Vitamin D status may explain racial disparities in survival among patients with advanced renal cell carcinoma in the targeted therapy era
Notice bibliographique
Résumé
In a recent article, Rose et al1 reported significantly reduced overall survival (by approximately 10%) for African Americans versus white Americans among patients with advanced renal cell carcinoma (RCC) in both the pre–targeted therapy era and the post–targeted therapy era. Both treatment and socioeconomic status were ruled out as explanations. Another recent article2 reported a significantly increased risk of death among RCC patients for African Americans versus white Americans in models adjusted for tumor characteristics and comorbid conditions, but this increase did not remain after further adjustments for the education level and deprivation index. A factor not considered in either article is the role of ultraviolet B (UVB) exposure and the vitamin D status. There is strong evidence from ecological and observational studies showing that UVB doses and serum 25-hydroxyvitamin D (25(OH)D) concentrations are inversely correlated with the incidence and/or mortality rates of many types of cancer, including RCC. The ecological study results were first reported in Cancer3 and are summarized in a review.4 The ecological study findings for RCC are weaker than those for a number of other types of cancer, however. Occupational UVB exposure has also been found to be inversely correlated with the incidence of RCC.5, 6 There are also several observational studies reporting inverse correlations between 25(OH)D concentrations and the risk for RCC.7-9 African Americans have mean 25(OH)D concentrations approximately 40% lower than those of white Americans.10 There are many diseases, including autoimmune diseases, many types of cancer, cardiovascular disease, diabetes mellitus, infectious diseases, mental illnesses, and neurocognitive dysfunction, linked to low UVB exposure and 25(OH)D concentrations.11 A review published in 2010 outlined the evidence showing that the vitamin D status accounted for some black-white health disparities.12 Subsequently, evidence was summarized for the role of the vitamin D status in black-white cancer-specific and overall survival disparities.13 In this study, the mortality rates for African Americans were on average approximately 25% higher than those for white Americans after consideration of the stage at diagnosis and treatment. The 25% value was consistent with the understanding of the 25(OH)D concentration–cancer incidence relation, which was recently updated on the basis of case-control studies of breast cancer incidence rates.14 There is additional evidence for the beneficial effects of vitamin D on overall mortality rates. A meta-analysis of 32 studies found a strong inverse correlation between the all-cause mortality rate and the 25(OH)D concentration for 25(OH)D concentrations < 36 ng/mL, with no further changes at higher concentrations.15 A meta-analysis of 14 vitamin D3 clinical trials found a relative risk of death of 0.89 (95% confidence interval, 0.80-0.99).16 For 8 trials using vitamin D, the relative risk of death was 1.04 (95% confidence interval, 0.97-1.11). A recent review presented an overview of the evidence showing that UVB exposure and vitamin D reduce the incidence of many types of cancer and increase survival.17 Primarily on the basis of observational studies, 25(OH)D concentrations should be raised to 30 to 40 ng/mL for optimal health.15-19 No specific funding was disclosed. William B. Grant receives funding from Bio-Tech Pharmacal, Inc (Fayetteville, Ark), and the Vitamin D Society (Woodstock, ON, Canada). He also reports personal fees from the Vitamin D Council. William B. Grant, PhD Sunlight, Nutrition, and Health Research Center San Francisco, California
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».