Is Vitamin D Deficiency Related to Increased Cancer Risk in Patients with Type 2 Diabetes Mellitus?

Anna Gabryanczyk,Agnieszka Śliwińska,Sylwia Klimczak,Izabela Szymczak-Pajor

doi:10.3390/ijms22126444

Anna Gabryanczyk, Agnieszka Śliwińska + Show 2 more

Open Access

https://doi.org/10.3390/ijms22126444

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Abstract

There is mounting evidence that type 2 diabetes mellitus (T2DM) is related with increased risk for the development of cancer. Apart from shared common risk factors typical for both diseases, diabetes driven factors including hyperinsulinemia, insulin resistance, hyperglycemia and low grade chronic inflammation are of great importance. Recently, vitamin D deficiency was reported to be associated with the pathogenesis of numerous diseases, including T2DM and cancer. However, little is known whether vitamin D deficiency may be responsible for elevated cancer risk development in T2DM patients. Therefore, the aim of the current review is to identify the molecular mechanisms by which vitamin D deficiency may contribute to cancer development in T2DM patients. Vitamin D via alleviation of insulin resistance, hyperglycemia, oxidative stress and inflammation reduces diabetes driven cancer risk factors. Moreover, vitamin D strengthens the DNA repair process, and regulates apoptosis and autophagy of cancer cells as well as signaling pathways involved in tumorigenesis i.e., tumor growth factor β (TGFβ), insulin-like growth factor (IGF) and Wnt-β-Cathenin. It should also be underlined that many types of cancer cells present alterations in vitamin D metabolism and action as a result of Vitamin D Receptor (VDR) and CYP27B1 expression dysregulation. Although, numerous studies revealed that adequate vitamin D concentration prevents or delays T2DM and cancer development, little is known how the vitamin affects cancer risk among T2DM patients. There is a pressing need for randomized clinical trials to clarify whether vitamin D deficiency may be a factor responsible for increased risk of cancer in T2DM patients, and whether the use of the vitamin by patients with diabetes and cancer may improve cancer prognosis and metabolic control of diabetes.

Highlights

Epidemiological studies reveal that morbidity of both diabetes and cancer is growing rapidly worldwide
The mechanisms for the association of type 2 diabetes mellitus (T2DM) and the incidence of cancer are not completely solved and understood, the insulin resistance/hyperinsulinism, hyperglycemia, oxidative stress and low grade chronic inflammation are biological factors related with T2DM that are considered as triggering factors of carcinogenesis [5,6,7,8]
There is a pressing need for randomized clinical trials to clarify whether vitamin D deficiency may be another factor responsible for increased risk of cancer in T2DM patients, and whether the use of the vitamin by patients with diabetes may decrease cancer risk. It seems that vitamin D deficiency may be one of the crucial factors responsible for increased cancer risk among T2DM patients

Summary

Introduction

Epidemiological studies reveal that morbidity of both diabetes and cancer is growing rapidly worldwide. It is estimated that in 2030 the number of diabetics will increase to 578 million worldwide [1]. In case of cancer incidence, the WHO reported 14 million patients in 2012, and estimated that there will be approximately 22 million of cases in 2032 [2]. Several studies have demonstrated that both T1DM and type 2 diabates (T2DM) are connected with increased cancer risk, it seems that epidemiologically and biologically T2DM has a stronger link with cancer [3]. Due to the fact that cancer and T2DM share common risk factors, such as obesity, gender, smoking, and aging, it is believed that T2DM has been closely associated with many types of cancer, including cancers of the pancreas, liver, colorectal, breast, endometrium, and bladder [4].

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