Higher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn's Disease

被引:343
作者
Ananthakrishnan, Ashwin N. [2 ]
Khalili, Hamed [2 ]
Higuchi, Leslie M. [2 ,3 ]
Bao, Ying [2 ,4 ]
Korzenik, Joshua R. [2 ]
Giovannucci, Edward L. [5 ,6 ]
Richter, James M. [2 ]
Fuchs, Charles S. [2 ,4 ,7 ]
Chan, Andrew T. [1 ,2 ,4 ]
机构
[1] Massachusetts Gen Hosp, Gastrointestinal Unit, Div Gastroenterol, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Childrens Hosp Boston, Div Gastroenterol & Nutr, Boston, MA USA
[4] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA
[5] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
[6] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[7] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA
基金
美国国家卫生研究院;
关键词
Ultraviolet Exposure; Nutrition; Inflammatory Bowel Disease; IBD; INFLAMMATORY-BOWEL-DISEASE; FOOD FREQUENCY QUESTIONNAIRE; RECEPTOR GENE POLYMORPHISM; COLORECTAL-CANCER; 25-HYDROXYVITAMIN-D LEVELS; 1,25-DIHYDROXYVITAMIN D-3; ULCERATIVE-COLITIS; ALPHA-TOCOPHEROL; UNITED-STATES; D DEFICIENCY;
D O I
10.1053/j.gastro.2011.11.040
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND & AIMS: Vitamin D influences innate immunity, which is believed to be involved in the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). However, data examining vitamin D status in relation to risk of CD and UC are lacking. METHODS: We conducted a prospective cohort study of 72,719 women (age, 40-73 y) enrolled in the Nurses' Health Study. In 1986, women completed an assessment of diet and lifestyle, from which a 25-hydroxy vitamin D [25(OH) D] prediction score was developed and validated against directly measured levels of plasma 25(OH) D. Through 2008, we confirmed reported diagnoses of incident CD or UC through medical record review. We used Cox proportional hazards modeling to examine the hazard ratio (HR) for incident CD or UC after adjusting for potential confounders. RESULTS: During 1,492,811 person-years of follow-up evaluation, we documented 122 incident cases of CD and 123 cases of UC. The median predicted 25(OH) D level was 22.3 ng/mL in the lowest and 32.2 ng/mL in the highest quartiles. Compared with the lowest quartile, the multivariate-adjusted HR associated with the highest quartile of vitamin D was 0.54 (95% confidence interval [CI], 0.30-.99) for CD (P-trend = .02) and 0.65 (95% CI, 0.34-1.25) for UC (P-trend = .17). Compared with women with a predicted 25(OH) D level less than 20 ng/mL, the multivariate-adjusted HR was 0.38 (95% CI, 0.15-0.97) for CD and 0.57 (95% CI, 0.19-1.70) for UC for women with a predicted 25(OH) D level greater than 30 ng/mL. There was a significant inverse association between dietary and supplemental vitamin D and UC, and a nonsignificant reduction in CD risk. CONCLUSIONS: Higher predicted plasma levels of 25(OH) D significantly reduce the risk for incident CD and nonsignificantly reduce the risk for UC in women.
引用
收藏
页码:482 / 489
页数:8
相关论文
共 49 条
[11]   The BsmI vitamin D receptor gene polymorphism is associated with ulcerative colitis in Jewish Ashkenazi patients [J].
Dresner-Pollak, R ;
Ackerman, Z ;
Eliakim, R ;
Karban, A ;
Chowers, Y ;
Fidder, HH .
GENETIC TESTING, 2004, 8 (04) :417-420
[12]  
Feskanich D, 2004, CANCER EPIDEM BIOMAR, V13, P1502
[13]   Plasma 25-hydroxyvitamin D levels and risk of incident hypertension [J].
Forman, John P. ;
Giovannucci, Edward ;
Holmes, Michelle D. ;
Bischoff-Ferrari, Heike A. ;
Tworoger, Shelley S. ;
Willett, Walter C. ;
Curhan, Gary C. .
HYPERTENSION, 2007, 49 (05) :1063-1069
[14]   Genome-wide meta-analysis increases to 71 the number of confirmed Crohn's disease susceptibility loci [J].
Franke, Andre ;
McGovern, Dermot P. B. ;
Barrett, Jeffrey C. ;
Wang, Kai ;
Radford-Smith, Graham L. ;
Ahmad, Tariq ;
Lees, Charlie W. ;
Balschun, Tobias ;
Lee, James ;
Roberts, Rebecca ;
Anderson, Carl A. ;
Bis, Joshua C. ;
Bumpstead, Suzanne ;
Ellinghaus, David ;
Festen, Eleonora M. ;
Georges, Michel ;
Green, Todd ;
Haritunians, Talin ;
Jostins, Luke ;
Latiano, Anna ;
Mathew, Christopher G. ;
Montgomery, Grant W. ;
Prescott, Natalie J. ;
Raychaudhuri, Soumya ;
Rotter, Jerome I. ;
Schumm, Philip ;
Sharma, Yashoda ;
Simms, Lisa A. ;
Taylor, Kent D. ;
Whiteman, David ;
Wijmenga, Cisca ;
Baldassano, Robert N. ;
Barclay, Murray ;
Bayless, Theodore M. ;
Brand, Stephan ;
Buening, Carsten ;
Cohen, Albert ;
Colombel, Jean-Frederick ;
Cottone, Mario ;
Stronati, Laura ;
Denson, Ted ;
De Vos, Martine ;
D'Inca, Renata ;
Dubinsky, Marla ;
Edwards, Cathryn ;
Florin, Tim ;
Franchimont, Denis ;
Gearry, Richard ;
Glas, Juergen ;
Van Gossum, Andre .
NATURE GENETICS, 2010, 42 (12) :1118-+
[15]   Prospective study of serum vitamin D and cancer mortality in the United States [J].
Freedman, D. Michal ;
Looker, Anne C. ;
Chang, Shih-Chen ;
Graubard, Barry I. .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2007, 99 (21) :1594-1602
[16]   Vitamin D receptor is required to control gastrointestinal immunity in IL-10 knockout mice [J].
Froicu, M ;
Zhu, Y ;
Cantorna, MT .
IMMUNOLOGY, 2006, 117 (03) :310-318
[17]   A crucial role for the vitamin D receptor in experimental inflammatory bowel diseases [J].
Froicu, M ;
Weaver, V ;
Wynn, TA ;
McDowell, MA ;
Welsh, JE ;
Cantorna, MT .
MOLECULAR ENDOCRINOLOGY, 2003, 17 (12) :2386-2392
[18]   Vitamin D and the vitamin D receptor are critical for control of the innate immune response to colonic injury [J].
Froicu, Monica ;
Cantorna, Margherita T. .
BMC IMMUNOLOGY, 2007, 8 (1)
[19]   Prospective study of predictors of vitamin D status and cancer incidence and mortality in men [J].
Giovannucci, E ;
Liu, Y ;
Rimm, EB ;
Hollis, BW ;
Fuchs, CS ;
Stampfer, MJ ;
Willett, WC .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2006, 98 (07) :451-459
[20]   Epidemiology of disease risks in relation to vitamin D insufficiency [J].
Grant, William B. .
PROGRESS IN BIOPHYSICS & MOLECULAR BIOLOGY, 2006, 92 (01) :65-79