Published online Sep 15, 2016. doi: 10.4251/wjgo.v8.i9.688
Peer-review started: March 27, 2016
First decision: May 13, 2016
Revised: June 9, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: September 15, 2016
Processing time: 169 Days and 13.7 Hours
To determine whether there is an increased risk of gastric adenocarcinoma associated with vitamin D deficiency (VDd).
A retrospective case control study was performed of all patients diagnosed with gastric adenocarcinoma between 2005 and 2015. After we excluded the patients without a documented vitamin D level, 49 patients were included in our study.
The average age of patients with gastric adenocarcinoma and documented vitamin D level was 64 years old (95%CI: 27-86) and average vitamin D level was 20.8 mg/dL (95%CI: 4-44). Compared to a matched control group, the prevalence of VDd/insufficiency in patients with gastric adenocarcinoma was significantly higher than normal vitamin D levels (83.7% vs 16.3%). Forty-one patients (83.7%) with adenocarcinoma showed VDd/insufficiency compared to 18 (37%) patients with normal vitamin D level without gastric cancer (OR: 8.8, 95%CI: 5-22, P value < 0.0001). The average age of males with gastric adenocarcinoma diagnosis was 60 years old vs 68 years old for females (P = 0.01). Stage II gastric adenocarcinoma was the most prevalent in our study (37%).
We reported a positive relationship between VDd and gastric adenocarcinoma, that is to say, patients with decreased VDd levels have an increased propensity for gastric adenocarcinoma.
Core tip: In recent years, vitamin D deficiency (VDd) has been associated with several gastrointestinal malignancies largely mediated by vitamin D receptors. It affects multiple cellular processes such as inhibiting differentiation, metastasis, proliferation and inducing apoptosis and cell cycle arrest. All these mechanisms support vitamin D’s anti-cancer role. VDd removes the tumorigenic activity that it elicits from regulating cell cycle, inhibiting cellular proliferation, angiogenesis and molecular signaling. Several studies have revealed that vitamin D3 substantially promotes apoptosis in undifferentiated gastric malignant cells, specifically HCG-27. A retrospective research was conducted to find an association between vitamin D serum levels and gastric cancer.