Abstract
Introduction
Aging is often associated with low-grade chronic inflammation and a senescent immune
system. Vitamin D is a regulator of immune function, and low plasma vitamin D is associated
with poor health. The association between plasma vitamin D and inflammatory biomarkers
and risk of postoperative complications and survival in patients with colorectal cancer
(CRC) is unknown. Our aim was to investigate these associations and how they are influenced
by age.
Materials and methods
Circulating vitamin D and the inflammatory biomarkers C-reactive protein (CRP), interleukin
(IL)-6, and YKL-40 were measured in 398 patients with stage I–III CRC preoperatively.
Older patients (≥70 years, n = 208) were compared to younger patients (<70 years, n = 190).
The relation between vitamin D and complications and high inflammatory biomarker levels
was presented by odds ratios ([OR], 95% confidence interval [CI]). Associations with
survival were presented with hazard ratios ([HR], 95% CI).
Results
Plasma vitamin D was higher in older patients than in younger patients (75 vs. 67 nmol/L,
P = 0.001). High vitamin D was associated with low plasma CRP in younger patients (OR = 0.35,
95% CI 0.17–0.76), but not in older patients (OR = 0.93, 0.49–1.76). High vitamin
D in older patients with CRC was associated with reduced risk of major complications
(OR = 0.52, 0.28–0.95). This was not found in younger patients (OR = 1.47, 0.70–3.11).
Deficient vitamin D (<25 nmol/L) was associated with short overall survival compared
to sufficient (>50 nmol/L) irrespective of age (HR = 3.39, 1.27–9.37, P = 0.02).
Conclusion
For patients with localized CRC, high vitamin D levels before resection were associated
with reduced risk of high inflammatory biomarkers for younger patients and reduced
risk of major postoperative complications for older patients. Vitamin D deficiency
was associated with reduced survival regardless of age.
Keywords
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Article info
Publication history
Published online: September 10, 2022
Accepted:
August 31,
2022
Received in revised form:
August 22,
2022
Received:
April 25,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
