Vitamin D and Calcium Supplement Use and High-Risk Breast Cancer: A Case–Control Study among BRCA1 and BRCA2 Mutation Carriers
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Assessment of Supplement Use
2.4. Assessment of Case and Control Status
2.5. Subject Selection
2.6. Statistical Analysis
3. Results
3.1. Subject Characteristics
3.2. Vitamin D Supplement Use and Breast Cancer
3.3. Calcium Supplement Use and Breast Cancer
3.4. Joint Effects of Vitamin D and Calcium and Breast Cancer
3.5. Quantitative Bias Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Cases | Controls | p a |
---|---|---|---|
(n = 134) | (n = 276) | ||
Age at breast cancer diagnosis (year) | 41.5 ± 8.3 b | ||
Age (year) c | 41.5 ± 8.3 | 42.7 ± 12.2 | 0.24 |
Mutation (%) | 0.15 | ||
BRCA1 | 61.9 | 54.3 | |
BRCA2 | 38.1 | 45.7 | |
BMI (kg/m2) | 26.4 ± 5.7 | 24.9 ± 4.7 | 0.01 |
Age at menarche (year) | 12.4 ± 1.4 | 12.6 ± 1.5 | 0.13 |
Menopausal status (%) | 0.01 | ||
Premenopausal | 78.1 | 65.6 | |
Postmenopausal | 21.9 | 34.4 | |
Oral contraceptive use | 0.42 | ||
Never | 15.6 | 19.0 | |
Ever | 84.4 | 81.0 | |
Parity (%) d | 0.0004 | ||
0 | 17.9 | 32.6 | |
1–2 | 61.9 | 41.7 | |
≥3 | 20.2 | 25.7 | |
Prophylactic bilateral oophorectomy (%) | 6.8 | 12.0 | 0.11 |
Alcohol consumption (%) | 0.16 | ||
Never | 25.4 | 19.3 | |
Ever | 74.6 | 80.7 | |
Smoking status (%) | 0.07 | ||
Never | 55.2 | 64.5 | |
Ever | 44.8 | 35.5 | |
Multivitamin supplement use (%) | 0.12 | ||
Never | 76.9 | 69.2 | |
Ever | 23.1 | 30.8 | |
Prenatal supplement use (%) e | 0.16 | ||
Never | 54.1 | 45.7 | |
Ever | 45.9 | 54.3 | |
Vitamin D | |||
Vitamin D-specific supplement use (%) | 7.7 | 15.0 | 0.05 |
Vitamin D-containing supplement use (%) | 60.2 | 68.5 | 0.11 |
Total average daily vitamin D supplement use (mcg/day) | 2.5 ± 5.0 | 4.6 ± 8.4 | 0.01 |
Calcium | |||
Calcium-specific supplement use (%) | 3.4 | 8.7 | 0.06 |
Calcium-containing supplement use (%) | 60.3 | 66.5 | 0.25 |
Total average daily calcium supplement use (mg/day) | 36.9 ± 75.9 | 65.6 ± 126.6 | 0.02 |
Cases/Controls | OR (95% CI) Basic Model a | p | OR (95% CI) Multivariable Model b | p | |
---|---|---|---|---|---|
Any vitamin D-containing supplement use c | |||||
All Participants | |||||
Never | 47/79 | Ref. | Ref. | Ref. | Ref. |
Ever | 71/172 | 0.70 (0.44, 1.10) | 0.12 | 0.54 (0.31, 0.91) | 0.02 |
BRCA1 | |||||
Never | 30/41 | Ref. | Ref. | Ref. | Ref. |
Ever | 41/94 | 0.60 (0.33, 1.10) | 0.10 | 0.40 (0.20, 0.81) | 0.01 |
BRCA2 | |||||
Never | 17/38 | Ref. | Ref. | Ref. | Ref. |
Ever | 30/78 | 0.86 (0.42, 1.75) | 0.67 | 0.79 (0.35, 1.78) | 0.57 |
Total average daily vitamin D supplement use (mcg/day) c | |||||
All Participants | |||||
None | 46/79 | Ref. | Ref. | Ref. | Ref. |
1.07 ≤ 7.50 | 26/44 | 1.03 (0.56, 1.90) | 0.91 | 0.72 (0.35, 1.46) | 0.36 |
>7.50 | 22/75 | 0.51 (0.28, 0.92) | 0.03 | 0.44 (0.22, 0.89) | 0.02 |
p-trend per mcg increase in vitamin D | 0.03 | 0.04 | |||
BRCA1 | |||||
None | 29/41 | Ref. | Ref. | Ref. | Ref. |
1.07 ≤ 7.50 | 17/20 | 1.19 (0.53, 2.65) | 0.68 | 0.74 (0.30, 1.86) | 0.53 |
>7.50 | 11/42 | 0.37 (0.16, 0.84) | 0.02 | 0.28 (0.11, 0.71) | 0.007 |
p-trend per mcg increase in vitamin D | 0.03 | 0.01 | |||
