Vitamin D und Krebs

Zusammenfassung

Zirka 60 % der deutschen Bevölkerung weisen einen Vitamin-D-Mangel auf, bestimmt über die Serumkonzentrationen von 25-Hydroxy-Vitamin D₃. Vitamin D hat antikarzinogene Wirkungen wie Apoptose-Induktion oder Inhibierung der Angiogenese. Sonnenlichtexposition verbessert den Vitamin-D-Status und vermindert das Krebsrisiko für die meisten Tumor-Lokalisationen. Die überwiegende Zahl der Studien zeigt, dass niedrige Vitamin-D-Aufnahme oder niedrige Serumkonzentrationen von 25-Hydroxy-Vitamin D₃ mit erhöhter Tumorinzidenz und -mortalität assoziiert sind. Bei Tumorpatienten sind höhere Serumkonzentrationen von 25-Hydroxy-Vitamin D₃ mit niedriger Gesamt- und krebsspezifischer Mortalität korreliert.

Summary

About 60 % of the German population has an insufficient vitamin D status, determined by serum concentrations of 25-hydroxy-vitamin D₃. Vitamin D exerts anticarcinogenic effects, including inhibition of angiogenesis and induction of apoptosis. Sunlight exposure, which improves the vitamin D status, lowers the total risk of cancer. Low vitamin D intake or low serum concentrations of 25-hydroxy-vitamin D₃ are associated with increased cancer incidence and mortality in most but not all prospective studies or randomized controlled trials. In cancer patients higher concentrations of 25-hydroxy-vitamin D₃ are interrelated with an improvement in overall survival.

Schlüsselwörter

Vitamin-D-Mangel - antikarzinogene Wirkungen - Tumorinzidenz und -mortalität - Überlebensrate bei Tumorpatienten -

Keywords

Vitamin D insufficiency - anticarcinogenic effects - cancer incidence - cancer mortality - survival in cancer patients

• Literatur

• 1 Abbas S et al. Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer – results of a large case-control study. Carcinogenesis 2008; 29: 93-99
• 2 Abbas S et al. Plasma 25-hydroxyvitamin D and premenopausal breast cancer in a German case-control-study. Int J Cancer 2009; 124: 250-255
• 3 Abnet CC et al. Circulating 25-hydroxyvitamin D and risk of esophageal and gastric cancer: Cohort consortium vitamin D pooling project of rarer cancers. Am J Epidemiol 2010; 172: 94-106
• 4 Ahn J et al. Serum vitamin D concentration and prostate cancer risk: a nested case-control study. J Natl Cancer Inst 2008; 100: 796-804
• 5 Apperly FL. The relation of solar radiation to cancer mortality in North America. Cancer Res 1941; 1: 191-195
• 6 Baggerly C Vortrag. Vitamin D – Update 2011. Kongress Berlin; 09.04.2011
• 7 Bayer W, Wührer K. Hochdosierte Vitamin D-Substitution: Einfluss auf Vitamin D und Parathormon. Z Orthomol Med 2010; 4: 1-8
• 8 Bischoff-Ferrari HA et al. Estimation of optimal serum concentrations of 25-hydroxy-vitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84: 18-28
• 9 Crew KD et al. High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy. J Clin Oncol 2009; 27: 2151-2156
• 10 D. A.CH.. Referenzwerte für die Nährstoffzufuhr. Frankfurt: Umschau Braus; 2000
• 11 Diaz GD et al. Apoptosis is induced by the active metabolite of vitamin D3 and its analogue EB1089 in colorectal adenoma and carcinoma cells: possible implications for prevention and therapy. Cancer Res 2000; 60: 2304-2312
• 12 Fakih MG et al. Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer. Int J Colorectal Dis 2009; 24: 219-224
• 13 Freedman DM et al. Prospective study of serum vitamin D and cancer mortality in the United States. J Natl Cancer Inst 2007; 99: 1594-1602
• 14 Garland CF et al. Vitamin D and prevention of breast cancer: pooled analysis. J Steroid Biochem Mol Biol 2007; 103: 708-711
• 15 Giovannucci E et al. The epidemiology of vitamin D and cancer incidence and mortality: a review. Cancer Causes Control 2005; 16: 83-95
• 16 Giovannucci E et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst 2006; 98: 451-459
• 17 Goodwin JP et al. Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer. J Clin Oncol 2009; 27: 3271-3273
• 18 Gorham ED et al. Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. Am J Prev Med 2007; 32: 210-216
• 19 Grant WB. An estimate of premature cancer mortality in the U. S. due to inadequate doses of solar ultraviolet-B radiation. Cancer 2002; 94: 1867-1875
• 20 Grant WB, Garland CF. The association of solar ultraviolet B (UVB) with reducing risk of cancer: Multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res 2006; 26: 2687-2700
• 21 Grant WB, Mohr SB. Ecological studies of ultraviolet B, vitamin D and cancer since 2000. Ann Epidemiol 2009; 19: 446-454
• 22 Heaney RP. The vitamin D requirement in health and disease. J Steroid Biochem Mol Biol 2005; 97: 13-19
• 23 Helzlsouer KJ. Overview of the cohort consortium vitamin D pooling project for rarer cancers. Am J Epidemiol 2010; 172: 4-9
• 24 Hintzpeter B et al. Vitamin D status and health correlates among German adults. Eur J Clin Nutr 2008; 62: 1079-1089
• 25 Institute of Medicine of the National Academies (USA). Report. Brief, November 2010
• 26 Kimmie N et al. Circulating 25-hydroxyvitamin D levels and survival in patients with colorectal cancer. J Clin Oncol 2008; 26: 2984-2991
• 27 Lappe JM et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007; 85: 1586-1591
• 28 MacLaughlin J et al. Aging decreases the capacity of human skin to produce vitamin D. J Clin Invest 1985; 76: 1536-1538
• 29 Mantell DJ et al. 1-α,25-dihydroxyvitamin D3 inhibits angiogenesis in vitro and in vivo. Circulation Res 2000; 87: 214-220
• 30 Martinez ME et al. Calcium, vitamin D and occurrence of colorectal cancer among women. J Natl Cancer Inst 1996; 88: 1375-1382
• 31 Moan J et al. Addressing the health benefits and risks, involving vitamin D or skin cancer, of increasing sun exposure. PNAS 2008; 105: 668-673
• 32 Pilz S et al. Low serum levels of 25-hydroxy-vitamin D predict fatal cancer in patients referred to coronary angiography. Cancer Epidemiol Biomarkers Prev 2008; 17: 1228-1233
• 33 Raman M et al. Vitamin D and gastrointestinal diseases: inflammatory bowel disease and colorectal cancer. Ther Adv Gastroenterol 2011; 4: 49-63
• 34 Snijder M et al. Adiposity in relation to vitamin D status and parathyreoid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119-4123
• 35 Thomas L Hrsg. Labor und Diagnose. 7.. Aufl. Frankfurt: TH-Books; 2008
• 36 Wactawski-Wende J et al. Calcium and Vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006; 354: 684-696
• 37 Wu K et al. A nested case-control study of plasma 25-hydroxyvitamin D concentration and risk of colorectal cancer. J Natl Cancer Inst 2007; 99: 1120-1129
• 38 Zelenluch-Jacquotte A et al. Circulating 25-hydroxyvitamin D and risk of endometrial cancer: Cohort consortium vitamin D pooling project of rarer cancers. Am J Epidemiol 2010; 172: 36-46
• 39 Zhou W et al. Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small cell lung cancer patients. J Clin Oncol 2007; 25: 479-485