A prospective study of vitamin D, proinflammatory cytokines, and risk of fragility fractures in women on aromatase inhibitors for breast cancer.

Autor: Liang E; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Beshara M; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Sheng H; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.; Department of Biostatistics, University at Buffalo, Buffalo, NY, USA., Huang XW; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.; Department of Biostatistics, University at Buffalo, Buffalo, NY, USA., Roh JM; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Laurent CA; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Lee C; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Delmerico J; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA., Tang L; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA., Lo JC; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Hong CC; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA., Ambrosone CB; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA., Kushi LH; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Kwan ML; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA., Yao S; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA. song.yao@roswellpark.org.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2024 Nov; Vol. 208 (2), pp. 349-358. Date of Electronic Publication: 2024 Jul 08.
DOI: 10.1007/s10549-024-07423-6
Abstrakt: Background: Vitamin D is critical to bone health by regulating intestinal absorption of calcium, whereas proinflammatory cytokines, including IL-1, IL-6, IL-12, and TNF-α, are known to increase bone resorption. We hypothesized that vitamin D and these cytokines at the time of breast cancer diagnosis were predictive for fragility fractures in women receiving aromatase inhibitors (AIs).
Methods: In a prospective cohort of 1,709 breast cancer patients treated with AIs, we measured the levels of 25-hydroxyvitamin D (25OHD), IL-1β, IL-6, IL-12, and TNF-α from baseline blood samples. The associations of these biomarkers were analyzed with bone turnover markers (BALP and TRACP), bone regulatory markers (OPG and RANKL), bone mineral density (BMD) close to cancer diagnosis, and risk of fragility fractures during a median of 7.5 years of follow up.
Results: Compared to patients with vitamin D deficiency, patients with sufficient levels had higher bone turnover, lower BMD, and higher fracture risk; the latter became non-significant after controlling for covariates including BMD and no longer existed when patients taking vitamin D supplement or bisphosphonates or with history of fracture or osteoporosis were excluded. There was a non-significant trend of higher levels of IL-1β and TNF-α associated with higher risk of fracture (highest vs. lowest tertile, IL-1β: adjusted HR=1.37, 95% CI=0.94-1.99; TNF-α: adjusted HR=1.38, 95% CI=0.96-1.98).
Conclusions: Our results do not support proinflammatory cytokines or vitamin D levels as predictors for risk of fragility fractures in women receiving AIs for breast cancer.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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