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Vitamin D deficiency and tumor aggressiveness in gastroenteropancreatic neuroendocrine tumors
Endocrine ( IF 3.7 ) Pub Date : 2021-09-17 , DOI: 10.1007/s12020-021-02869-w
Barbara Altieri 1 , Luigi Barrea 2 , Roberta Modica 2 , Filomena Bottiglieri 2 , Federica de Cicco 2 , Giovanna Muscogiuri 2 , Luisa Circelli 3 , Giovanni Savarese 3 , Carolina Di Somma 2 , Silvia Savastano 2 , Annamaria Colao 2, 4 , Antongiulio Faggiano 5
Affiliation  

Purpose

Data regarding vitamin D status in patients affected by gastroenteropancreatic (GEP) neuroendocrine tumor (NET) are limited and often showing contrasting results. The aim of the study was to evaluate the incidence of vitamin D deficiency (<20 ng/mL) in GEP-NET patients and compare the 25-hydroxyvitamin D (25(OH)D) levels with clinicopathological parameters and clinical outcome.

Methods

A retrospective cross-sectional study including 75 low grade (G1-G2) GEP-NETs and 123 healthy controls matched for age, sex, and body mass index, was performed.

Results

GEP-NET patients had significantly lower 25(OH)D levels compared to controls (17.9 ± 7.8 vs 24.2 ± 7.7 ng/mL, p < 0.0001). Ileal NETs were associated to lower 25(OH)D levels compared to other primary tumor sites (p = 0.049) and small bowel resection posed a significant increased risk of severe vitamin D deficiency (OR = 2.81, 95% CI = 1.25–3.37, p = 0.018). No correlation with somatostatin analogs treatment was found. 25(OH)D levels were significantly lower in G2 compared to G1 GEP-NETs (15.6 ± 7.8 vs 19.9 ± 7.4 ng/mL, p = 0.016) and in patients with progressive disease (12.6 ± 5.7 ng/mL) compared to those with stable disease (mean 21.5 ± 8.2 ng/mL, p = 0.001) or tumor free after surgery (19.6 ± 7.3 ng/mL, p = 0.002). Patients with vitamin D deficiency and insufficiency had shorter progression-free survival compared to those with sufficiency (p = 0.014), whereas no correlation was found with disease-specific survival.

Conclusions

Vitamin D deficiency is highly prevalent among GEP-NETs and could be associated with high tumor grade and disease progression. Therefore, the monitoring of 25(OH)D levels is relevant in these patients and vitamin D supplementation should be considered in the management of GEP-NET patients with vitamin D deficiency or insufficiency.



中文翻译:

胃肠胰神经内分泌肿瘤中的维生素 D 缺乏和肿瘤侵袭性

目的

有关受胃肠胰 (GEP) 神经内分泌肿瘤 (NET) 影响的患者维生素 D 状态的数据有限,并且经常显示出对比的结果。该研究的目的是评估 GEP-NET 患者中维生素 D 缺乏症 (<20 ng/mL) 的发生率,并将 25-羟基维生素 D (25(OH)D) 水平与临床病理参数和临床结果进行比较。

方法

进行了一项回顾性横断面研究,包括 75 名低级别 (G1-G2) GEP-NET 和 123 名年龄、性别和体重指数相匹配的健康对照。

结果

与对照组相比,GEP-NET 患者的 25(OH)D 水平显着降低(17.9 ± 7.8 vs 24.2 ± 7.7 ng/mL,p  < 0.0001)。与其他原发肿瘤部位相比,回肠 NET 与较低的 25(OH)D 水平相关(p  = 0.049),小肠切除术显着增加了严重维生素 D 缺乏症的风险(OR = 2.81, 95% CI = 1.25–3.37, p  = 0.018)。未发现与生长抑素类似物治疗的相关性。与 GEP-NETs (15.6 ± 7.8 vs 19.9 ± 7.4 ng/mL, p  = 0.016) 和进展性疾病患者 (12.6 ± 5.7 ng/mL) 相比,G2 患者的 25(OH)D 水平显着低于 GEP-NETs (12.6 ± 5.7 ng/mL)疾病稳定(平均 21.5 ± 8.2 ng/mL,p  = 0.001)或术后无肿瘤(19.6 ± 7.3 ng/mL,p  = 0.002)。与维生素 D 缺乏和不足的患者相比,维生素 D 缺乏和不足的患者的无进展生存期较短(p  = 0.014),而与疾病特异性生存期没有相关性。

结论

维生素 D 缺乏症在 GEP-NET 中非常普遍,并且可能与高肿瘤等级和疾病进展有关。因此,在这些患者中监测 25(OH)D 水平是相关的,在维生素 D 缺乏或不足的 GEP-NET 患者的管理中应考虑补充维生素 D。

更新日期:2021-09-17
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