Skip to main content
Top
Published in: Digestive Diseases and Sciences 8/2015

01-08-2015 | Original Article

Vitamin D Deficiency Adds an Element of Risk to Insulin Resistance in Colorectal Neoplasms

Authors: Myong Ki Baeg, Myung-Gyu Choi, Sun-Hye Ko, Bo-Geun Park, Kyung-Do Han, Jae Myung Park, Bo-In Lee, In-Seok Lee, Sang-Woo Kim

Published in: Digestive Diseases and Sciences | Issue 8/2015

Login to get access

Abstract

Background

Both insulin resistance (IR) and vitamin D deficiency (VitDdef) have been suggested as risk factors for colorectal neoplasms (CRNs). However, the associations between the two with regard to CRNs are unclear.

Aims

To determine whether IR is a risk factor for CRNs and whether VitDdef confers an additive risk of CRNs.

Methods

Colonoscopy-naïve asymptomatic women undergoing a routine health screening program were analyzed. IR was defined as homeostatic model assessment of IR >3 and VitDdef set as <20 ng/mL. Multivariable logistic regression was performed between women with and without CRNs, matched for age and body mass index, to investigate associations with CRNs in IR, VitDdef, and VitDdef combined with IR.

Results

We analyzed 216 women with CRNs and 216 without CRNs. A significant association was found between IR and CRNs (OR 1.838, 95 % CI 1.029–3.285, P = 0.040) but not with VitDdef. IR conferred a higher risk in advanced CRNs (OR 3.244, 95 % CI 1.588–6.631, P = 0.001) than CRNs. When VitDdef was combined with IR, risks of both CRNs and advanced CRNs increased (OR 2.131, 95 % CI 1.077–4.216, P = 0.030 and OR 4.438, 95 % CI 2.058–9.571, P < 0.001, respectively).

