title: Plasma 25-hydroxyvitamin D3, folate and vitamin B12 biomarkers among international colorectal cancer patients: a pilot study.
abstract: Vitamin D and folate are associated with decreased colorectal cancer risk and their association with colorectal cancer prognosis is under investigation. We assessed the levels of plasma 25-hydroxyvitamin D3 (25(OH)D3), folate and vitamin B12 in an international pilot study in order to determine variability of these biomarkers based on geographical location. Plasma 25(OH)D3, folate and vitamin B12 concentrations were measured in 149 invasive, newly diagnosed colorectal cancer cases from Heidelberg (Germany), Seattle (WA, USA), and Tampa (FL, USA) and in ninety-one age- and sex-matched controls. Their associations with potential predictors were assessed using multivariate linear regression analyses. Plasma 25(OH)D3, folate and vitamin B12 concentrations differed by location. Other predictors were season for 25(OH)D3 and tumour stage (vitamin B12). Season-corrected average 25(OH)D3 concentrations were higher in Heidelberg (31·7 ng/ml; range 11·0-83·0 ng/ml) than in Seattle (23·3 ng/ml; range 4·0-80·0 ng/ml) and Tampa (21·1 ng/ml; range 4·6-51·6 ng/ml). In Heidelberg, a strong seasonal variation was observed. Folate (11·1 ng/ml) and vitamin B12 (395 pg/ml) concentrations in Heidelberg were lower than those in Seattle (25·3 ng/ml and 740 pg/ml, respectively) and Tampa (23·8 ng/ml and 522 pg/ml, respectively). Differences in plasma 25(OH)D3 and folate concentrations between Heidelberg and the US sites were observed, probably reflecting variation in outdoor activities and sun-avoidance behaviour during summer as well as in folic acid fortification and supplement use. Intra-site differences at each study location were greater than between-location variability, suggesting that individual health behaviours play a significant role. Nevertheless, the intra-site differences we observed may be due to chance because of the limited sample size. Our pilot study illustrates the value of an international cohort in studying colorectal cancer prognosis to discern geographical differences in a broad range of exposures.
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany ; Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ulrich
authors.affiliation: Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine and Siteman Cancer Center , St Louis, MO , USA.
authors.forename: Adetunji T
authors.initials: AT
authors.lastname: Toriola
authors.affiliation: H. LeeMoffitt Cancer Center , Tampa, FL , USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.affiliation: Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.affiliation: Department of Cancer Epidemiology , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chang-Claude
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Clare
authors.initials: C
authors.lastname: Abbenhardt
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Kotzmann
authors.affiliation: Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Song
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Owen
authors.affiliation: Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoffmeister
authors.affiliation: University of Heidelberg , Heidelberg , Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.affiliation: H. LeeMoffitt Cancer Center , Tampa, FL , USA.
authors.forename: David
authors.initials: D
authors.lastname: Shibata
authors.affiliation: Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Vickers
authors.affiliation: Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Rush
authors.affiliation: Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Makar
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Würtele
authors.affiliation: Division of Preventive Oncology , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Roswitha
authors.initials: R
authors.lastname: Haubner
authors.affiliation: H. LeeMoffitt Cancer Center , Tampa, FL , USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sellers
authors.affiliation: Fred Hutchinson Cancer Research Center , Seattle, WA , USA.
authors.forename: William
authors.initials: W
authors.lastname: Grady
keywords: 25(OH)D3, 25-hydroxyvitamin D3; Colorectal cancer; DACHS, Darmkrebs Chancen der Verhütung durch Screening; Folate; Survival; Vitamin B12; Vitamin D