ABSTRACT
BACKGROUND As breast epithelium is affected by vitamin D, it may have a direct effect on breast density and the risk of breast cancer. Our aim was to study the serum levels of vitamin D in patients with malignant and benign breast disease, and to study the association, if any, between vitamin D levels, mammographic breast density (MD) and molecular subtypes of breast cancer. METHODS In this cross-sectional, observational study, we enrolled 162 consecutive adult women with benign and malignant breast masses subjected to mammography and core-needle biopsy. Serum levels of vitamin D were estimated and correlated with MD and with immunohistochemical subtyping of breast cancer. RESULTS The mean vitamin D level in these 162 patients was 12.44 (5.88) ng/ml, with vitamin D deficiency seen in 98%. The mean (SD) vitamin D level in MD type 1 was 16.19 (4.62) ng/ml and it decreased to 7.54 (2.58) ng/ml in MD type 4. High MD was associated with significantly lower vitamin D levels. The mean vitamin D level in patients with benign breast disease (n=102) was 13.73 (5.68) ng/ml, while it was significantly lower in patients with breast cancer (n=60) at 10.26 (5.61) ng/ml. Among patients with breast cancer, the good prognosis luminal A molecular subtype had mean vitamin D level of 12.94 (6.16) ng/ml, whereas the poor prognosis triple-negative subtype had a significantly lower value of 7.68 (3.42) ng/ml. CONCLUSION Our study shows that vitamin D deficiency has a significant relationship with breast cancer (v. benign breast disease), high MD (showing increased breast cancer risk) and poor prognosis triple-negative breast cancer. Vitamin D deficiency could be an important, potentially modifiable, risk factor for the prevention of breast cancer in susceptible populations.
ABSTRACT
Background: Cardiac autonomic dysfunction (CAD) and neuropathy is common in diabetes mellitus but theabnormalities in Autonomic nervous system (ANS) and the influence of altered glycaemic indices oncardiovascular parameters by using HRV has not been elucidated in prediabetics. Hence, the present studywas aimed to measure HRV and to find out the association, if any, between the parameters of HRV andglycaemic index in Prediabetics.Methods: Recording of short term HRV in thirty prediabetics and thirty apparently healthy controls of eithersex in the age group of 40 to 65 years were done. The subjects were enrolled as per American DiabetesAssociation (ADA) criteria on the basis of their glycaemic indices viz: Fasting blood sugar (FBS), 2h Oralglucose tolerance test (OGTT) and Glycated haemoglobin (HbA1c).Result: Prediabetic subjects showed a significant decrease (p=0.007) in SDNN (Time Domain parameter ofHRV) when compared with the control group, whereas the RMSSD and other frequency domain parametersof HRV did not show any significant difference in the two groups. However, the correlation analysis betweenvarious parameters of HRV and glycaemic indices showed a significant negative association.Conclusion: A significant decrease in SDNN along with significant negative association between HRVparameters and glycaemic indices indicates towards a decrease in parasympathetic activity of cardiacautonomic function and hence the possibility of initiation of CAD in Prediabetic stage itself.