- 期刊
- Ahead-of-Print
Serum vitamin D decreases during chemotherapy: an Australian prospective cohort study
摘要
Background and Objectives: Vitamin D plays an important role in bone and muscle function, and cell proliferation. The impact of chemotherapy and associated behavioural changes such as fatigue and sun avoidance on vitamin D (25(OH) D) is unknown. This study aims to evaluate variations in serum vitamin D during chemotherapy and the predictive value of latitude, season and pre-existing vitamin D deficiency. Methods and Study Design: A 12- week prospective cohort study was conducted in chemotherapy-naïve patients in two Australian locations with different sun exposure. Vitamin D deficiency was defined as ≤25 nmol/L and insufficiency 26-50 nmol/L 25(OH) D. Demographics, chemotherapy regimen, nutritional status, sun exposure, geographic location, and season were collected at baseline, 6 and 12 weeks after commencing chemotherapy. Results: Eighty-five patients (μ55.3±13.4 years of age; 49% female) were recruited, 96% Caucasian. Fifty-four patients were treated with curative intent (mostly for breast [n=29] or colorectal [n=12] cancers). At baseline, 10 patients were vitamin D deficient and 33 were insufficient. Mean serum 25(OH) D (nmol/L) was higher at latitude -27.5° (Brisbane) than latitude -34.9° (Adelaide) (μ61.9±22.1 vs. μ42.2±19.2, p＜0.001) and varied according to season (spring: μ46.9±20.3, summer: μ50.8±18.2, autumn: μ76.4±25.2, winter: μ36.5±15.7, p＜0.001). Serum 25(OH) D decreased with chemotherapy (baseline: μ49.2±22.3, 6-weeks: μ40.9±19.0, 12-weeks: μ45.9±19.7, p=0.05), with a significant and more rapid decline in winter and autumn (p=0.03). Conclusions: Chemotherapy is associated with a decrease in serum vitamin D, particularly during winter and autumn. Investigations into the underlying mechanism and associated potential outcomes with this decrease requires further investigation.
延伸閱讀
- Bilinski, K., & Talbot, P. (2014). Vitamin D Supplementation in Australia: Implications for the Development of Supplementation Guidelines. Journal of Nutrition and Metabolism, (2014), 66-69. https://doi.org/10.1155/2014/374208
- Ullah, M. I., Uwaifo, G. I., Nicholas, W. C., & Koch, C. A. (2010). Does Vitamin D Deficiency Cause Hypertension? Current Evidence from Clinical Studies and Potential Mechanisms. International Journal of Endocrinology, 2010(), 221-231. https://doi.org/10.1155/2010/579640
- 董玲吟、邱百誼、林君宜、李銘宗（2018）。EFFICACY OF VITAMIN D FOR MODERATE OR SEVERE DEPRESS ION: SYSTEMATIC REVIEW AND META-ANALYSIS。秀傳醫學雜誌，17(1)，59-64。https://doi.org/10.3966/156104972018061701008
- Chippirraz, E. L., Fernández, R. G., García, J. V., Mena, A. G., Grinberg, A. G., Montero, M. M., Sorli, L., Calzado, S., Horcajada, J. P., Pérez, A. D., & Freud, H. K. (2016). Validation Protocol of Vitamin D Supplementation in Patients with HIV-Infection. AIDS Research and Treatment, 2016(), 156-163. https://doi.org/10.1155/2016/5120831
- Arslan, A. A., Clendenen, T. V., Koenig, K. L., Hultdin, J., Enquist, K., Ågren, Å., Lukanova, A., Sjodin, H., Jacquotte, A. Z., Shore, R. E., Hallmans, G., Toniolo, P., & Lundin, E. (2009). Circulating Vitamin D and Risk of Epithelial Ovarian Cancer. Journal of Oncology, 2009(), 337-344. https://doi.org/10.1155/2009/672492