Retrospective Analysis of Vitamin D Levels in Patients with Chronic Renal Failure, Obesity, and Cancer

Öz

OBJECTIVE: In our study, it was purposed to research the distribution of vitamin D according to age, sex, and seasons of the
patients diagnosed with obesity, cancer, and chronic renal failure who applied to Inonu University Turgut Ozal Medical Center
between 2018-2021.
MATERIALS AND METHODS: In our descriptive study, vitamin D measurements from 01.01.2018-01.01.2021 users who visited
Inonu University Turgut Ozal Medical Center and were diagnosed with obesity, cancer, and chronic renal failure were scanned in
their files and assessed retrospectively. The patients were grouped according to their sex, age, and seasons in which the samples
were taken. 25(OH)D levels were analyzed by LC-MS/MS method. The patients were classified as deficient, inadequate, and
normal in terms of vitamin D level
RESULTS: Vitamin D deficiency was monitored in 54.9% (n = 981) of 1787 cancer patients admitted to our hospital, 63.3% (n =
558) of 882 chronic renal failure patients, and 65.8% (n = 1903) of 2894 obese patients.
CONCLUSION: Of the 5563 obesity, cancer, and chronic renal failure patients who applied to our hospital; vitamin D deficiency
was found in 61.9% (n = 3442), vitamin D deficiency was found in 23.1% (n = 1284), while vitamin D level was found to be normal
in only 15% (n = 837). In terms of vitamin D deficiency, the highest deficiency was seen in obese patients with a rate 

Anahtar Kelimeler

• vitamin d
• cancer
• obesity

Kronik Böbrek Yetmezliği, Obezite ve Kanser Hastalarında Vitamin D Düzeyleri Üzerine Bir İnceleme

Öz

Amaç: Çalışmamızda 2018-2021 yılları arasında Turgut Özal Tıp Merkezine başvuran obezite, kanser ve KBY tanılı hastaların yaş, cinsiyet ve mevsimlere göre vitamin D düzeylerinin dağılımının incelenmesi amaçlandı. Gereç ve Yöntem: Tanımlayıcı tipte olan çalışmamızda 01.01.2018-01.01.2021 tarihleri arasında İnönü Üniversitesi (İÜ) Turgut Özal Tıp Merkezine başvuran obezite, kanser ve KBY tanılı vitamin D seviyeleri ölçülen hastaların dosyaları taranarak retrospektif olarak değerlendirildi. Hastalar örneklerin alındığı mevsimlere, cinsiyetlerine ve yaşlarına göre gruplandırıldı. 25(OH)D vitamini düzeyleri LC-MS/MS yöntemi ile analiz edildi. Hastalar vitamin D düzeyi bakımından eksik, yetersiz ve normal olanlar olarak sınıflandırıldı. Bulgular: Hastanemize başvuran 1787 kanser hastasının %54,9’unda (n=981); 882 KBY hastasının %63,3’ünde (n=558) ve 2894 obezite hastasının %65,8’inde (n=1903) vitamin D eksikliği tespit edildi. Hastalıklara göre vitamin D düzeyleri arasında anlamlı bir fark vardı (p<0.001). Sonuç: Hastanemize başvuran toplam 5563 obezite, kanser ve KBY hastasının; %61,9’unda (n=3442) vitamin D eksikliği, %23,1’inde (n=1284) vitamin D yetersizliği tespit edilirken, sadece %15'inde (n=837) vitamin D seviyesi normal olarak bulundu. Vitamin D eksikliği bakımından %57 oranla en fazla eksiklik obezite hastalarında görüldü. Çalışmamızda vitamin D düzeylerinin incelenen hastalıklara, mevsimlere ve yaş gruplarına bağlı olarak değiştiği görüldü.

Anahtar Kelimeler

• Vitamin D
• kanser
• kronik böbrek yetmezliği
• obezite

Kaynakça

1. 1. Wacker M, Holiack MF. Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5(1):111–48.
2. 2. Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Patel K, et al. Vitamin D and Cardiometabolic Outcomes: A Systematic Review Anastassios. Ann Intern Med. 2011;152(5):307–14.
3. 3. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011;86(1):50–60.
4. 4. Hossein-nezhad A, Spira A, Holick MF. Influence of Vitamin D Status and Vitamin D3 Supplementation on Genome Wide Expression of White Blood Cells: A Randomized Double-Blind Clinical Trial. PLoS One. 2013;8(3).
5. 5. Holick MF. Medical progress: Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81.
6. 6. Yavuz D, Mete T, Yavuz R, Altunoğlu A. D Vitamini, Kalsiyum & Mineral Metabolizması, D Vitaminin İskelet Dışı Etkileri ve Kronik Böbrek Yetmezliğinde Nütrisyonel D Vitamini Kullanımı. Ankara Med J. 2014;14(4):162–71.
7. 7. Marquardt P, Krause R, Schaller M, Bach D, Von Gersdorff G. Vitamin D status and cancer prevalence of hemodialysis patients in Germany. Anticancer Res. 2015;35(2):1181–7.
8. 8. Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez H, et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2007;72(8):1004–13.

