Abstract
Abstract Background: Colorectal adenomas are clear precursors of cancer; hyperplastic polyps have recently been hypothesized to also have malignant potential. However, these two distinct colorectal lesions are probably on different molecular pathways to neoplasia. An inverse association between vitamin D and adenoma risk has been reported, but this is the first study, to our knowledge, that examines circulating 25(OH)D in relation to risk of hyperplastic polyps. Methods: We conducted a colonoscopy-based case-control study of adenomas and hyperplastic polyps among 474 members of a large integrated health plan. Self-administered questionnaires provided data on demographics and colorectal polyp risk factors, and we assayed plasma samples donated by participants at the time of the colonoscopy for total 25-hydroxyvitamin-D (25(OH)D) concentration. Polytomous regression was used to estimate separate odds ratios for adenomas (n = 153) and hyperplastic polyps (n = 91) by tertile of 25(OH)D. Results: An inverse association between 25(OH)D and adenomas was observed (comparing upper to lower tertiles: adjusted OR [95%CI]: 0.60 [0.34-1.08]). After restriction of the analyses to study participants with no history of polyps, this OR estimate moved further from the null and became statistically significant (adjusted OR [95%CI]: 0.43 [0.20-0.96]). In comparison, no statistically significant association between hyperplastic polyps and 25(OH)D was observed among the full study participants (adjusted OR [95%CI]: 1.12 [0.59-2.13]) nor among those without prior polyps (adjusted OR [95%CI]: 1.27 [0.57-2.35]). Conclusions: There is no evidence in our study that the established inverse association between circulating 25(OH)D and colorectal adenoma applies to hyperplastic polyps.
Published Version
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