Highlights
- •Pre-treatment vitamin D was associated with inflammatory biomarkers in PDAC.
- •Vitamin D deficiency was associated with increased levels of IL-6, YKL-40 and CRP.
- •Vitamin D deficiency yielded a short survival in patients with early stage.
- •Vitamin D deficiency did not influence survival in patients with advanced stage.
Abstract
Background
Vitamin D deficiency and inflammation are associated with increased mortality. We
investigated the relationship between pre-treatment serum vitamin D levels, inflammatory
biomarkers (IL-6, YKL-40 and CRP) and overall survival (OS) in pancreatic ductal adenocarcinoma
(PDAC) patients.
Methods
Pre-treatment serum vitamin D, IL-6, YKL-40 and CRP levels were determined in 1,267
patients with PDAC enrolled from July 2008 to September 2018 in the prospective BIOPAC
study (NCT03311776). The patients were grouped according to vitamin D levels: sufficient
>50 nmol/L, insufficient 25–50 nmol/L and deficient <25 nmol/L.
Results
Across all tumour stages, vitamin D-deficient patients had the highest median levels
of IL-6 (8.3 pg/mL, range 0.7–91), YKL-40 (177 ng/ml, range 25–5279) and CRP (15.5 mg/L,
range 0.8–384). The resected stage I and II patients with vitamin D deficiencies had
a shorter median OS, 18.3 months (95% CI, 12.1–31.5 months) than those with sufficient
levels, 29.7 months (95% CI, 22.3–36.1 months), and the hazard ratio for death was
1.55 (95% CI, 1.04–2.31; p = 0.03). In advanced PDAC, there was no significant difference in OS between the
vitamin D groups.
Conclusions
Vitamin D deficiency was associated with increased inflammatory biomarkers in all
PDAC stages. The resected stage I and II patients with sufficient vitamin D levels
had a higher OS than those with a vitamin D deficiency. However, there was no correlation
between vitamin D levels and survival in advanced PDAC. Future studies need to investigate
vitamin D supplementation effects on survival in PDAC.
Keywords
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Article info
Publication history
Published online: December 17, 2020
Accepted:
October 30,
2020
Received:
August 19,
2020
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter re: Pre-treatment serum vitamin D deficiency is associated with increased inflammatory biomarkers and short overall survival in patients with pancreatic cancer: Analysis of the prognostic effect of serum vitamin D on pancreatic cancer: Several confoundersEuropean Journal of CancerVol. 158
- PreviewWith great interest, we read the paper entitled ‘Pre-treatment serum vitamin D deficiency is associated with increased inflammatory biomarkers and short overall survival in patients with pancreatic cancer’ by Rasmussen et al. [1], which investigated the correlations between pre-treatment serum vitamin D levels and serum inflammatory markers and survival in patients with pancreatic cancer. The findings suggested that vitamin D deficiency was associated with elevated markers of inflammation in all pancreatic cancer stages.
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- Response to the letter entitled: Re: Pre-treatment serum vitamin D deficiency is associated with increased inflammatory biomarkers and short overall survival in patients with pancreatic cancer: Analysis of the prognostic effect of serum vitamin D on pancreatic cancer: Several confoundersEuropean Journal of CancerVol. 158