Serum 25-hydroxyvitamin D is inversely associated with body mass index in cancer

Background: The association between vitamin D deficiency and obesity in healthy populations and different disease states remains unsettled with studies reporting conflicting findings. Moreover, current dietary recommendations for vitamin D do not take into account a person's body mass index (BMI). We investigated the relationship between serum 25-hydroxy-vitamin D [25(OH)D] and BMI in cancer. Methods: A consecutive case series of 738 cancer patients. Serum 25(OH)D was measured at presentation to the hospital. The cohort was divided into 4 BMI groups (underweight: < 18.5, normal weight: 18.5-24.9, overweight: 25-29.9, and obese: > 30.0 kg/m(2)). Mean 25(OH) D was compared across the 4 BMI groups using ANOVA. Linear regression was used to quantify the relationship between BMI and 25(OH)D. Results: 303 were males and 435 females. Mean age at diagnosis was 55.6 years. The mean BMI was 27.9 kg/m(2) and mean serum 25(OH)D was 21.9 ng/ml. Most common cancers were lung (134), breast (131), colorectal (97), pancreas (86) and prostate (45). Obese patients had significantly lower serum 25(OH)D levels (17.9 ng/ml) as compared to normal weight (24.6 ng/ml) and overweight (22.8 ng/ml) patients; p < 0.001. After adjusting for age, every 1 kg/m(2) increase in BMI was significantly associated with 0.42 ng/ml decline in serum 25(OH)D levels. Conclusions: Obese cancer patients (BMI >= 30 kg/m(2)) had significantly lower levels of serum 25(OH)D as compared to non-obese patients (BMI < 30 kg/m(2)). BMI should be taken into account when assessing a patient's vitamin D status and more aggressive vitamin D supplementation should be considered in obese cancer patients.