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Abstract：
OBJECTIVE: Surgery had a significant impact on 25-hydroxyvitamin D (25-(OH)D) levels. Uncertainty still existed regarding the effects of peri-operative 25(OH)D deficiency on colorectal cancer (CRC) patients\' prognosis. The purpose of the present study was to explore the potential association between the peri-operative 25(OH)D deficiency and the survival outcome of CRC.
METHODS: Seven electronic databases [including PubMed, EMBASE, Web of Science, The Cochrane Library, OvidMEDLINE(R), China National Knowledge Infrastructure (CNKI) and Wangfang data] were searched without language limitations. The primary outcomes were overall survival and all-cause mortality. Secondary outcomes were the incidence of 25(OH)D deficiency and risk variables for low 25(OH)D level in the peri-operative period.
RESULTS: 14 eligible studies were obtained with 9324 patients for meta-analysis. In the peri-operative period, the pooled incidence of blood 25(OH)D deficiency was 59.61% (95% CI: 45.74-73.48). The incidence of blood 25(OH)D deficiency post-operatively (66.60%) was higher than that pre-operatively (52.65%, 95% CI: 32.94-72.36). Male (RR = 1.09, 95% CI: 1.03-1.16), rectum tumor (RR = 1.23, 95% CI: 1.03-1.47), spring and winter sampling (RR = 1.24, 95% CI: 1.02-1.49) were the risk factors for the 25(OH)D deficiency. The association between the low 25(OH)D post-operatively and short-term overall survival (HR = 0.43, 95% CI: 0.24-0.77) was most prominent, while a low 25(OH)D pre-operatively (HR = 0.47, 95% CI: 0.31-0.70) was more significantly associated with long-term all-cause mortality than that after surgery.
CONCLUSIONS: Peri-operative 25(OH)D impacted the CRC patients\' prognosis. Due to possible confounding effects of systemic inflammatory response (SIR), simultaneous measurement of vitamin D and SIR is essential for colorectal survival.
METHODS: Seven electronic databases [including PubMed, EMBASE, Web of Science, The Cochrane Library, OvidMEDLINE(R), China National Knowledge Infrastructure (CNKI) and Wangfang data] were searched without language limitations. The primary outcomes were overall survival and all-cause mortality. Secondary outcomes were the incidence of 25(OH)D deficiency and risk variables for low 25(OH)D level in the peri-operative period.
RESULTS: 14 eligible studies were obtained with 9324 patients for meta-analysis. In the peri-operative period, the pooled incidence of blood 25(OH)D deficiency was 59.61% (95% CI: 45.74-73.48). The incidence of blood 25(OH)D deficiency post-operatively (66.60%) was higher than that pre-operatively (52.65%, 95% CI: 32.94-72.36). Male (RR = 1.09, 95% CI: 1.03-1.16), rectum tumor (RR = 1.23, 95% CI: 1.03-1.47), spring and winter sampling (RR = 1.24, 95% CI: 1.02-1.49) were the risk factors for the 25(OH)D deficiency. The association between the low 25(OH)D post-operatively and short-term overall survival (HR = 0.43, 95% CI: 0.24-0.77) was most prominent, while a low 25(OH)D pre-operatively (HR = 0.47, 95% CI: 0.31-0.70) was more significantly associated with long-term all-cause mortality than that after surgery.
CONCLUSIONS: Peri-operative 25(OH)D impacted the CRC patients\' prognosis. Due to possible confounding effects of systemic inflammatory response (SIR), simultaneous measurement of vitamin D and SIR is essential for colorectal survival.
摘要：
目的：手术对25-羟基维生素D（25-（OH）D）水平有显著影响。围手术期25(OH)D缺乏对结直肠癌(CRC)患者预后的影响仍存在不确定性。本研究的目的是探讨围手术期25（OH）D缺乏与CRC生存结局之间的潜在关联。
方法：七个电子数据库[包括PubMed，EMBASE,WebofScience,科克伦图书馆,OvidMEDLINE(R),中国国家知识基础设施(CNKI)和王方数据]进行了无语言限制的搜索。主要结果是总生存率和全因死亡率。次要结果是围手术期25(OH)D缺乏的发生率和低25(OH)D水平的风险变量。
结果：获得了14项符合条件的研究，9324例患者用于荟萃分析。在围手术期,血25(OH)D缺乏的合并发生率为59.61%(95%CI:45.74-73.48).术后血25(OH)D缺乏的发生率(66.60%)高于术前(52.65%,95%CI：32.94-72.36）。男性（RR=1.09，95%CI：1.03-1.16），直肠肿瘤（RR=1.23，95%CI：1.03-1.47），春季和冬季采样（RR=1.24，95％CI：1.02-1.49）是25（OH）D缺乏的危险因素。术后低25(OH)D与短期总生存率(HR=0.43,95%CI:0.24-0.77)之间的关联最为显著,而术前低25(OH)D(HR=0.47,95%CI:0.31-0.70)与长期全因死亡率的相关性比手术后更显著.
结论：围手术期25(OH)D影响CRC患者的预后。由于全身炎症反应（SIR）的可能混淆作用，同时测定维生素D和SIR对结直肠存活至关重要.
方法：七个电子数据库[包括PubMed，EMBASE,WebofScience,科克伦图书馆,OvidMEDLINE(R),中国国家知识基础设施(CNKI)和王方数据]进行了无语言限制的搜索。主要结果是总生存率和全因死亡率。次要结果是围手术期25(OH)D缺乏的发生率和低25(OH)D水平的风险变量。
结果：获得了14项符合条件的研究，9324例患者用于荟萃分析。在围手术期,血25(OH)D缺乏的合并发生率为59.61%(95%CI:45.74-73.48).术后血25(OH)D缺乏的发生率(66.60%)高于术前(52.65%,95%CI：32.94-72.36）。男性（RR=1.09，95%CI：1.03-1.16），直肠肿瘤（RR=1.23，95%CI：1.03-1.47），春季和冬季采样（RR=1.24，95％CI：1.02-1.49）是25（OH）D缺乏的危险因素。术后低25(OH)D与短期总生存率(HR=0.43,95%CI:0.24-0.77)之间的关联最为显著,而术前低25(OH)D(HR=0.47,95%CI:0.31-0.70)与长期全因死亡率的相关性比手术后更显著.
结论：围手术期25(OH)D影响CRC患者的预后。由于全身炎症反应（SIR）的可能混淆作用，同时测定维生素D和SIR对结直肠存活至关重要.