9. 9. Elder GJ. Vitamin D levels, bone turnover and bone mineral density show seasonal variation in patients with chronic kidney disease stage 5. Nephrology. 2007;12(2):208.
10. 10. Yao Y, Zhu L, He L, Duan Y, Liang W, Nie Z, et al. A meta-analysis of the relationship between vitamin D deficiency and obesity. International journal of clinical and experimental medicine. 2015;8(9):14977–84.
11. 11. Vimaleswaran KS, Berry DJ, Lu C, Tikkanen E, Pilz S, Hiraki LT, et al. Causal Relationship between Obesity and Vitamin D Status: Bi-Directional Mendelian Randomization Analysis of Multiple Cohorts. PLoS Med. 2013;10(2).
12. 12. McGill AT, Stewart JM, Lithander FE, Strik CM, Poppitt SD. Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutr J. 2008;7(1):3–7.
13. 13. Ding C, Gao D, Wilding J, Trayhurn P, Bing C. Vitamin D signalling in adipose tissue. Br J Nutr. 2012;108(11):1915–23.
14. 14. Pereira-Santos M, Costa PRF, Assis AMO, Santos CAST, Santos DB. Obesity and vitamin D deficiency: A systematic review and meta-analysis. Obes Rev. 2015;16(4):341–9.
15. 15. Saneei P, Salehi-Abargouei A, Esmaillzadeh A. Serum 25-hydroxy vitamin D levels in relation to body mass index: A systematic review and meta-analysis. Obes Rev. 2013;14(5):393–404.
16. 16. Lagunova Z, Porojnicu LC, Lindberg F, Hexeberg S, Moan J. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res. 2009;29(9):3713–20.
17. 17. Ernst B, Thurnheer M, Schmid SM, Wilms B, Schultes B. Seasonal variation in the deficiency of 25-hydroxyvitamin d3 in mildly to extremely obese subjects. Obes Surg. 2009;19(2):180–3.
18. 18. Bischof MG, Heinze G, Vierhapper H. Vitamin D status and its relation to age and body mass index. Horm Res. 2006;66(5):211–5.
19. 19. Park S, Ham JO, Lee BK. A positive association of vitamin D deficiency and sarcopenia in 50 year old Female, but not men. Clin Nutr. 2014;33(5):900–5.
20. 20. B Öngen, C Kabaroğlu ZP. D Vitamini’nin Biyokimyasal ve Laboratuvar De¤erlendirmesi Biochemical. Cailiao Gongcheng/Journal Mater Eng. 2009;6(7):23–31.
21. 21. Li M, Chen P, Li J, Chu R, Xie D, Wang H. Review: The impacts of circulating 25-Hydroxyvitamin D levels on cancer patient outcomes: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2014;99(7):2327–36.
22. 22. Urbschat A, Paulus P, von Quernheim QF, Brück P, Badenhoop K, Zeuzem S, et al. Vitamin D hydroxylases CYP2R1, CYP27B1 and CYP24A1 in renal cell carcinoma. Eur J Clin Invest. 2013;43(12):1282–90.
23. 23. Feldman D, Krishnan A V., Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14(5):342–57.
24. 24. Sofi NY, Jain M, Kapil U, Seenu V, R. L, Yadav CP, et al. Reproductive factors, nutritional status and serum 25(OH)D levels in Female with breast cancer: A case control study. J Steroid Biochem Mol Biol. 2018;175:200–4.
25. 25. Shi L, Nechuta S, Gao YT, Zheng Y, Dorjgochoo T, Wu J, et al. Correlates of 25-hydroxyvitamin D among Chinese breast cancer patients. PLoS One. 2014;9(1):14–6.
26. 26. Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JAE, et al. The nonskeletal effects of vitamin D: An endocrine society scientific statement. Endocr Rev. 2012;33(3):456–92.
27. 27. Zhang Y, Fang F, Tang J, Jia L, Feng Y, Xu P, et al. Association between Vitamin D supplementation and mortality: Systematic review and meta-analysis. BMJ. 2019;366.
28. 28. John EM, Dreon DM, Koo J, Schwartz GG. Residential sunlight exposure is associated with a decreased risk of prostate cancer. J Steroid Biochem Mol Biol. 2004;89–90:549–52.
29. 29. Hanchette CL, Schwartz GG. Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation. Cancer. 1992;70(12):2861–9.
30. 30. Freedman DM, Dosemeci M, McGlynn K. Sunlight and mortality from breast, ovarian, colon, prostate, and non-melanoma skin cancer: A composite death certificate based case-control study. Occup Environ Med. 2002;59(4):257–62.
31. 31. Robsahm TE, Tretli S, Dahlback A, Moan J. Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control. 2004;15(2):149–58.
32. 32. Hekimsoy Z, Dinç G, Kafesçiler S, Onur E, Güvenç Y, Pala T, et al. Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health. 2010;10.
33. 33. Mansoor S, Habib A, Ghani F, Fatmi Z, Badruddin S, Mansoor S, et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clin Biochem. 2010;43(18):1431–5.
34. 34. Brot C, Vestergaard P, Kolthoff N, Gram J, Hermann AP, Sørensen OH. Vitamin D status and its adequacy in healthy Danish perimenopausal Female: relationships to dietary intake, sun exposure and serum parathyroid hormone. Br J Nutr. 2001;86(S1):S97–103.
35. 35. Öğüş E, Sürer H, Kılınç AŞ, Fidancı V, Yılmaz G, Dindar N, et al. D Vitamini Düzeylerinin Aylara, Cinsiyete ve Yaşa Göre Değerlendirilmesi. Ankara Med J. 2015;15(1):1–5.
36. 36. Telo S, Kaman D, Akgöl G. Klinik Araştırma Elazığ İlinde D Vitamini Düzeylerinin Yaş, Cinsiyet ve Mevsimlere Göre Değişimi. Firat Med J. 2017;22(1):29–33.
37. 37. Çatak Z. Elazığ Bölgesinin 25 Hidroksivitamin D Düzeylerinin Değerlendirilmesi ve Populasyona Dayalı Yeni Referans Aralıklarının Belirlenmesi. 2018;23(1):6–10.