title: Effects of supplemental vitamin D and calcium on biomarkers of inflammation in colorectal adenoma patients: a randomized, controlled clinical trial.
abstract: Vitamin D and calcium affect several pathways involved in inflammation, tumor growth, and immune surveillance relevant to carcinogenesis. Also, epidemiologic evidence indicates that calcium and vitamin D may reduce risk for developing colorectal adenomas and cancer. To investigate the effects of calcium and vitamin D on biomarkers of inflammation in colorectal adenoma patients, we conducted a pilot, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial (n = 92) of 2 g/d calcium and/or 800 IU/d vitamin D(3) supplementation versus placebo over 6 months. Plasma concentrations of proinflammatory markers [C-reactive protein (CRP), TNF-α, interleukin (IL)-6, IL-1β, and IL-8] and an anti-inflammatory marker (IL-10) were measured using ELISAs. After 6 months of treatment, in the vitamin D(3) supplementation group, CRP decreased 32% overall (P = 0.11), 37% in men (P = 0.05), and 41% among non-nonsteroidal anti-inflammatory drug (NSAID) users (P = 0.05) relative to placebo. In the vitamin D(3) supplementation group, TNF-α decreased 13%, IL-6 32%, IL-1β 50%, and IL-8 15%; in the calcium supplementation group, IL-6 decreased 37%, IL-8 11%, and IL-1β 27%. Although these changes were not statistically significant, a combined inflammatory markers z-score decreased 77% (P = 0.003) in the vitamin D(3) treatment group overall, 83% (P = 0.01) among men, and 48% among non-NSAID users (P = 0.01). There was no evidence of synergy between vitamin D(3) and calcium or effects on IL-10. These preliminary results are consistent with a pattern of reduction in tumor-promoting inflammation biomarkers with vitamin D(3) or calcium supplementation alone and support further investigation of vitamin D(3) as a chemopreventive agent against inflammation and colorectal neoplasms.
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
authors: Myfanwy H
authors: MH
authors: Hopkins
authors: Joy
authors: J
authors: Owen
authors: Thomas
authors: T
authors: Ahearn
authors: Veronika
authors: V
authors: Fedirko
authors: W Dana
authors: WD
authors: Flanders
authors: Dean P
authors: DP
authors: Jones
authors: Roberd M
authors: RM
authors: Bostick
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002118:Calcium / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000178:diet therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D014408:Biomarkers, Tumor; D018836:Inflammation Mediators; D014807:Vitamin D; D002118:Calcium