The Relationship Between Dietary Vitamin D Intake And The Risk Of Lung Cancer And The Association Of Plasma Vitamin D With The Function Of Immune System In Lung Cancer Patients

BackgroundLung cancer is the leading malignant tumor world wild,and non-small cell lung cancer?NSCLC?is the main pathology type.Most of the patients with lung cancer is diagnosed in the terminal time because of little clinical charactor appeared in the ealier peroides.According to this,primary prevention is the most important strategy for lung cancer.Vitamin D?VitD?is a steroid hormone,and it is reported to be related with cancer development recently.Although sunshine is the main way to get VitD,but to people who lived in high latitude,dietary intake is the main source of VitD.Some spiedemiology studies suggested that VitD reduced the risk of lung cancer.There was a negative correlation between VitD levels in patients with lung cancer and its mortality.A cochrance meta-analysis found that VitD supplements reduced the motality of malignant tumor.To further explore the association between dietary intake of VitD and risk of non-small cell lung cancer,part one of the present study was conducted.Immune system is related with the development of lung cancer,which is mainly responsed by T lymphocyte which mediated cellular immunity.CD3⁺CD4⁺T lymphocyte levels and CD4⁺/CD8⁺decrease,CD3⁺CD8⁺T lymphocyte levels increase in patients with malignant tumor,which is indicators of the function of immune system of patients with NSCLC.Treg lymphocyte is differentiate from CD3⁺CD4⁺T cells induced by different cell factor,which is important for the balance of immuno system in patients with tumor.VitD has been reported participate in proliferation,differentiation of T lymphocyte and antigen presenting cell,which is important for the function of immune system.The aim the present study is to evaluate the plasma vitamin D status and the function of T-cell dependent immunity in non-small cell lung cancer?NSCLC?patients,so as to explore the correlation between them.Methods1.Dietary intake of vitamin D and risk of non-small cell lung cancer:A case control studyFrom December 15^th,2014 to December 28^th,2015,a 1:1 matched case control study was conducted.Respondents included 200 NSCLC cases?58 cases from the Affiliated Hospital of Qingdao University,116 cases from Qingdao University Affiliated Hiser Hospital,26 cases from Pingdu hospital of traditional Chinese medicine?,and 200 sex-and age-matched?±3 years?controls from the physical examination center of the same hospital.Face to face interviews were performed to get the information on covariates.The habitual dietary intake was determined by a 125-item food frequency questionnaire.Conditional logistic regression was adapted to analysis the association between dietary intake of VitD and the risk of NSCLC.Trend of chi-square test was adapted to analysis dose-response relationship between them.2.The Correlation between Plasma Vitamin D and Subsets of CD3⁺,CD3⁺CD4⁺, CD3⁺CD8⁺T Lymphocyte and Treg in Non-small Cell Lung Cancer PatientsFrom November 2014 to October 2015,78 patients with NSCLC in Haici hospital were enrolled,including 46 cases of adenocarcinoma,32 cases squamous cell carcinoma.78 age and sex matched healthy volunteers was selected in the control group.The levels of 25?OH?vitamin D₃?25?OH?D₃?in blood was tested by Enzyme-linked immunoassays?ELISA?.The subsets of T lymphocyte was tested by flow cytometry?FCM?.Correlation between 25?OH?D₃ and the subsets of T lymphocyte were calculated.Results1.Dietary intake of vitamin D and risk of non-small cell lung cancer:A case control study1.1 The dietary intake of vitamin D in NSCLC patients was 5.41±1.19 ug,which was lower compared with 7.53±1.58 ug in controls?z=3.87,P<0.001?.1.2 The dietary intake of vitamin D in earlier NSCLC patients was 5.96±1.39ug,which was higher compared with 5.07±1.84 ug in progression NSCLC patients?P<0.05?.1.3 The dietary intake of vitamin D in lung aquamous cell carcinoma patients was 5.21±1.20 ug,in lung adenocarcinoma is 5.33±1.45 ug,no significant difference was found between them?P<0.05?.1.4 The univariate logistic analysis showed that the NSCLC odds ratios?95%CI?for the quartile 2 was 0.67?0.37¹.18?,for the quartile 3 was 0.56?0.32⁰.97?,for the quartile4 was 0.48?0.27⁰.85?,according to the lowest quartile of VitD dietary intake.There is a dose-response relationship between NSCLC odds ratios and VitD dietary intake.With the increasing of VitD dietary intake,the odds ratios of NSCLC dropped.1.5 After adjustment for potential covariates in demography,socioeconomics,health behaviors,body mass index,and some nutrients,the negtive associations was still significant.2.The Correlation between Plasma Vitamin D and Subsets of CD3⁺,CD3⁺CD4⁺,CD3⁺CD8⁺T Lymphocyte and Treg in Non-small Cell Lung Cancer Patients2.1 The levels of plasma 25?OH?D3 in NSCLC patients and in controls were?26.4±5.8?ng/ml and?37.2±8.1?ng/ml respectively.There was a significant difference between them?t=4.196,P<0.05?.2.2 The levels of plasma 25?OH?D3 in lung adenocarcinoma patients and in Lung phosphorous cancer patients were 26.6±6.5 ng/ml and 25.7±7.1 ng/ml respectively.There was no significant difference between them?P>0.05?.2.3 The dietary intake of vitamin D in NSCLC patients was positive correlated with the levels of plasma 25?OH?D3?r=0.8964,p<0.05?.2.4 The levels of CD3+,CD3+CD4+and CD4+/CD8+were lower in patients than those in controls,while the level of CD3+CD8+was higher?P<0.05?.2.5 The plasma 25?OH?D3 is positive correlation with CD3+,CD3+CD4+?rs=0.725rs=0.683,P<0.05?and negative with CD3+CD8+?rs=-0.575,P<0.05?.2.6 The percent of Treg cell?%?is 5.573±1.26 in NSCLC patients,which is higher than0.379±0.072 in the control group?P<0.05?.2.7 The blood 25?OH?D3 is negtive correlation with Treg cells?rs=-0.550,P<0.05?.Conclusion1.The dietary intake of vitamin D in NSCLC patients is lower than normal population,deficiency in dietary intake of vitamin D may be associated with higher risk of NSCLC,and there was a dose-response relationship existed.2.The blood vitamin D concentration is lower in NSCLC patients compared with healthy control.There is a positive correlation between the daily vitmine D intake and blood vitmine D concentration.3.There is a correlation between the plasma vitamin D concentration and the defect of the T cell dependent immunity in NSCLC patients.4.Daily intake of VitD may affected the vitmine D concentration in NSCLC patients and lead to the disorder of the subgroup of T cell and the ratio of Treg cells.