title: Gender- and site-specific differences of colorectal neoplasia relate to vitamin D.
abstract: BACKGROUND
  The effect of vitamin D on colorectal adenomas may vary with regard to gender, localisation and histological type of the lesion.
  
  
  OBJECTIVE
  To define the role of vitamin D and gender in a Caucasian cohort of subjects undergoing screening colonoscopy after consideration of established risk factors.
  
  
  METHODS
  One thousand five hundred and thirty-two subjects (813 males, 58.8 ± 9.7 years; 719 females, 59.7 ± 10.7 years) were allocated to tertiles of 25-hydroxyvitamin D3 [25(OH)D3 ] serum concentrations. The number, localisation, size and histology of the detected colonic lesions were recorded.
  
  
  RESULTS
  Among men, no association was found between vitamin D and the total number, size and histological stage of adenomas at any site. In female subjects, less women with adenomas were found in the highest vitamin D tertile (N = 42/239; 17.2%) as compared to the low vitamin D group (N = 60/240; 25.0%; P = 0.035). In particular, the number of women with adenomas in the proximal colon was significantly lower in the highest tertile (N = 21/239, 8.8%) compared to the low vitamin D group (N = 41/240; 17.1%; P = 0.007). The rates at other sites were not different. The inverse association of vitamin D serum concentrations with the presence of adenomas in the proximal colon was maintained after adjustment for potential confounders. In 80 women on vitamin D supplementation, the rate of adenomas was lower compared to those not on supplementation (3/80; 3.8%; vs. 90/719; 12.5%; P = 0.016).
  
  
  CONCLUSIONS
  A potential preventive effect of vitamin D on colorectal adenomas was found in the proximal colon in women. This observation is supported by further decrease of lesions in the proximal colon of women on vitamin D supplementation.
authors.affiliation: Department of Internal Medicine, Oberndorf Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria; First Department of Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria; Obesity Research Unit, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Aigner
authors.forename: A
authors.initials: A
authors.lastname: Stadlmayr
authors.forename: U
authors.initials: U
authors.lastname: Huber-Schönauer
authors.forename: J
authors.initials: J
authors.lastname: Zwerina
authors.forename: E
authors.initials: E
authors.lastname: Husar-Memmer
authors.forename: D
authors.initials: D
authors.lastname: Niederseer
authors.forename: M
authors.initials: M
authors.lastname: Trauner
authors.forename: A
authors.initials: A
authors.lastname: Heuberger
authors.forename: F
authors.initials: F
authors.lastname: Hohla
authors.forename: G
authors.initials: G
authors.lastname: Schett
authors.forename: W
authors.initials: W
authors.lastname: Patsch
authors.forename: C
authors.initials: C
authors.lastname: Datz
mesh_terms: D000236:Adenoma / Q000097:blood / Q000473:pathology* / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000473:pathology* / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012727:Sex Characteristics; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood* / Q000494:pharmacology
chemical_list: D014807:Vitamin D