Conclusions

IR increases the risk of CRNs, and a combination of IR and VitDdef further increases this risk. As both VitDdef and IR are modifiable risk factors, such associations may have important clinical implications in the prevention of CRNs.
Literature
1.
go back to reference Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA. Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol. 2011;106:1911–1921; quiz 1922. Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA. Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol. 2011;106:1911–1921; quiz 1922.
2.
go back to reference Garland C, Shekelle RB, Barrett-Connor E, Criqui MH, Rossof AH, Paul O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet. 1985;1:307–309.PubMedCrossRef Garland C, Shekelle RB, Barrett-Connor E, Criqui MH, Rossof AH, Paul O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet. 1985;1:307–309.PubMedCrossRef
4.
go back to reference Sandhu MS, Dunger DB, Giovannucci EL. Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. J Natl Cancer Inst. 2002;94:972–980.PubMedCrossRef Sandhu MS, Dunger DB, Giovannucci EL. Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. J Natl Cancer Inst. 2002;94:972–980.PubMedCrossRef
5.
go back to reference Sax AT, Jenkins DG, Devin JL, Hughes GI, Bolam KA, Skinner TL. The insulin-like growth factor axis: a biological mechanism linking physical activity to colorectal cancer survival. Cancer Epidemiol. 2014;38:455–459.PubMedCrossRef Sax AT, Jenkins DG, Devin JL, Hughes GI, Bolam KA, Skinner TL. The insulin-like growth factor axis: a biological mechanism linking physical activity to colorectal cancer survival. Cancer Epidemiol. 2014;38:455–459.PubMedCrossRef
6.
go back to reference Schoen RE, Weissfeld JL, Kuller LH, et al. Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps. Gastroenterology. 2005;129:464–475.PubMedCrossRef Schoen RE, Weissfeld JL, Kuller LH, et al. Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps. Gastroenterology. 2005;129:464–475.PubMedCrossRef
7.
go back to reference Rampal S, Yang MH, Sung J, et al. Association between markers of glucose metabolism and risk of colorectal adenoma. Gastroenterology. 2014;147:78–87 e73. Rampal S, Yang MH, Sung J, et al. Association between markers of glucose metabolism and risk of colorectal adenoma. Gastroenterology. 2014;147:78–87 e73.
8.
go back to reference Tsilidis KK, Brancati FL, Pollak MN, et al. Metabolic syndrome components and colorectal adenoma in the CLUE II cohort. Cancer Causes Control. 2010;21:1–10.PubMedCentralPubMedCrossRef Tsilidis KK, Brancati FL, Pollak MN, et al. Metabolic syndrome components and colorectal adenoma in the CLUE II cohort. Cancer Causes Control. 2010;21:1–10.PubMedCentralPubMedCrossRef
9.
go back to reference Ma Y, Zhang P, Wang F, Yang J, Liu Z, Qin H. Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol. 2011;29:3775–3782.PubMedCrossRef Ma Y, Zhang P, Wang F, Yang J, Liu Z, Qin H. Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol. 2011;29:3775–3782.PubMedCrossRef
10.
go back to reference Lee JE, Li H, Chan AT, et al. Circulating levels of vitamin D and colon and rectal cancer: the Physicians’ Health Study and a meta-analysis of prospective studies. Cancer Prev Res (Phila). 2011;4:735–743.CrossRef Lee JE, Li H, Chan AT, et al. Circulating levels of vitamin D and colon and rectal cancer: the Physicians’ Health Study and a meta-analysis of prospective studies. Cancer Prev Res (Phila). 2011;4:735–743.CrossRef
11.
go back to reference Giovannucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control. 2005;16:83–95.PubMedCrossRef Giovannucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control. 2005;16:83–95.PubMedCrossRef
12.
go back to reference Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14:342–357.PubMedCrossRef Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14:342–357.PubMedCrossRef
13.
go back to reference Hong SN, Kim JH, Choe WH, et al. Circulating vitamin D and colorectal adenoma in asymptomatic average-risk individuals who underwent first screening colonoscopy: a case–control study. Dig Dis Sci. 2012;57:753–763.PubMedCrossRef Hong SN, Kim JH, Choe WH, et al. Circulating vitamin D and colorectal adenoma in asymptomatic average-risk individuals who underwent first screening colonoscopy: a case–control study. Dig Dis Sci. 2012;57:753–763.PubMedCrossRef
