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Observational Study
. 2020 Apr 26;12(5):1229.
doi: 10.3390/nu12051229.

Plasma 25-Hydroxyvitamin D Levels and VDR Gene Expression in Peripheral Blood Mononuclear Cells of Leukemia Patients and Healthy Subjects in Central Kazakhstan

Assel G Zhumina  1 , Konstantin Li  2 , Anna A Konovalova  1   2 , Yelena A Li  2 , Margarita Yu Ishmuratova  1 , Gayane P Pogossyan  1   2 , Michael Danilenko  3
Affiliations
Observational Study

Plasma 25-Hydroxyvitamin D Levels and VDR Gene Expression in Peripheral Blood Mononuclear Cells of Leukemia Patients and Healthy Subjects in Central Kazakhstan

Assel G Zhumina et al. Nutrients. .

Abstract

Low blood levels of the vitamin D metabolite 25-hydroxyvitamin D [25(OH)D] have been associated with an increased risk and poorer outcomes of various cancers, including hematological malignancies. The Central Kazakhstan area has a relatively high incidence rate of leukemia. However, the relationship between vitamin D status and leukemia or other types of cancer in Kazakhstan has not yet been addressed. Therefore, in this first pilot single-center study conducted in Central Kazakhstan, we compared plasma levels of 25(OH)D and the vitamin D receptor (VDR) gene expression levels in peripheral blood mononuclear cells of patients with leukemia and demographically matching healthy volunteers. The levels of 25(OH)D in patients were found to be significantly lower (10.8 ± 7.0 ng/mL; n = 31) than in healthy subjects (21.6 ± 7.8 ng/mL; n = 34; p < 0.0001). A similar difference was observed in both younger (<60 years old) and older (>60 years old) participants, though there was no association between 25(OH)D concentration and age within the patient group. In female patients, 25(OH)D levels were significantly lower than in male patients (p = 0.04). No significant seasonal variations of 25(OH)D were observed in either the patient or the control group. VDR gene expression levels appeared to be similar in leukemia patients and healthy subjects, and no correlation between the cellular VDR expression and plasma 25(OH)D concentrations was observed in either group of participants. We did not observe a significant association of 25(OH)D or VDR levels and overall survival of leukemia patients. This observational study conducted for the first time in Kazakhstan supports previous findings demonstrating reduced blood 25(OH)D levels in cancer (leukemia) patients. Larger studies are required to determine whether low 25(OH)D plasma concentrations represent a risk factor for leukemia development and/or progression.

Keywords: 25(OH)D; leukemia; observational study; vitamin D; vitamin D receptor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Plasma 25(OH)D levels in blood samples of patients with leukemia and healthy subjects taken during colder and warmer seasons. Comparison between: (A) all the participated patients (n = 31) and healthy subjects (n = 34); (B) patients (n = 20) and healthy subjects (n = 19) in October-April; and (C) patients (n = 11) and healthy subjects (n = 15) in May-September. Data are the means (long horizontal lines) ± SD. ***, p < 0.001; ****, p < 0.0001.
Figure 2
Figure 2
Plasma 25(OH)D levels in blood samples of patients with leukemia and healthy subjects of different age and gender. Comparison between: (A) younger (n = 18) and older (n = 13) patients; (B) younger (n = 19) and older (n = 15) healthy subjects, (C) male (n = 14) and female (n = 17) patients; and (D) male (n = 17) and female (n = 17) healthy subjects. Data are the means (long horizontal lines) ± SD. **, p < 0.01; ***, p < 0.001; ns, not significant; y.o., years old.
Figure 3
Figure 3
Relationship between plasma 25(OH)D levels and BMI in patients with leukemia and healthy subjects. Bivariate (Pearson) correlation analysis (31 patients and 34 healthy volunteers); r, correlation coefficient.
Figure 4
Figure 4
Vitamin D receptor (VDR) expression in peripheral blood mononuclear cells (PBMC) vs. 25(OH)D levels in the plasma of patients with leukemia and healthy subjects. (A) Comparison of VDR expression between patients (n = 20) and healthy individuals (n = 19). Data are the means (long horizontal lines) ± SD. Correlation analysis of VDR expression and 25(OH)D levels in patients (B) and healthy subjects (C); ns, not significant; r, correlation coefficient.
Figure 5
Figure 5
Overall survival of patients with chronic myeloid leukemia (CML). Kaplan–Meier analysis with a log-rank (Mantel–Cox) test.
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