@article{3163160,
    title = "Prediagnostic Circulating Vitamin D Levels and Risk of Hepatocellular
Carcinoma in European Populations: A Nested Case-Control Study",
    author = "Fedirko, Veronika and Duarte-Salles, Talita and Bamia, Christina and and Trichopoulou, Antonia and Aleksandrova, Krasimira and Trichopoulos, and Dimitrios and Trepo, Elisabeth and Tjonneland, Anne and Olsen, Anja and and Overvad, Kim and Boutron-Ruault, Marie-Christine and Clavel-Chapelon, and Francoise and Kvaskoff, Marina and Kuehn, Tilman and Lukanova, Annie and and Boeing, Heiner and Buijsse, Brian and Klinaki, Eleni and Tsimakidi, and Chrysanthi and Naccarati, Alessio and Tagliabue, Giovanna and Panico, and Salvatore and Tumino, Rosario and Palli, Domenico and Bueno-de-Mesquita, and H. Bas and Siersema, Peter D. and Peters, Petra H. and Lund, Eiliv and and Brustad, Magritt and Olsen, Karina Standahl and Weiderpass, Elisabete and and Zamora-Ros, Raul and Sanchez, Maria-Jose and Ardanaz, Eva and and Amiano, Pilar and Navarro, Carmen and Ramon Quiros, J. and Werner, and Marten and Sund, Malin and Lindkvist, Bjorn and Malm, Johan and Travis, and Ruth C. and Khaw, Kay-Tee and Stepien, Magdalena and Scalbert, Augustin and and Romieu, Isabelle and Lagiou, Pagona and Riboli, Elio and Jenab, and Mazda",
    journal = "Gastroenterologie a Hepatologie",
    year = "2014",
    volume = "60",
    number = "4",
    pages = "1222-1230",
    publisher = "Wiley",
    doi = "10.1002/hep.27079",
    abstract = "The association between vitamin D status and hepatocellular carcinoma
(HCC) has not been well investigated, despite experimental evidence
supporting an important role of vitamin D in liver pathophysiology. Our
objective was to investigate the association between prediagnostic
circulating 25-hydroxyvitamin D [25(OH)D] serum levels and the risk of
HCC in a prospective, nested case-control study among 520,000
participants in the European Prospective Investigation into Cancer and
Nutrition (EPIC) cohort. Each case (n=138) diagnosed between 1992 and
2010 was matched to one control by age, sex, study center, date and time
of blood collection, and fasting status. Serum baseline levels of
25(OH)D were measured by liquid chromatography/tandem mass spectrometry.
Multivariable incident rate ratios (IRRs) of HCC associated with
continuous (per 10 nmol/L) or categorical levels (tertiles or a
priori-defined categories) of prediagnostic 25(OH)D were calculated
using conditional logistic regression. Higher 25(OH)D levels were
associated with a 49% reduction in the risk of HCC (highest versus
lowest tertile: multivariable IRR=0.51, 95% confidence interval [CI],
0.26 to 0.99; P-trend=0.04; per 10 nmol/L increase: IRR=0.80, 95% CI,
0.68-0.94). The finding did not vary substantially by time from
enrolment to diagnosis, and did not change after adjustment for
biomarkers of preexisting liver damage, nor chronic infection with
hepatitis B or C viruses. The findings were not modified by body size or
smoking status. Conclusion: In this prospective study on western
European populations, serum levels of 25(OH)D were inversely associated
with the risk of HCC. Given the rising incidence of this cancer in
low-risk developed countries and the strong public health interest
surrounding the potentially cancer-protective roles of vitamin D,
additional studies in different populations are required. (Hepatology
2014;60:1222-1230)"
}