Original Research Article DOI: 10.18231/2394-6377.2018.0038 International Journal of Clinical Biochemistry and Research, April-June, 2018;5(2):185-190 185 Effect of serum vitamin D deficiency in the prevalence of haematological malignancies Rama Mani Gorle 1 , Munta Anil Kumar 2,* , Santa Ayyagari 3 1 Head and Consultant, Dept. of Clinical Biochemistry, ELBIT Medical Diagnostics Pvt. Limited, Hyderabad, Telangana, 2 Associate Professor, Dept. of Biochemistry, Maharajah’s Institute of Medical Sciences, Vizianagaram, Andhra Pradesh, 3 Sr. Consultant Medical Oncologist, Basavatarakam Indo-American Cancer Institute and Research Centre, Hyderabad, Telangana, India *Corresponding Author: Email: drmakbio@gmail.com Received: 01 st February, 2018 Accepted: 07 th March, 2018 Abstract Introduction: The awareness on vitamin D related metabolic activities have drawn attention in the recent times. The studies reported vitamin D deficiency may result in the progression of malignancies. 1,2 Being a tropical country, 80% of the Indians are found to be vitamin D deficient and thus the evaluation of serum vitamin D deficiency helps in understanding its risk association in haematological malignancies. 3,4 Materials and Methods: The study comprised of 250 haematological malignancy cases and 250 age and sex matched healthy controls. The diagnosis was confirmed by blood, bone marrow or lymph node biopsies. Serum vitamin D levels were analysed by Electrochemiluminescence Immunoassay (ECLIA) method and statistical analysis was done by using Medcalc 11.6. The data were expressed as mean ± SD and the risk association of vitamin D deficiency and comparison in the experimental groups was done by using the odds ratio (OR) and odds relative risk ratio (RR). Results: Among the 250 haematological cases, 185(74.0%) showed low serum vitamin D levels, whereas controls had comparatively lesser deficiency rate (60%). Despite significant vitamin D deficiency of control group, haematological malignancies showed highly significant risk association towards the disease occurrence (OR=1.90; t-test =0.0026). Conclusion: Low serum vitamin D levels were significantly associated with haematological malignancies. Additional population based studies are required to evolve therapeutic strategies and treatment protocols for the risk reduction and management of malignancies. Keywords: Vitamin D, Deficiency, Tropical countries, Haematological, Malignancy. Introduction Vitamin D is centrally involved in the bone metabolism and calcium regulation along with other functions. However, extensive studies revealed its multitude activities in numerous biological activities like mediator of calcium and phosphate balance to cellular differentiation and immune modulation etc. 5 In recent days, the deficiency of vitamin D is considered a global problem and of national health concern and the rate is rampantly increasing. 1,6-8 In Indian population more than 80% has serum vitamin D levels below the optimal range. 3 International Agency for Research on Cancer (IARC) Global Cancer (GLOBOCAN) study on incidence rates of leukaemia in 172 countries found that reduced UV-B radiation (UVR) exposure and lower vitamin D levels were associated with higher risks of cancer. Leukaemia rates were highest in countries relatively closer to the poles and lowest in countries closer to the equator. 3 Multi-country studies, mostly using latitude as a proxy for UVR, showed lower rates of mortality or incidence of breast, lung, ovarian, kidney, brain, and uterine cancer and leukaemia in adults residing in countries closer to the equator where UVR levels are higher. 9 Several epidemiological studies have also suggested that inadequate levels of vitamin D may be a risk factor for the development of leukaemia. Many studies revealed that vitamin D influences the expression of more than 200 genes and almost every tissue (brain, heart, skin, kidney, pancreas etc.) has vitamin D receptors (VDR). 10 VDRs have been identified on haematopoietic and lymphoid cells, leading to efforts to understand the role of vitamin D in blood cell development and immune system function. 5 These effects may impact normal and dysfunctional haematopoietic and immune function, which may allow better understanding of haematologic disorders including malignancies. 8,5,11 Vitamin D and extracellular calcium is involved in the regulation of cell proliferation, differentiation and function. Vitamin D influences the expression of CYP27B1, which encodes 1α-hydroxylase and extracellular calcium-sensing receptor (CaR), controls the normal and cancer cell growth. Hence, the insufficiency of vitamin D may lead to progression of the cancer. Vitamin D indirectly may suppress the tumour growth and progression by facilitating the immunocytotoxic killing of tumour cells by reducing the levels of immunosuppressive CD34 lymphocytes, which generally confine the cytotoxic activity of infiltrating tumour-specific CD8+T lymphocytes. 2, 9,12,13