Association between circulating concentrations of 25(OH)D and colorectal adenoma: A pooled analysis

The relationship between the biomarker of vitamin D status, 25(OH)D, and risk for colorectal neoplasia is suggestive but equivocal. Questions remain regarding whether there are differential associations between 25(OH)D and colorectal adenoma by gender, colorectal sub-site, or features of baseline and recurrent adenomas. We sought to investigate the relationship between 25(OH)D and both baseline and recurrent adenoma characteristics. This study was conducted among 2074 participants in a pooled population of two clinical intervention trials of colorectal adenoma recurrence. A cross-sectional analysis of 25(OH)D and baseline adenoma characteristics and a prospective study of recurrent adenomas and their characteristics were conducted. There was a statistically significant inverse association between 25(OH)D concentrations and the presence of three or more adenomas at baseline. Compared to participants with 25(OH)D levels <20 ng/ml, the adjusted ORs (95% CIs) were 0.99 (0.70–1.41) for those with concentrations of ≥20 and < 30 ng/ml, and 0.73 (0.50–1.06) among participants with levels ≥ 30 ng/ml (p-trend=0.05). Baseline villous histology was also significantly inversely related to 25(OH)D levels (p-trend=0.04). Conversely, 25(OH)D concentrations were not associated with overall colorectal adenoma recurrence, with ORs (95% CIs) of 0.91 (0.71–1.17) and 0.95 (0.73–1.24; p-trend = 0.85). These findings support the concept that the relationship between vitamin D and colorectal neoplasia may vary by stage of adenoma development.