BRCA2 | |||||
None | 17/38 | Ref. | Ref. | Ref. | Ref. |
1.07 ≤ 7.50 | 9/24 | 0.87 (0.33, 2.27) | 0.77 | 0.66 (0.22, 1.97) | 0.46 |
>7.50 | 11/33 | 0.75 (0.31, 1.84) | 0.53 | 0.82 (0.29, 2.27) | 0.70 |
p-trend per mcg increase in vitamin D | 0.41 | 0.63 |
Cases/Controls | OR (95% CI) Basic Model a | p | OR (95% CI) Multivariable Model b | p | |
---|---|---|---|---|---|
Any calcium-containing supplement use c | |||||
All Participants | |||||
Never | 46/86 | Ref. | Ref. | Ref. | Ref. |
Ever | 70/171 | 0.77 (0.49, 1.22) | 0.27 | 0.61 (0.36, 1.05) | 0.07 |
BRCA1 | |||||
Never | 32/44 | Ref. | Ref. | Ref. | Ref. |
Ever | 41/95 | 0.60 (0.33, 1.08) | 0.09 | 0.41 (0.21, 0.81) | 0.01 |
BRCA2 | |||||
Never | 14/42 | Ref. | Ref. | Ref. | Ref. |
Ever | 29/76 | 1.15 (0.55, 2.41) | 0.72 | 1.13 (0.49, 2.63) | 0.77 |
Total average daily calcium supplement use (mg/day) c | |||||
All Participants | |||||
None | 45/86 | Ref. | Ref. | Ref. | Ref. |
15.63 ≤ 105.88 | 24/45 | 1.02 (0.55, 1.90) | 0.94 | 0.71 (0.35, 1.44) | 0.34 |
>105.88 | 24/76 | 0.61 (0.34, 1.09) | 0.09 | 0.56 (0.28, 1.09) | 0.09 |
p-trend per mg increase in calcium | 0.05 | 0.04 | |||
BRCA1 | |||||
None | 31/44 | Ref. | Ref. | Ref. | Ref. |
15.63 ≤ 105.88 | 14/24 | 0.81 (0.36, 1.81) | 0.60 | 0.50 (0.20, 1.25) | 0.14 |
>105.88 | 14/39 | 0.50 (0.23, 1.08) | 0.08 | 0.38 (0.16, 0.91) | 0.03 |
p-trend per mg increase in calcium | 0.08 | 0.05 | |||
BRCA2 | |||||
None | 14/42 | Ref. | Ref. | Ref. | Ref. |
15.63 ≤ 105.88 | 10/21 | 1.47 (0.56, 3.86) | 0.44 | 1.17 (0.39, 3.48) | 0.78 |
>105.88 | 10/37 | 0.80 (0.32, 2.03) | 0.64 | 1.00 (0.35, 2.84) | 0.99 |
p-trend per mg increase in calcium | 0.31 | 0.54 |
Supplement Use | Cases/Controls | OR (95% CI) Basic Model a | p | OR (95% CI) Multivariable Model b | p |
---|---|---|---|---|---|
Never vitamin D user/never calcium user | 43/76 | Ref. | Ref. | Ref. | Ref. |
Ever calcium use only | 1/3 | 0.57 (0.06, 5.80) | 0.64 | 0.80 (0.07, 9.24) | 0.86 |
Ever vitamin D use only | 1/7 | 0.24 (0.03, 2.04) | 0.19 | 0.28 (0.03, 2.60) | 0.26 |
Ever vitamin D use/ever calcium use | 69/164 | 0.75 (0.47, 1.20) | 0.24 | 0.60 (0.34, 1.03) | 0.07 |
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Guyonnet, E.; Kim, S.J.; Pullella, K.; Zhang, C.X.W.; McCuaig, J.M.; Armel, S.; Narod, S.A.; Kotsopoulos, J. Vitamin D and Calcium Supplement Use and High-Risk Breast Cancer: A Case–Control Study among BRCA1 and BRCA2 Mutation Carriers. Cancers 2023, 15, 2790. https://doi.org/10.3390/cancers15102790
Guyonnet E, Kim SJ, Pullella K, Zhang CXW, McCuaig JM, Armel S, Narod SA, Kotsopoulos J. Vitamin D and Calcium Supplement Use and High-Risk Breast Cancer: A Case–Control Study among BRCA1 and BRCA2 Mutation Carriers. Cancers. 2023; 15(10):2790. https://doi.org/10.3390/cancers15102790
Chicago/Turabian StyleGuyonnet, Emma, Shana J. Kim, Katherine Pullella, Cindy X. W. Zhang, Jeanna M. McCuaig, Susan Armel, Steven A. Narod, and Joanne Kotsopoulos. 2023. "Vitamin D and Calcium Supplement Use and High-Risk Breast Cancer: A Case–Control Study among BRCA1 and BRCA2 Mutation Carriers" Cancers 15, no. 10: 2790. https://doi.org/10.3390/cancers15102790