Comparative Efficacy of Vitamin D Status in Reducing the Risk of Bladder Cancer: A Systematic Review and Network Meta-Analysis
Nutrition, Available online 19 December 2015, doi:10.1016/j.nut.2015.10.023
Yue Zhao, MD, PhD1, a, Changhao Chen, MD, PhD2, a, Wenwei Pan, MD, PhD2, a, Ming Gao, MD3, He Wang, MD, PhD2, Ren Mao, MD, PhD1, Tianxin Lin, MD, PhD2, , , Jian Huang, MD, PhD2, ,
Highlights
●Based on the network meta-analysis, vitamin D was inversely associated with bladder cancer risk.
●The sufficient serum 25(OH)D might play an important role in decreasing the bladder cancer risk.
●The serum 25(OH)D concentration ≥ 74 nmol/L was associated with a 60% lower risk of bladder cancer.
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- All items in category Bladder Cancer Vitamin D
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Objective: The optimal concentration of individual vitamin D intake for preventing bladder cancer has not been defined. To evaluate the comparative efficacy of different serum 25-hydroxyvitamin D concentrations in preventing bladder cancer, we conducted a systematic search of the literature published up to April 2015.Methods: We applied a pair-wise meta-analysis to estimate direct evidence from intervention-control studies and a network meta-analysis within a Bayesian framework to combine direct and indirect evidence. Moreover, a dose-response curve was utilized to predict the optimal median serum 25-hydroxyvitamin D concentration based on the odds ratio (OR) for each quintile concentration.
Results: Seven studies of a total of 90757 participants, including 2509 bladder cancer patients, were included. Two prospective cohort studies with 57591 participants and 494 bladder cancer patients, and five case-control studies with 33166 participants and 2264 bladder cancer patients. From the network meta-analysis, we observed that sufficient serum 25-hydroxyvitamin D concentrations (> 75 nmol/L) were superior to all other 25-hydroxyvitamin D concentrations in decreasing the risk of bladder cancer: OR= 0.68 and 95% credible interval (CrI) 0.52-0.87 compared with severely deficient concentrations (< 25 nmol/L); OR= 0.65 and 95% CrI 0.49-0.86 compared with moderately deficient concentrations (25-37.5 nmol/L); OR= 0.61 and 95% CrI 0.47-0.80 compared with slightly deficient concentrations (37.5-50 nmol/L); and OR= 0.65 and 95% CrI 0.48-0.85 compared with insufficient concentrations (50-75 nmol/L). In addition, we noted a roughly inverse correlation between bladder cancer risk and 25-hydroxyvitamin D concentrations (R2 = 0.98, p = 0.007).
Conclusions: Ensuring sufficient serum 25-hydroxyvitamin D concentrations might play an important role in decreasing the risk of bladder cancer. The serum 25-hydroxyvitamin D concentration ≥ 74 nmol/L was associated with a 60% lower risk of bladder cancer incidence.
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