Nytt fokus på cancerpatienter som lider brist på D-vitamin.

Nytt fokus på cancerpatienter som lider brist på D-vitamin.D-vitamin reglerar ett stort antal biokemiska processer som är viktiga för vår hälsa. Måttlig brist på D-vitamin är mycket vanligt, och allvarlig brist bidrar till att kritiskt sjuka cancerpatienter läggs in på intensivvård och dör inom ett år. Därför kan cancerpatienter som har avslutat sin intensivvårdsbehandling dra nytta av att ta tillskott med D-vitamin. Detta framgår av en studie från Wien, publicerad i Nutrients. Studien är i linje med tidigare studier som visar att D-vitamin har flera cancerförebyggande mekanismer. Därför är det viktigt att vara välförsedd hela livet.

Brist på D-vitamin är vanligt bland cancerpatienter och beror på flera faktorer som inomhuslivsstil, längre sjukhusvistelser, undvikande av solljus efter strålning och kemoterapi samt nedsatt näringsstatus på grund av aptitlöshet.
Den nya studien, som utfördes av forskare från Medicinska Universitetet i Wien i Österrike, syftade till att analysera blodets innehåll av D-vitamin hos kritiskt sjuka cancerpatienter som fick intensivvårdsbehandling. Dessutom undersökte forskarna huruvida brist på D-vitamin och svår brist på D-vitamin hos dessa cancerpatienter bidrog till ytterligare intensivvårdsbehandling, sjukhusvistelse och dödsfall efter ett år.
Detta är den första studien av kritiskt sjuka cancerpatienter som behandlar D-vitaminbrist, och den största som i detta sammanhang behandlar patienter som får intensivvårdsbehandling.

Brist på D-vitamin gör cancer mer livshotande

Forskarna studerade mer specifikt patienter och data från en tidigare studie som pågick mellan oktober 2014 och januari 2019. Enligt rapporten är D-vitaminbrist mycket vanligt bland kritiskt sjuka cancerpatienter i behov av intensivvårdsbehandling. Men effekten på dödligheten inom ett år var okänd.
Man tog blodprover på patienterna inom 72 timmar efter inläggning på intensivvårdsavdelningen. Blodproverna visade att 74 procent led brist på D-vitamin och att 54 procent led svår brist på D-vitamin. Ung ålder, cancerbehandlingsresistens och sepsisrelaterad organsvikt (SOFA) var oberoende faktorer associerade med brist på D-vitamin.
Efter att ha justerat för dessa faktorer fann forskarna bakom den nya studien att allvarlig D-vitaminbrist i sig själv ökade risken för att avlida på sjukhus inom ett år. Men det ökade inte risken för att avlida på intensivvårdsavdelning.
Forskarna drar därför slutsatsen att D-vitaminbrist är mycket vanligt bland kritiskt sjuka cancerpatienter. Mer fokus bör också läggas på säsongsbetingad brist, yngre patienter och patienter med svår organdysfunktion.
Forskarna påpekar dock att studien har sina begränsningar, eftersom patienter med mörk hy var underrepresenterade. Forskarna framhåller även att ålder, gener, härkomst, rökvanor, läkemedel, njurersättningsbehandling (RRT) och infektioner kan påverka blodets innehåll av D-vitamin hos kritiskt sjuka patienter och den allmänna befolkningen. Eftersom det saknades en kontrollgrupp i studien efterlyser forskarna därför fler studier på området.
Den nya studien har publicerats i Nutrients och är i linje med tidigare studier som visar på ett samband mellan D-vitamin och cancer.

Blodets innehåll av D-vitamin

  • Blodets innehåll av D-vitamin mäts som 25-hydroxyvitamin D.
  • Det delas in i vanlig brist (under 30 nmol/l), otillräckligt innehåll (30–50 nmol/l) och tillräckligt innehåll (över 50 nmol/l).
  • Enligt flera ledande forskare ligger den optimala nivån på mellan 75–100 nmol/l.

Starkare tillskott med D-vitamin minskar cancerrisken och cancerdödsfall

Flera nya metaanalyser har nu visat att starkare tillskott med D-vitamin inte bara minskar risken för att få olika cancerformer, utan också förbättrar chansen till överlevnad om man har fått diagnosen.

Referenser

Nina Buchtele et al. Prevalence and Impact of Vitamin D Deficiency in Critically Ill Cancer Patients Admitted to the Intensive Care Unit. Nutrients 2021

Nikki Hancocks. Study puts cancer patient vitamin D deficiency under the spotlight. NUTRAingredients.com 2021

Paulette D Chandler et al. Effect of Vitamin D3 Supplements on Development of Advanced Cancer. JAMA 2020

Brian P. Dunleavy. Study: Vitamin D reduces risk for metastatic cancer, death by 17 %. UPI Nov. 18, 2020

Vital Study Findings 2020

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