Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy

Abstract

Purpose Lower serum Vitamin D levels has demonstrated associations with increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low- or intermediate risk disease, vitamin D may serve as an important biomarker of disease aggression. The aim of this study is to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin (25-OH D) levels. Patients and Methods This is a cross-sectional study from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extra-prostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy. Results 45.8 % (87/190) of men in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (IQR 59.0–67.0). On univariate analysis men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 vs 27.0 ng/ml, p = 0.007) when compared to their counterparts. On multivariate analysis controlling for age, serum PSA, and suspicious digital rectal examination, serum 25-OH D < 30 ng/mL was associated with increased odds of adverse pathology (OR 2.64, 95% CI 1.25, 5.59, p = 0.01). Conclusion Insufficiency/Deficiency in serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study.

Race and BMI modify associations of calcium and vitamin D intake with prostate cancer

“…Epidemiologic evidence also does not provide definitive support for an inverse association between vitamin D and PCa [26–28], and other studies that explored the relationship between vitamin D intake and PCa did not find significant associations [5, 7]. However, previously, we demonstrated that serum vitamin D levels were associated with prostate biopsy outcome and adverse pathology after undergoing radical prostatectomy in our study group [18, 29], and this is the first study to demonstrate significant association between vitamin D intake and PCa. Compared to other work, our study has the advantage of including a large number of AA participants and men living in a low ultraviolet radiation environment who were vitamin D deficient [14, 15].…”

“…PCa patients and controls ages 40 to 79 years old were recruited from six public and academic hospitals in Chicago, IL (Cook County Health and Hospital System, Northwestern Memorial Hospital, Jesse Brown Veterans Affairs Medical Center, University of Illinois Hospital and Health Science System, and University of Chicago Hospital) between 2009 and 2014 [18] and Washington, D.C. (Howard University Hospital) between 2000 and 2004 [19]. The patients underwent their first prostate biopsy due to an elevated or abnormal serum prostate specific antigen (PSA) level or an abnormal digital rectal examination.…”

High levels of PIWI‐interacting RNAs are present in the small RNA landscape of prostate epithelium from vitamin D clinical trial specimens

“…In addition to its well‐characterized systemic effects, vitamin D acts locally and VDR is ubiquitously expressed. Epidemiological studies have consistently shown an association between low vitamin D and increased aggressive pathology and mortality in prostate cancer (PCa) but not with PCa incidence . The recent Vitamin D and Omega‐3 Trail (VITAL) study did not show an effect of vitamin D on PCa incidence, but when the first 2 years of follow‐up were excluded, there was a significant 25% reduction in all‐cancer mortality in the vitamin D–supplemented patients .…”

Association of Vitamin D With Prostate Carcinoma: A Single Institutional Observational Study

“…Vitamin D (VD) is best known for its actions in regulating calcium levels and bone remodeling [1] (reviewed in Brown et al, 1999), but recent studies highlight a role for VD in the growth and differentiation of various cell types [2,3]. VD may be obtained from the dietary sources; however, it is majorly synthesized in the skin by the action of sunrays.…”