Background
We previously observed that high serum 25-hydroxyvitamin D [25(OH)D] (>38.0 ng/mL) was inversely associated with breast cancer. Here, we examined effect modification by single nucleotide polymorphisms (SNPs) in vitamin D-related genes.
Methods
The Sister Study enrolled 50,884 US women who had a sister with breast cancer, but who had never had breast cancer themselves. Using a case-cohort design, we compared 1,524 women who developed breast cancer within 5 years to 1,810 randomly selected participants. We estimated ratios of hazards ratios (RHRs) for the 25(OH)D-breast cancer association per copy of the minor allele using Cox proportional hazards models. We considered 82 SNPs in 7 vitamin D-related genes (CYP24A1, CYP27B1, CYP2R1, GC, DHCR7/NADSYN1, RXRA, and VDR). We also tested gene-based interactions with 25(OH)D.
Results
The SNP with the smallest interaction p-value was rs4328262 in VDR (p=0.0008); the 25(OH)D hazard ratio (HR) was 0.92 (95% confidence interval [CI]: 0.68–1.24) among those homozygous for the common allele, and the minor allele was estimated to decrease the HR by 33% per copy (RHR=0.67, 95% confidence interval [CI]=0.53–0.85). Five other VDR SNPs showed evidence of interaction at p<0.05, as did one SNP in CYP2R1 and one in RXRA. As a group, the 82 SNPs showed evidence of multiplicative interaction with 25(OH)D (p=0.04). In gene-based tests, only VDR showed strong evidence of interaction (p=0.04).
Conclusions
SNPs in vitamin D-related genes may modify the association between serum 25(OH)D and breast cancer.
Impact
This work strengthens the evidence for protective effects of vitamin D.