Plasma 25-Hydroxyvitamin D₃ Levels in Colorectal Cancer Patients and Associations with Physical Activity

ABSTRACT

Physical activity (PA) and vitamin D are thought to affect colorectal cancer prognosis. The present study investigates associations between 25(OH)D₃ and PA in prospectively followed colorectal cancer patients in the ColoCare study. At 6, 12, and 24 mo after surgery, patients donated a blood sample, wore an accelerometer for 10 consecutive days, and completed a PA questionnaire. Plasma 25-hydroxyvitamin D₃ (25(OH)D₃) levels were measured by high-performance liquid chromatography. We tested associations using partial correlations and multivariate linear regression analysis, adjusted for season, age, and body mass index. A total of 137 assessments of 25(OH)D₃ levels and PA were conducted (58 at 6 mo, 51 at 12 mo, and 28 at 24 mo). More than 60% of the patients were vitamin D-deficient (25(OH)D₃ ≤20 ng/ml), independent of study time point. At 6-mo follow-up, accelerometry-based vigorous and moderate-to-vigorous PAs were positively associated with 25(OH)D₃ levels (P = 0.04; P = 0.006,). PA together with season was a significant predictor of elevated 25(OH)D₃ levels. Our results suggest that the majority of colorectal cancer patients may suffer from vitamin D deficiency. Engaging in PA may be an effective approach to increase their 25(OH)D₃ levels.

Acknowledgments

The authors thank all ColoCare study subjects, the entire ColoCare study team, and David Liesenfeld, who assisted in recruitment for the PA assessment. Furthermore, the authors would like to thank Dr. Yesilda Balavarca for her statistical advice.

Disclosure of Funding

This study was funded by the Lackas Foundation, the Division of Preventive Oncology (Prof. Dr. Ulrich) and the German Consortium of Translational Cancer Research (DKTK). Prof. Dr. Ulrich and Dr. Böhm were also funded by the Huntsman Cancer Foundation.

Conflict of Interest

There are no conflicts of interest to be declared.

Compliance with Ethical Standards

Funding

This study was funded by the Lackas Foundation, the Division of Preventive Oncology (Prof. Dr. Ulrich) and the German Consortium of Translational Cancer Research (DKTK). Prof. Dr. Ulrich and Dr. Böhm were also funded by the Huntsman Cancer Foundation.

Ethical Approval

All procedures performed in studies involving human subjects were in accordance with the ethical standards of the ethics committee Heidelberg and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual subjects included in the study.