Bone tumors much more likely to be malignant if low Vitamin D – multiple studies

Does vitamin D deficiency predict tumour malignancy in patients with bone tumours? Data from a multi-center cohort analysis – Dec 2020

Journal of Bone Oncology 25 (2020) 100329. https://doi.org/10.1016/jjbo.2020.100329

Konstantin Horasa,b,, Ulrike van Herckb, Gerrit S. Maierc, Uwe Mausc,d, Norbert Harrassere,f, Franz Jakobb, Manuel Weissenbergera, Jorg Amholdta, Boris M. Holzapfela, Maximilian Ruderta

a Department of Orthopaedics, Koenig-Ludwig-Haus, University of Wuerzburg, Germany b Bernhard-Heine Centre for Musculoskeletal Research, University of Wuerzburg, Germany c Department of Orthopaedic Surgery, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany d Department of Orthopaedic and Trauma Surgery, University of Duesseldorf, Germany e Department of Orthopaedics, Klinikum rechts der Isar, TU, Munich, Germany f Excellent Center of Medicine (ECOM), Munich, Germany

Vitamin D deficiency is a global health concern that is estimated to afflict over one billion people globally. The major role of vitamin D is that of a regulator of calcium and phosphate metabolism, thus, being essential for proper bone mineralisation. Concomitantly, vitamin D is known to exert numerous extra-skeletal actions. For example, it has become evident that vitamin D has direct anti-proliferative, pro-differentiation and pro-apoptotic actions on cancer cells. Hence, vitamin D deficiency has been associated with increased cancer risk and worse prognosis in several malignancies. We have recently demonstrated that vitamin D deficiency promotes secondary cancer growth in bone. These findings were partly attributable to an increase in bone remodelling but also through direct effects of vitamin D on cancer cells. To date, very little is known about vitamin D status of patients with bone tumours in general. Thus, the objective of this study was to assess vitamin D status of patients with diverse bone tumours. Moreover, the aim was to elucidate whether or not there is an association between prediagnostic vitamin D status and tumour malignancy in patients with bone tumours.

In a multi-center analysis, 25(OH)D, PTH and calcium levels of 225 patients that presented with various bone tumours between 2017 and 2018 were assessed. Collectively, 76% of all patients had insufficient vitamin D levels with a total mean 25(OH)D level of 21.43 ng/ml (53.58 nmol/L). In particular, 52% (117/225) of patients were identified as vitamin D deficient and further 24% of patients (55/225) were vitamin D insufficient. Notably, patients diagnosed with malignant bone tumours had significantly lower 25(OH)D levels than patients diagnosed with benign bone tumours Publisher wants $54 for the PDF.

!!!!High%20Prevalence%20of%20Vitamin%20D%20Deficiency%20in%20Patients%20with%20Bone%20Tumors-%202017 Cancer%20Invest.%202017%20Aug%2011:1-7.%20doi:%2010.1080/07357907.2017.1351985.%20 Horas%20K1,2,%20Maier%20G3,%20Jakob%20F2,%20Maus%20U3,%20Kurth%20A4,%20Jakuscheit%20A1,%20Rudert%20M1,%20Holzapfel%20BM1,5.

The%20aim%20of%20this%20study%20was%20to%20evaluate%20the%20prevalence%20of%20vitamin%20D%20deficiency%20in%20patients%20with%20different%20types%20of%20bone%20tumors%20and%20to%20elucidate%20whether%20or%20not%20there%20are%20differences%20in%20prediagnostic%20vitamin%20D%20levels%20in%20patients%20with%20malignant%20compared%20to%20benign%20bone%20tumors.%20Prediagnostic%20serum%2025(OH)D%20levels%20of%20105%20consecutive%20patients%20that%20presented%20with%20bone%20tumors%20and%20tumor-like%20lesions%20to%20two%20Orthopedic%20Level%20I%20University%20Centers%20in%20Germany%20between%202011%20and%202016%20were%20measured%20on%20admission.%20

We%20found%20an%20alarming%20and%20widespread%20rate%20of%20vitamin%20D%20deficiency%20in%20patients%20with%20bone%20tumors.%20Specifically,%2083%%20of%20all%20patients%20had%20low%20vitamin%20D%20levels%20with%20a%20mean%2025(OH)D%20level%20of%2019.82%20ng/ml.%20

Notably,%20patients%20diagnosed%20with%20malignant%20bone%20tumors%20had%20significantly%20lower%20vitamin%20D%20levels%20compared%20to%20patients%20with%20benign%20bone%20lesions%20(p%20=%200.0008).%20

In%20conclusion,%20it%20is%20essential%20to%20assess%20vitamin%20D%20levels%20in%20patients%20with%20tumors%20involving%20bone.%20In%20addition,%20there%20might%20be%20an%20association%20between%20vitamin%20D%20deficiency%20and%20the%20onset%20or%20course%20of%20primary%20malignant%20bone%20tumors.

PMID:%2028799812%20DOI:%2010.1080/07357907.2017.1351985

[http://www.tandfonline.com/doi/full/10.1080/07357907.2017.1351985?needAccess=true)