Gut barrier dysfunction promotes chronic inflammation, contributing to several gastrointestinal diseases, including colorectal cancer. Preliminary evidence suggests that vitamin D and calcium could prevent colorectal carcinogenesis in part by influencing gut barrier function. However, relevant human data are scarce. We tested the effects of supplemental calcium (1,200 mg/day) and/or vitamin D3 (1,000 IU/day) on circulating concentrations of biomarkers of gut permeability (anti-flagellin and anti-lipopolysaccharide immunoglobulins A and G, measured via enzyme-linked immunosorbent assay) from baseline to 1 and 3 or 5 years post baseline among 175 colorectal adenoma patients in a randomized, double-blinded, placebo-controlled clinical trial. We also assessed factors associated with baseline concentrations of these biomarkers. We found no appreciable effects of supplemental vitamin D3 and/or calcium on individual or aggregate biomarkers of gut permeability. At baseline, a combined permeability score (the summed concentrations of all four biomarkers) was 14% lower among women (P = 0.01) and 10% higher among those who consumed >1 serving/day of red or processed meats relative to those who consumed none (Ptrend = 0.03). The permeability score was estimated to be 49% higher among participants with a body mass index (BMI) >35 kg/m2 relative to those with a BMI <22.5 kg/m2 (Ptrend = 0.17). Our results suggest that daily supplemental vitamin D3 and/or calcium may not modify circulating concentrations of gut permeability biomarkers within 1 or 3 to 5 years, but support continued investigation of modifiable factors, such as diet and excess adiposity, that could affect gut permeability.

中文翻译：

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补充钙和维生素 D 对结肠腺瘤患者肠道屏障功能循环生物标志物的影响：一项随机临床试验

肠道屏障功能障碍会促进慢性炎症，导致多种胃肠道疾病，包括结直肠癌。初步证据表明，维生素 D 和钙可以部分通过影响肠道屏障功能来预防结直肠癌的发生。然而，相关的人类数据却很少。我们测试了补充钙（1,200 毫克/天）和/或维生素 D3（1,000 IU/天）对肠道通透性生物标志物（抗鞭毛蛋白和抗脂多糖免疫球蛋白 A 和 G）循环浓度的影响，通过酶联法测量在一项随机、双盲、安慰剂对照临床试验中，对 175 名结直肠腺瘤患者进行了从基线到基线后 1、3 或 5 年的免疫吸附测定。我们还评估了与这些生物标志物基线浓度相关的因素。我们发现补充维生素 D3 和/或钙对肠道通透性的个体或总体生物标志物没有明显影响。在基线时，与食用红肉或加工肉类的女性相比，每天食用 > 1 份红肉或加工肉类的女性的综合渗透性评分（所有四种生物标志物的浓度总和）低 14%（P = 0.01），高 10%无（Ptrend = 0.03）。据估计，体重指数 (BMI) > 35 kg/m2 的参与者的渗透性评分比 BMI <22.5 kg/m2 的参与者高 49% (Ptrend = 0.17)。我们的结果表明，每日补充维生素 D3 和/或钙可能不会在 1 或 3 至 5 年内改变肠道通透性生物标志物的循环浓度，但支持继续研究可能影响肠道通透性的可改变因素，例如饮食和过度肥胖。