14.
go back to reference Peters U, McGlynn KA, Chatterjee N, et al. Vitamin D, calcium, and vitamin D receptor polymorphism in colorectal adenomas. Cancer Epidemiol Biomark Prev. 2001;10:1267–1274. Peters U, McGlynn KA, Chatterjee N, et al. Vitamin D, calcium, and vitamin D receptor polymorphism in colorectal adenomas. Cancer Epidemiol Biomark Prev. 2001;10:1267–1274.
15.
go back to reference Fedirko V, Bostick RM, Goodman M, Flanders WD, Gross MD. Blood 25-hydroxyvitamin D3 concentrations and incident sporadic colorectal adenoma risk: a pooled case–control study. Am J Epidemiol. 2010;172:489–500.PubMedCentralPubMedCrossRef Fedirko V, Bostick RM, Goodman M, Flanders WD, Gross MD. Blood 25-hydroxyvitamin D3 concentrations and incident sporadic colorectal adenoma risk: a pooled case–control study. Am J Epidemiol. 2010;172:489–500.PubMedCentralPubMedCrossRef
16.
go back to reference Platz EA, Hankinson SE, Hollis BW, et al. Plasma 1,25-dihydroxy- and 25-hydroxyvitamin D and adenomatous polyps of the distal colorectum. Cancer Epidemiol Biomark Prev. 2000;9:1059–1065. Platz EA, Hankinson SE, Hollis BW, et al. Plasma 1,25-dihydroxy- and 25-hydroxyvitamin D and adenomatous polyps of the distal colorectum. Cancer Epidemiol Biomark Prev. 2000;9:1059–1065.
17.
go back to reference Jacobs ET, Alberts DS, Benuzillo J, Hollis BW, Thompson PA, Martinez ME. Serum 25(OH)D levels, dietary intake of vitamin D, and colorectal adenoma recurrence. J Steroid Biochem Mol Biol. 2007;103:752–756.PubMedCentralPubMedCrossRef Jacobs ET, Alberts DS, Benuzillo J, Hollis BW, Thompson PA, Martinez ME. Serum 25(OH)D levels, dietary intake of vitamin D, and colorectal adenoma recurrence. J Steroid Biochem Mol Biol. 2007;103:752–756.PubMedCentralPubMedCrossRef
18.
go back to reference Zheng XE, Lipka S, Li T, et al. The relationship of vitamin D status, smoking, and colorectal adenoma: a retrospective study in an ethnically diverse community. J Steroid Biochem Mol Biol. 2013;136:280–283.PubMedCrossRef Zheng XE, Lipka S, Li T, et al. The relationship of vitamin D status, smoking, and colorectal adenoma: a retrospective study in an ethnically diverse community. J Steroid Biochem Mol Biol. 2013;136:280–283.PubMedCrossRef
19.
go back to reference Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005;28:1228–1230.PubMedCrossRef Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005;28:1228–1230.PubMedCrossRef
20.
go back to reference Amirbaigloo A, Hosseinpanah F, Sarvghadi F, Tohidi M, Eskandary PS, Azizi F. Absence of association between vitamin D deficiency and incident metabolic syndrome: tehran lipid and glucose study. Metab Syndr Relat Disord. 2013;11:236–242.PubMedCrossRef Amirbaigloo A, Hosseinpanah F, Sarvghadi F, Tohidi M, Eskandary PS, Azizi F. Absence of association between vitamin D deficiency and incident metabolic syndrome: tehran lipid and glucose study. Metab Syndr Relat Disord. 2013;11:236–242.PubMedCrossRef
21.
go back to reference Al-Shoumer KA, Al-Asoosi AA, Ali AH, Nair VS. Does insulin resistance in type 2 diabetes alter vitamin D status? Prim Care Diabetes. 2013;7:283–287.PubMedCrossRef Al-Shoumer KA, Al-Asoosi AA, Ali AH, Nair VS. Does insulin resistance in type 2 diabetes alter vitamin D status? Prim Care Diabetes. 2013;7:283–287.PubMedCrossRef
22.
go back to reference Tuohimaa P, Tenkanen L, Syvala H, et al. Interaction of factors related to the metabolic syndrome and vitamin D on risk of prostate cancer. Cancer Epidemiol Biomark Prev. 2007;16:302–307.CrossRef Tuohimaa P, Tenkanen L, Syvala H, et al. Interaction of factors related to the metabolic syndrome and vitamin D on risk of prostate cancer. Cancer Epidemiol Biomark Prev. 2007;16:302–307.CrossRef
23.
go back to reference Murtaugh MA, Sweeney C, Ma KN, et al. Vitamin D receptor gene polymorphisms, dietary promotion of insulin resistance, and colon and rectal cancer. Nutr Cancer. 2006;55:35–43.PubMedCrossRef Murtaugh MA, Sweeney C, Ma KN, et al. Vitamin D receptor gene polymorphisms, dietary promotion of insulin resistance, and colon and rectal cancer. Nutr Cancer. 2006;55:35–43.PubMedCrossRef
