A feasibility study of perioperative vitamin D supplementation in patients undergoing colorectal cancer resection

Frontiers in Nutrition · 10 authors, 4 centres

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Supplementation was well-tolerated with no related adverse events, no episodes of hypercalcemia, and high reported compliance.

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Supplementation was well-tolerated with no related adverse events, no episodes of hypercalcemia, and high reported compliance. Supplemented patients had markedly higher 25OHD on the day of surgery (103.9 vs. 42.5 nmol/l, P = 8.2E-12) and at all post-operative timepoints, with multivariate modeling showing an estimated 59.4 nmol/l higher 25OHD (P = 3.7E-21). The post-operative drop in 25OHD was attenuated (24% vs. 129 mg/l at days 3-5, P = 0.04).

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cohort

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surgery

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ORIGINAL PAPER

PMC10103841

A feasibility study of perioperative vitamin D supplementation in patients undergoing colorectal cancer resection

Frontiers in Nutrition

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ABSTRACT

Abstract Background Vitamin D supplementation improves colorectal cancer (CRC) survival outcomes in randomized trials. The aim of this study was to test the feasibility, safety and efficacy of vitamin D supplementation in the pre- and perioperative period in patients undergoing CRC surgery. Methods Patients were given 3200IU oral cholecalciferol (D3) per day perioperatively. Serial serum 25-hydroxyvitamin (25OHD) was measured by liquid chromatography tandem mass spectrometry and compared to untreated CRC controls. 25OHD and C-reactive protein (CRP) levels were compared using adjusted generalized linear mixed-effects models. Results A total of 122 patients underwent serial perioperative sampling, including 41 patients given high-dose perioperative supplementation. Supplementation was well-tolerated with no adverse or serious adverse events related to supplementation reported. Pre-operative supplementation increased 25OHD levels on the day of surgery (103.9 vs. 42.5 nmol/l, P = 8.2E–12). Supplementation increased 25OHD levels at all post-operative timepoints ( P < 0.001) and attenuated the post-operative drop in 25OHD (46 vs. 24% drop, P = 3.0E–4). Rate of vitamin D peri-operative insufficiency was significantly less in those on supplementation (e.g., day 3–5, 14 vs. 84%, P = 1.41E–08), with multivariate modeling across all timepoints indicating a ∼59 nmol/l higher 25OHD compared to control patients ( P = 3.7E–21). Post-operative CRP was lower in patients taking supplementation (e.g., day 3–5 timepoint; 129 vs. 81 mg/l, P = 0.04). Conclusion High dose pre-operative vitamin D supplementation is associated with higher perioperative 25OHD levels, lower rates of vitamin D insufficiency and reduced early post-operative CRP. Alongside published evidence for a beneficial effect of vitamin D on CRC survival outcomes, these novel findings provide strong rationale for early initiation of vitamin D supplementation after a diagnosis of CRC. Keywords: colorectal < cancer type, vitamin D, nutraceuticals, supplementation, surgery

CITATION EXPORT

P G Vaughan-Shaw, L F Buijs, J P Blackmur et al.. A feasibility study of perioperative vitamin D supplementation in patients undergoing colorectal cancer resection. Frontiers in Nutrition. (2023). https://doi.org/10.3389/fnut.2023.1106431

AUTHORS

10 · 4 CENTRES

P G Vaughan-Shaw, L F Buijs, J P Blackmur, A Ewing, H Becher, E Theodoratou, L Y Ooi, F V N Din, S M Farrington, M G Dunlop

1MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, United Kingdom
2Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, United Kingdom
3Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom
4Department of Pathology, National University Hospital, Singapore, Singapore