Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors Journal Article

Authors: Sheean, P; Arroyo, C.; Woo, J.; Schiffer, L.; Stolley, M
Article Title: Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors
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/m(2)], 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 (lt;30 ng/mL or lt;75 nmol/L) and the Institute of Medicine (lt;20 ng/mL or lt;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.
Keywords: vitamin D; Obesity; Breast cancer; African American; Serum 25(OH)D
Journal Title: Journal of the Academy of Nutrition and Dietetics
Volume: 118
Issue: 4
ISSN: 2212-2672; 2212-2672
Publisher: Academy of Nutrition and Dietetics. Published by Elsevier Inc  
Journal Place: United States
Date Published: 2018
Start Page: 568
End Page: 577
Language: eng
Notes: LR: 20180328; CI: Copyright (c) 2018; GR: P30 AG022849/AG/NIA NIH HHS/United States; GR: R01 CA154406/CA/NCI NIH HHS/United States; GR: R25 CA057699/CA/NCI NIH HHS/United States; JID: 101573920; NIHMS917984; OTO: NOTNLM; PMCR: 2019/04/01 00:00; 2017/04/28 00:00 [received]; 2017/10/13 00:00 [accepted]; 2019/04/01 00:00 [pmc-release]; 2018/01/07 06:00 [pubmed]; 2018/01/07 06:00 [medline]; 2018/01/07 06:00 [entrez]; ppublish