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Meta-Analysis
. 2019 Apr 29;14(4):e0216284.
doi: 10.1371/journal.pone.0216284. eCollection 2019.

Vitamin D status and risk of non-Hodgkin lymphoma: An updated meta-analysis

Hye Yin Park  1   2 , Yun-Chul Hong  2   3   4 , Kyoungho Lee  1 , Jaewoo Koh  1
Affiliations
Meta-Analysis

Vitamin D status and risk of non-Hodgkin lymphoma: An updated meta-analysis

Hye Yin Park et al. PLoS One. .

Abstract

Purpose: This meta-analysis aimed to extensively investigate the association between various measures of vitamin D status and non-Hodgkin lymphoma (NHL) and its subtypes.

Methods: We searched MEDLINE (PubMed), Embase, and the Cochrane Library in February 2018. Two authors independently reviewed and selected articles based on predetermined criteria.

Results: A total of 30 studies with 56,458 NHL cases were finally selected, with 24, 9, and 3 studies on sunlight/ultraviolet radiation (UVR) exposure, dietary intake, and serum/plasma 25-hydroxyvitamin D levels, respectively. Significant protective effects of overall sunlight/UVR exposure on NHL and subtypes were observed, with summary relative risks (RRs) ranging from 0.67-0.80 (RR for NHL = 0.80; 95% confidence interval [CI]: 0.71-0.90) among subjects with high exposure compared to those with low exposure. The results were consistent with various classifications of sunlight/UVR exposure. In contrast, when exposure measures of dietary vitamin D intake (RR for NHL = 1.03; 95% CI: 0.90-1.19) and serum/plasma 25-hydroxyvitamin D levels (RR for NHL = 0.97; 95% CI: 0.82-1.15) were used, risk estimates were inconsistent or non-significant for NHL and the subtypes.

Conclusion: While risk estimates varied by different measures of vitamin D status, a protective effect of sunlight/UVR exposure on NHL incidence was verified, across most of the tested subtypes as well as exposure categories.

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Conflict of interest statement

We have the following interests. Hye Yin Park, Kyoungho Lee and Jaewoo Koh are affiliated to Samsung Electronics Co. Ltd. (HYP, KL, JK - Samsung Health Research Institute, Samsung Electronics Co. Ltd.; HYP, Y-CH - Institute of Environmental Medicine, Seoul National University Medical Research Center; Y-CH - Department of Preventive Medicine, and Environment Health Center, Seoul National University College of Medicine). There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Fig 1
Fig 1. Flow diagram of identification of relevant studies.
Fig 2
Fig 2. Meta-analysis of the association between vitamin D status and non-Hodgkin lymphoma incidence by different sources of exposure.
(a) overall sunlight/UVR exposure; (b) dietary vitamin D intake; (c) serum/plasma 25-hydroxyvitamin D. Meta-analyses results are presented in summary relative risks (RR) and their 95% confidence intervals (95% CI).
See this image and copyright information in PMC

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