24.
go back to reference Wu K, Feskanich D, Fuchs CS, Willett WC, Hollis BW, Giovannucci EL. A nested case control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. J Natl Cancer Inst. 2007;99:1120–1129.PubMedCrossRef Wu K, Feskanich D, Fuchs CS, Willett WC, Hollis BW, Giovannucci EL. A nested case control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. J Natl Cancer Inst. 2007;99:1120–1129.PubMedCrossRef
25.
go back to reference Choi EY. 25(OH)D status and demographic and lifestyle determinants of 25(OH)D among Korean adults. Asia Pac J Clin Nutr. 2012;21:526–535.PubMed Choi EY. 25(OH)D status and demographic and lifestyle determinants of 25(OH)D among Korean adults. Asia Pac J Clin Nutr. 2012;21:526–535.PubMed
26.
go back to reference Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–1645.PubMedCrossRef Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–1645.PubMedCrossRef
27.
go back to reference Lee S, Choi S, Kim HJ, et al. Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. J Korean Med Sci. 2006;21:695–700.PubMedCentralPubMedCrossRef Lee S, Choi S, Kim HJ, et al. Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. J Korean Med Sci. 2006;21:695–700.PubMedCentralPubMedCrossRef
28.
go back to reference Rosen CJ, Gallagher JC. The 2011 IOM report on vitamin D and calcium requirements for north America: clinical implications for providers treating patients with low bone mineral density. J Clin Densitom. 2011;14:79–84.PubMedCrossRef Rosen CJ, Gallagher JC. The 2011 IOM report on vitamin D and calcium requirements for north America: clinical implications for providers treating patients with low bone mineral density. J Clin Densitom. 2011;14:79–84.PubMedCrossRef
29.
go back to reference Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.PubMedCrossRef Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.PubMedCrossRef
30.
go back to reference Deng L, Gui Z, Zhao L, Wang J, Shen L. Diabetes mellitus and the incidence of colorectal cancer: an updated systematic review and meta-analysis. Dig Dis Sci. 2012;57:1576–1585.PubMedCrossRef Deng L, Gui Z, Zhao L, Wang J, Shen L. Diabetes mellitus and the incidence of colorectal cancer: an updated systematic review and meta-analysis. Dig Dis Sci. 2012;57:1576–1585.PubMedCrossRef
31.
go back to reference Yamamoto S, Nakagawa T, Matsushita Y, et al. Visceral fat area and markers of insulin resistance in relation to colorectal neoplasia. Diabetes Care. 2010;33:184–189.PubMedCentralPubMedCrossRef Yamamoto S, Nakagawa T, Matsushita Y, et al. Visceral fat area and markers of insulin resistance in relation to colorectal neoplasia. Diabetes Care. 2010;33:184–189.PubMedCentralPubMedCrossRef
32.
go back to reference Peters U, Hayes RB, Chatterjee N, et al. Circulating vitamin D metabolites, polymorphism in vitamin D receptor, and colorectal adenoma risk. Cancer Epidemiol Biomark Prev. 2004;13:546–552. Peters U, Hayes RB, Chatterjee N, et al. Circulating vitamin D metabolites, polymorphism in vitamin D receptor, and colorectal adenoma risk. Cancer Epidemiol Biomark Prev. 2004;13:546–552.
33.
go back to reference Wei MY, Garland CF, Gorham ED, Mohr SB, Giovannucci E. Vitamin D and prevention of colorectal adenoma: a meta-analysis. Cancer Epidemiol Biomark Prev. 2008;17:2958–2969.CrossRef Wei MY, Garland CF, Gorham ED, Mohr SB, Giovannucci E. Vitamin D and prevention of colorectal adenoma: a meta-analysis. Cancer Epidemiol Biomark Prev. 2008;17:2958–2969.CrossRef
34.
go back to reference Jacobs ET, Hibler EA, Lance P, Sardo CL, Jurutka PW. Association between circulating concentrations of 25(OH)D and colorectal adenoma: a pooled analysis. Int J Cancer. 2013;133:2980–2988.PubMedCentralPubMed Jacobs ET, Hibler EA, Lance P, Sardo CL, Jurutka PW. Association between circulating concentrations of 25(OH)D and colorectal adenoma: a pooled analysis. Int J Cancer. 2013;133:2980–2988.PubMedCentralPubMed
35.
