This collaborative proposal between the University of North Carolina ? Chapel Hill and Emory University is an adjunct pilot metabolomic study to an ongoing multi-center, randomized, double-blind, placebo-controlled, modified 2 x 2 factorial chemoprevention clinical trial (R01 CA98286;PI: J. Baron) (n = 2,259) that is testing the efficacy of supplemental vitamin D3 (1,000 IU daily) and calcium (1,200 mg elemental calcium daily), alone and in combination vs. placebo over 3 ? 5 years in preventing sporadic colorectal adenoma recurrence (the ?parent study?). The objective of this proposal is to establish a new interactive collaboration between clinical researchers in the parent study and metabolomics experts, and to incorporate a novel high-resolution metabolomics approach into the parent study to better understand the independent and synergistic antineoplastic actions and other effects of vitamin D and calcium in humans. Our innovative approach utilizes high-resolution mass spectrometry to measure >20,000 metabolites, and provides a unique workflow using false discovery rates (FDR) to prioritize metabolites for subsequent study, correlation analysis to enhance identification of relevant metabolic modules associated with these prioritized metabolites, pathway mapping using available online tools to identify relevant metabolic pathways, and post-hoc application of ion dissociation (MS/MS) spectroscopy to representative metabolites to confirm pathway identification. In the pilot study we will obtain preliminary data on the effects of supplementation with vitamin D and/or calcium on individual metabolites and metabolic pathways in a sub-set of participants (n = 120) with baseline and follow-up biopsies of normal-appearing rectal mucosa. The preliminary results obtained from this pilot study will lead to larger, full-scale, metabolomic investigations to elucidate 1) the individual and combined effects of vitamin D and calcium on metabolomic pathways in humans (thus providing a more comprehensive assessment of the benefits and risks of these heavily promoted agents as supplements), 2) whether these metabolomic changes correlate with genetic variation and systemic and tissue-specific biomarkers in humans (and thus their direct relevance to the chemoprevention of colorectal neoplasms), and 3) whether the metabolomic changes predict the occurrence of sporadic colorectal adenomas in humans, thus paving the way for the development of treatable biomarkers of risk for colorectal neoplasia that are analogous to lipid profiles for the prevention of ischemic heart disease. Elucidating the effects of vitamin D and/or calcium supplementation on individual metabolites and metabolomic pathways may inform the potential use of these chemopreventive agents for preventing colorectal neoplasms, and, possibly, other chronic diseases.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1 (O1))
Program Officer
Umar, Asad
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
Zip Code
Liu, Siyu; Barry, Elizabeth L; Baron, John A et al. (2016) Effects of supplemental calcium and vitamin D on the APC/β-catenin pathway in the normal colorectal mucosa of colorectal adenoma patients. Mol Carcinog :
Rees, Judy R; Mott, Leila A; Barry, Elizabeth L et al. (2016) Randomized controlled trials: who fails run-in? Trials 17:374
Barry, Elizabeth L; Peacock, Janet L; Rees, Judy R et al. (2016) Vitamin D Receptor Genotype, Vitamin D3 Supplementation, and Risk of Colorectal Adenomas: A Randomized Clinical Trial. JAMA Oncol :
Baron, John A; Barry, Elizabeth L; Mott, Leila A et al. (2015) A Trial of Calcium and Vitamin D for the Prevention of Colorectal Adenomas. N Engl J Med 373:1519-30
Obuch, Joshua C; Pigott, Courtney M; Ahnen, Dennis J (2015) Sessile serrated polyps: detection, eradication, and prevention of the evil twin. Curr Treat Options Gastroenterol 13:156-70
Peery, Anne F; Sandler, Robert S; Galanko, Joseph A et al. (2015) Risk Factors for Hemorrhoids on Screening Colonoscopy. PLoS One 10:e0139100
Crockett, Seth D; Mott, Leila A; Barry, Elizabeth L et al. (2014) C-reactive protein and risk of colorectal adenomas or serrated polyps: a prospective study. Cancer Prev Res (Phila) 7:1122-7
Barry, Elizabeth L; Rees, Judy R; Peacock, Janet L et al. (2014) Genetic variants in CYP2R1, CYP24A1, and VDR modify the efficacy of vitamin D3 supplementation for increasing serum 25-hydroxyvitamin D levels in a randomized controlled trial. J Clin Endocrinol Metab 99:E2133-7
Barry, Elizabeth L; Mott, Leila A; Melamed, Michal L et al. (2014) Calcium supplementation increases blood creatinine concentration in a randomized controlled trial. PLoS One 9:e108094
Peery, Anne F; Baron, John A (2014) Reply: To PMID 23891924. Clin Gastroenterol Hepatol 12:1201-2

Showing the most recent 10 out of 16 publications