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Research: MONDUL and COLLEAGUES,
Listed in Issue 237
Abstract
MONDUL and COLLEAGUES, (1)Nutritional Epidemiology Branch Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD studied whether circulating vitamin D-binding protein (DBP) concentration was prospectively associated with the risk of renal cell cancer.
Background
Cell culture experiments suggest that vitamin D may inhibit renal carcinogenesis, but human studies of circulating 25-hydroxyvitamin D [25(OH)D], the accepted measure of vitamin D status, and kidney cancer have been null. Limited research has examined the role of circulating vitamin D-binding protein (DBP) in the association between 25(OH)D and disease risk, and it is unclear whether free 25(OH)D in circulation is a better measure of effective exposure, or if DBP may independently impact outcomes.
Methodology
The authors conducted a nested case-control analysis within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study to examine whether circulating DBP concentration was prospectively associated with risk of renal cell carcinoma, and whether it modified the association with 25(OH)D. Renal cell carcinoma cases (n = 262) were matched 1:1 to controls on age (±1 year) and date of blood collection (± 30 days). The authors estimated odds ratios (ORs) and 95% confidence intervals (CIs) of renal cell carcinoma risk by quartiles of 25(OH)D, DBP and the molar ratio of 25(OH)D:DBP, a proxy for free circulating 25(OH)D.
Results
Men with higher DBP concentrations were at significantly decreased risk of kidney cancer (Q4 vs. Q1: OR = 0.17, 95% CI = 0.08-0.33; p-trend < 0.0001), a finding unchanged by adjustment for 25(OH)D. Although we observed no association with total 25(OH)D, we found slightly increased risk with higher levels of estimated free 25(OH)D [Q4 vs. Q1 of the 25(OH)D:DBP ratio, OR = 1.61, 95% CI = 0.95-2.73; p-trend = 0.09].
Conclusion
The strong protective association observed between higher circulating DBP concentration and kidney cancer risk requires replication but suggests a vitamin D-independent influence of DBP.
References
Mondul AM(1), Weinstein SJ, Moy KA, Männistö S, Albanes D. Vitamin D-binding protein, circulating vitamin D and risk of renal cell carcinoma. Int J Cancer. 1;134(11):2699-706. doi: 10.1002/ijc.28596. Jun 2014. Epub Jan 302014.
