Effects of Calcium and/or Vitamin D Supplementation on Biomarkers of Gut Barrier Function in Colorectal Adenoma Patients: a Randomized Clinical Trial Open Access

Abstract

Background: Gut barrier dysfunction may lead to chronic inflammation and contribute to several gastrointestinal diseases, including colorectal cancer. Preliminary evidence suggests that vitamin D and calcium could prevent colorectal carcinogenesis in part by influencing gut barrier function, however, human data are scarce.

Methods: We tested the effects of supplemental calcium (1,200 mg/day) and/or vitamin D3 (1,000 IU/day) on circulating biomarkers of gut permeability [anti-flagellin (FLIC) and anti-lipopolysaccharide (LPS) immunoglobulins (Igs), measured via ELISA] at year 1 and following 3 or 5 years of treatment after baseline examination among colorectal adenoma patients in a randomized, double-blinded, placebo-controlled clinical trial (n = 175), and assessed factors associated with baseline levels of these biomarkers.

Results: We found that vitamin D3 and/or calcium supplementation has no substantial effects on individual or aggregate biomarkers of gut permeability. Subgroup analyses by baseline BMI, aspirin use, calcium intake, and blood 25(OH)-vitamin D concentrations yielded similar results. At baseline, a combined permeability score (the summed concentrations of all four biomarkers) was 14% higher among women (P= 0.01) and 10% higher among those who had >1 serving/day of red or processed meat compared to those having 0 servings/day (Ptrend= 0.03).

Conclusions: Our results suggest that daily supplementation with vitamin D3

and/or calcium may not modify levels of gut permeability biomarkers, and support continued investigation of modifiable factors such as diet that could affect gut permeability. 

Table of Contents

Chapter I: Background/ Literature Review...................................................1

Chapter II: Manuscript.................................................................................9

Abstract...................................10

Introduction............................11

Methods...................................12

Results.....................................20

Discussion................................22

Tables.......................................26

References................................31

Supplementary Tables..............38

Chapter III: Summary, Public Health Implications, Possible Future Directions...........................................................................63 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Calcium Colorectal Cancer Clinical Trail Vitamin D Gut Barrier
Committee Chair / Thesis Advisor	Dr. Veronika Fedirko, Emory University

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