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Serum 25-hydroxyvitamin D concentrations and colorectal cancer incidence in adults with type 2 diabetes

British Journal of Cancer volume 129, pages 486–491 (2023)Cite this article

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Abstract

Background

To examine the association of serum 25-hydroxyvitamin D (25[OH]D) with colorectal cancer (CRC) risk in adults with type 2 diabetes (T2D).

Methods

Using UK Biobank data, this study included 18,453 adults with T2D. Serum 25(OH)D concentrations were determined by the chemiluminescent immunoassay method. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC outcomes.

Results

During a median follow-up of 8.8 years, there were 284 incident CRC cases. Compared with adults with serum 25(OH)D concentrations <25.0 nmol/L, the adjusted HRs (95% CIs) for lower to higher serum 25(OH)D concentrations (25.0 to <50.0, 50.0 to <75.0, and ≥75.0 nmol/L) were 0.61 (0.46–0.82), 0.50 (0.34–0.74), and 0.53 (0.30–0.94), respectively (Ptrend = 0.001). The risk of CRC decreased by 19.0% for per 1-SD increment in serum 25(OH)D concentrations. A nonlinear association of serum 25(OH)D concentrations with CRC risk was observed using a restricted cubic spline analysis (P nonlinearity = 0.002).

Conclusions

Higher serum 25(OH)D concentrations were significantly and nonlinearly associated with a lower risk of CRC. These findings highlight the potential benefits of maintaining adequate vitamin D levels in CRC prevention among adults with T2D.

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Data availability

Data are available in a public, open access repository. The UK Biobank data are available from the UK Biobank on request (www.ukbiobank.ac.uk/).

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Acknowledgements

We thank the UK Biobank participants. This research has been conducted using the UK Biobank resource under application number 43795.

Funding

This work was supported by the National Natural Science Foundation of China (82060619), the China Postdoctoral Science Foundation funded project (2021M691456), the Science and Technology Programme of Guizhou Province (ZK[2021]495), the Doctoral Research Fund Project of Zunyi Medical University (F-947), Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2019), and the Construction of High-level University of Guangdong (G621331128). The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China

    Jiao-Jiao Ren & Ping-Ming Gao

  2. Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China

    Jiao-Jiao Ren, Zhi-Hao Li, Wen-Fang Zhong, Pei-Liang Chen, Qing-Mei Huang, Xiao-Meng Wang & Chen Mao

  3. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China

    Ping-Ming Gao

  4. Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China

    Chen Mao

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Contributions

CM and J-JR contributed to the concept and design. J-JR, Z-HL, W-FZ, P-LC, Q-MH, X-MW, P-MG, and CM contributed to acquisition, analysis, or interpretation of data. J-JR and CM contributed to funding acquisition. J-JR, Z-HL, and W-FZ contributed to methodology. P-LC, Q-MH, and X-MW contributed to administrative, technical, or material support. J-JR and W-FZ wrote original draft. CM and P-MG contributed to supervision. All authors contributed to the analysis and interpretation of data and revise the article, and have approved the final version of the article. CM is the study guarantor and takes responsibility for the integrity of the data and the accuracy of the data analyses.

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Correspondence to Ping-Ming Gao or Chen Mao.

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The study was approved by the research ethics committee (UK Biobank 11/NW/0382) and all participants provided informed consent at baseline. Any additional ethical approval was adjudged unnecessary for the present study.

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Ren, JJ., Li, ZH., Zhong, WF. et al. Serum 25-hydroxyvitamin D concentrations and colorectal cancer incidence in adults with type 2 diabetes. Br J Cancer 129, 486–491 (2023). https://doi.org/10.1038/s41416-023-02323-w

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