Faculty Collaboration Database

Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors. J Acad Nutr Diet 2018 Apr;118(4):568-577

Date

01/07/2018

Pubmed ID

29305131

Pubmed Central ID

PMC5869090

DOI

10.1016/j.jand.2017.10.009

Scopus ID

2-s2.0-85039808167 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors.

OBJECTIVES: To determine the prevalence of low serum 25(OH)D in an exclusively African-American cohort of female breast cancer survivors with overweight/obesity and to evaluate the role of ultraviolet (UV) light exposure, body composition, and dietary sources of vitamin D on serum 25(OH)D levels.

DESIGN: Cross-sectional.

PARTICIPANTS: Pre- and postmenopausal African-American breast cancer survivors (n=244) were recruited from various neighborhoods in the city of Chicago, IL, between September 2011 and September 2014 for a larger weight loss trial.

MAIN OUTCOME MEASURES: Demographic, clinical, anthropometric (body mass index [calculated as kg/m²], waist circumference, and hip circumference), blood specimen, dietary intake (food frequency questionnaire), and sun behavior data were collected by trained study personnel before trial participation. Dual-energy x-ray absorptiometry was used to quantify adiposity (total, percentage, regional, visceral) and lean mass. Serum 25(OH)D was used as the biomarker reflective of vitamin D status.

STATISTICAL ANALYSES: Mean (±standard deviation), frequencies, and multivariate linear regression modeling.

RESULTS: The average participant was 57.4 years old (±10.0), 6.9 years (±5.2) from initial breast cancer diagnosis with a body mass index of 36.2 (±6.2). The majority of participants (60%) reported habitual oral vitamin D supplementation with mean intake of 327 IU (±169). Vitamin D deficiency was prevalent in 81% and 43%, when the cut points of the Endocrine Society (<30 ng/mL or <75 nmol/L) and the Institute of Medicine (<20 ng/mL or <50 nmol/L) were applied, respectively. A multivariate model adjusting for age, seasonality of blood draw, total energy intake, use of supplemental vitamin D, darker skin pigmentation, breast cancer stage, and waist-to-hip ratio was able to explain 28.8% of the observed variance in serum 25(OH)D concentrations. No significant associations were detected for body mass index or any dual-energy x-ray absorptiometry measures of body composition.

CONCLUSIONS: Considering the number of women who endorsed use of vitamin D supplementation, the prevalence of vitamin D deficiency among these African-American breast cancer survivors was high. Vitamin D supplementation, sun behavior, and waist-to-hip ratio may serve as future points of intervention to improve the vitamin D status of this minority survivor population.

Author List

Sheean P, Arroyo C, Woo J, Schiffer L, Stolley M

Author

Melinda Stolley PhD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Breast Neoplasms
Cancer Survivors
Chicago
Cross-Sectional Studies
Dietary Supplements
Female
Humans
Middle Aged
Nutritional Status
Prevalence
Vitamin D
Vitamin D Deficiency