmol/L threshold, for a 10 nmol/L, 20 nmol/L, or 25 nmol/L increment in circulating 25-OH-D levels, the risk of breast cancer overall mortality decreased by 6%, 12%, and 14%, respectively. There was no significant nonlinearity in the relationship between overall survival and circulating 25-OH-D levels. Our findings suggest that there is a highly significant linear dose-response relationship between circulating 25-OH-D levels and overall survival in patients with breast cancer. However, better designed prospective cohort studies and clinical trials are needed to further confirm these findings. |
Keywords: | breast cancer dose-response meta-analysis dose-response relationship meta-analysis overall survival vitamin D |
Rights: | © The Author(s) 2017. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
DOI: | 10.1177/1534735417712007 |
Published version: | http://dx.doi.org/10.1177/1534735417712007 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
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hdl_116870.pdf | Published Version | 346.23 kB | Adobe PDF | View/Open |
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