title: Calcium, vitamin D, and apoptosis in the rectal epithelium.
abstract: OBJECTIVE
  Decreased apoptosis in the colon is potentially an early indicator of colon cancer risk and may be influenced by calcium and vitamin D. This report describes the associations of calcium intake and 25-hydroxyvitamin D levels with apoptosis in colorectal epithelium.
  
  
  METHODS
  Consecutive patients undergoing colonoscopies were recruited for a study designed to examine risk and etiologic factors for colorectal adenomas. Diet was assessed by food frequency questionnaire, and in one subpopulation, serum 25-hydroxyvitamin D levels were measured using an enzyme immunoassay. Apoptosis was scored from normal rectal mucosal pinch biopsies. Linear and logistic regression analyses were used to examine associations between calcium, serum vitamin D, and apoptotic scores. Data were available for 498 and 280 patients for the calcium and vitamin D analyses, respectively.
  
  
  RESULTS
  Associations of calcium intake and vitamin D with apoptosis were modified by adenoma case-status. In an adjusted logistic regression model, patients with adenomas in the highest versus lowest tertile of dietary calcium intake had 3.4 times higher odds [95% confidence interval (CI), 0.9-12.9] of elevated apoptotic scores. In adenoma-free patients, high calcium intake was not related to apoptosis (OR, 1.2; 95% CI, 0.6-2.7). In contrast, the highest level of 25-hydroxyvitamin D was associated with higher apoptosis in adenoma-free patients (OR, 2.6; 95% CI, 1.1-6.2) and slightly lower levels in patients with adenomas (OR, 0.6; 95% CI, 0.2-2.2).
  
  
  CONCLUSIONS
  These results are consistent with a calcium and vitamin D-mediated apoptotic mechanism in colon carcinogenesis.
authors.affiliation: Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7555, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Miller
authors.forename: Temitope O
authors.initials: TO
authors.lastname: Keku
authors.forename: Jessie A
authors.initials: JA
authors.lastname: Satia
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Martin
authors.forename: Joeseph A
authors.initials: JA
authors.lastname: Galanko
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
mesh_terms: D000236:Adenoma / Q000378:metabolism* / Q000473:pathology*; D017209:Apoptosis; D002118:Calcium / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000378:metabolism / Q000473:pathology; D014807:Vitamin D / Q000378:metabolism*
chemical_list: D014807:Vitamin D; D002118:Calcium