go back to reference Seo JA, Eun CR, Cho H, et al. Low vitamin D status is associated with nonalcoholic fatty liver disease independent of visceral obesity in Korean adults. PLoS ONE. 2013;8:e75197.PubMedCentralPubMedCrossRef Seo JA, Eun CR, Cho H, et al. Low vitamin D status is associated with nonalcoholic fatty liver disease independent of visceral obesity in Korean adults. PLoS ONE. 2013;8:e75197.PubMedCentralPubMedCrossRef
36.
go back to reference Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin N Am. 2014;43:205–232.CrossRef Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin N Am. 2014;43:205–232.CrossRef
37.
go back to reference Gulseth HL, Gjelstad IM, Birkeland KI, Drevon CA. Vitamin D and the metabolic syndrome. Curr Vasc Pharmacol. 2013;11:968–984.PubMedCrossRef Gulseth HL, Gjelstad IM, Birkeland KI, Drevon CA. Vitamin D and the metabolic syndrome. Curr Vasc Pharmacol. 2013;11:968–984.PubMedCrossRef
38.
go back to reference Merrimen JL, Evans AJ, Srigley JR. Preneoplasia in the prostate gland with emphasis on high grade prostatic intraepithelial neoplasia. Pathology. 2013;45:251–263.PubMedCrossRef Merrimen JL, Evans AJ, Srigley JR. Preneoplasia in the prostate gland with emphasis on high grade prostatic intraepithelial neoplasia. Pathology. 2013;45:251–263.PubMedCrossRef
39.
go back to reference Mitri J, Dawson-Hughes B, Hu FB, Pittas AG. Effects of vitamin D and calcium supplementation on pancreatic beta cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial. Am J Clin Nutr. 2011;94:486–494.PubMedCentralPubMedCrossRef Mitri J, Dawson-Hughes B, Hu FB, Pittas AG. Effects of vitamin D and calcium supplementation on pancreatic beta cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial. Am J Clin Nutr. 2011;94:486–494.PubMedCentralPubMedCrossRef
40.
go back to reference Colston KW, Perks CM, Xie SP, Holly JM. Growth inhibition of both MCF-7 and Hs578T human breast cancer cell lines by vitamin D analogues is associated with increased expression of insulin-like growth factor binding protein-3. J Mol Endocrinol. 1998;20:157–162.PubMedCrossRef Colston KW, Perks CM, Xie SP, Holly JM. Growth inhibition of both MCF-7 and Hs578T human breast cancer cell lines by vitamin D analogues is associated with increased expression of insulin-like growth factor binding protein-3. J Mol Endocrinol. 1998;20:157–162.PubMedCrossRef
41.
go back to reference Brosseau C, Pirianov G, Colston KW. Role of insulin-like growth factor binding protein-3 in 1, 25-dihydroxyvitamin-d 3-induced breast cancer cell apoptosis. Int J Cell Biol. 2013;2013:960378.PubMedCentralPubMedCrossRef Brosseau C, Pirianov G, Colston KW. Role of insulin-like growth factor binding protein-3 in 1, 25-dihydroxyvitamin-d 3-induced breast cancer cell apoptosis. Int J Cell Biol. 2013;2013:960378.PubMedCentralPubMedCrossRef
42.
go back to reference Oh YS, Kim EJ, Schaffer BS, et al. Synthetic low-calcaemic vitamin D(3) analogues inhibit secretion of insulin-like growth factor II and stimulate production of insulin-like growth factor-binding protein-6 in conjunction with growth suppression of HT-29 colon cancer cells. Mol Cell Endocrinol. 2001;183:141–149.PubMedCrossRef Oh YS, Kim EJ, Schaffer BS, et al. Synthetic low-calcaemic vitamin D(3) analogues inhibit secretion of insulin-like growth factor II and stimulate production of insulin-like growth factor-binding protein-6 in conjunction with growth suppression of HT-29 colon cancer cells. Mol Cell Endocrinol. 2001;183:141–149.PubMedCrossRef
43.
go back to reference Martin JL, Baxter RC. Signalling pathways of insulin-like growth factors (IGFs) and IGF binding protein-3. Growth Factors. 2011;29:235–244.PubMedCrossRef Martin JL, Baxter RC. Signalling pathways of insulin-like growth factors (IGFs) and IGF binding protein-3. Growth Factors. 2011;29:235–244.PubMedCrossRef
Metadata
Title
Vitamin D Deficiency Adds an Element of Risk to Insulin Resistance in Colorectal Neoplasms
Authors
Myong Ki Baeg
Myung-Gyu Choi
Sun-Hye Ko
Bo-Geun Park
Kyung-Do Han
Jae Myung Park
Bo-In Lee
In-Seok Lee
Sang-Woo Kim
Publication date
01-08-2015
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 8/2015
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3644-6

Other articles of this Issue 8/2015

Digestive Diseases and Sciences 8/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine