Vitamin D supplementation following malnutrition associated with time-related increase of cancer diagnoses: A cohort study of 389 patients with Wernicke-Korsakoff syndrome
Menée aux Pays-Bas à partir de données portant sur 389 patients atteints du syndrome de Wernicke-Korsakoff lié à un alcoolisme chronique, cette étude de cohorte rétrospective analyse l'association entre une supplémentation en vitamine D en lien avec une malnutrition et un diagnostic de cancer (durée médiane de suivi : 3 ans)
Background : Vitamin deficiencies may reflect less than optimal health in select populations. Our objective was to determine whether vitamin D supplementation (VDs) following malnutrition may be adversely related to cancer diagnoses in a select group of patients with alcoholic Wernicke-Korsakoff syndrome (WKS). Method : Retrospective, cohort study of all patients admitted to Slingedael Korsakoff center, from 1996 till 2018, subdivided into three predefined groups depending upon differences in vitamin D supplementation: (1) ‘early’ supplementation ‒ started during or before the previous hospital admission ‒ before the transfer to our center, (2) ‘late’ supplementation started later in our center, and (3) ‘no’ vitamin D supplementation received. Data collection involved the patients’ age, sex, body mass index, skin type, baseline serum 25-hydroxyvitamin D concentrations if available, doses of cholecalciferol (vitamin D3) supplementation, other vitamins, sun exposure, malnutrition, alcohol use, smoking, cognitive diagnoses, somatic comorbidity, cancer diagnoses, cause of death, and length of stay in Slingedael. New tumors (dependent variable) may have been diagnosed during VDs (exposed cases) or before the start of VDs, if any (unexposed cases). Results : New cancers were diagnosed in 87/389 (22.4%) patients after median 3.0 years of follow-up (IQR 1.1‒5.8 years). In logistic regression analysis, age, smoking, and length of stay in log(years) showed odds ratios of 1.021, 2.74, and 1.68, respectively. The temporal relationship of VDs and cancer diagnosis was significant in VDs that started in the year leading up to the diagnosis (Wilcoxon signed-ranks test of positive ranks corresponding with supplementation and negative ranks corresponding with non-supplementation: Z score -2.54, P=0.011). Conclusion : Vitamin D supplementation was time-related to cancer diagnosis in a cohort of patients with alcoholic WKS. The study may suggest the proliferation of cancer as an adverse effect of vitamin D supplementation, particularly in malnourished patients.
Nutrition 2019