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@ARTICLE{Brenner:168688,
      author       = {H. Brenner$^*$ and S. Kuznia$^*$ and C. Laetsch$^*$ and T.
                      Niedermaier$^*$ and B. Schöttker$^*$},
      title        = {{P}revention of {A}dvanced {C}ancer by {V}itamin {D}3
                      {S}upplementation: {I}nteraction by {B}ody {M}ass {I}ndex
                      {R}evisited.},
      journal      = {Nutrients},
      volume       = {13},
      number       = {5},
      issn         = {2072-6643},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2021-00996},
      pages        = {1408},
      year         = {2021},
      note         = {#EA:C070#LA:C070#},
      abstract     = {Meta-analyses of randomized controlled trials (RCTs) have
                      demonstrated a protective effect of vitamin D3
                      (cholecalciferol) supplementation against cancer mortality.
                      In the VITAL study, a RCT including 25,871 men ≥ 50 years
                      and women ≥ 55 years, protective effects of vitamin D3
                      supplementation (2000 IU/day over a median of 5.3 years)
                      with respect to incidence of any cancer and of advanced
                      cancer (metastatic cancer or cancer death) were seen for
                      normal-weight participants but not for overweight or obese
                      participants. We aimed to explore potential reasons for this
                      apparent variation of vitamin D effects by body mass index.
                      We conducted complementary analyses of published data from
                      the VITAL study on the association of body weight with
                      cancer outcomes, stratified by vitamin D3 supplementation.
                      Significantly increased risks of any cancer and of advanced
                      cancer were seen among normal-weight participants compared
                      to obese participants in the control group (relative risk
                      (RR), 1.27; $95\%$ confidence interval (CI), 1.07-1.52, and
                      RR, 1.44; $95\%$ CI, 1.04-1.97, respectively). No such
                      patterns were seen in the intervention group. Among those
                      with incident cancer, vitamin D3 supplementation was
                      associated with a significantly reduced risk of advanced
                      cancer (RR, 0.86; $95\%$ CI, 0.74-0.99). The observed
                      patterns point to pre-diagnostic weight loss of cancer
                      patients and preventive effects of vitamin D3
                      supplementation from cancer progression as plausible
                      explanations for the body mass index (BMI)-intervention
                      interactions. Further research, including RCTs more
                      comprehensively exploring the potential of adjuvant vitamin
                      D therapy for cancer patients, should be pursued with
                      priority.},
      keywords     = {body mass index (Other) / cancer (Other) / prevention
                      (Other) / supplementation (Other) / vitamin D (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33922032},
      doi          = {10.3390/nu13051408},
      url          = {https://inrepo02.dkfz.de/record/168688},
}