Vitamin D deficiency predicts prostate biopsy outcomes.
OBJECTIVE
The association between vitamin D and prostate biopsy outcomes has not been evaluated. We examine serum vitamin D levels with prostate biopsy results in men with an abnormal prostate-specific antigen and/or digital rectal examination.


METHODS
Serum 25-hydroxyvitamin D (25-OH D) was obtained from 667 men, ages 40 to 79 years, prospectively enrolled from Chicago urology clinics undergoing first prostate biopsy. Logistic regression was used to evaluate the associations between 25-OH D status and incident prostate cancer, Gleason score, and tumor stage.


RESULTS
Among European American (EA) men, there was an association of 25-OH D <12 ng/mL with higher Gleason score ≥ 4+4 [OR, 3.66; 95% confidence interval (CI), 1.41-9.50; P = 0.008] and tumor stage [stage ≥ cT2b vs. ≤ cT2a, OR, 2.42 (1.14-5.10); P = 0.008]. In African American (AA) men, we find increased odds of prostate cancer diagnosis on biopsy with 25-OH D < 20 ng/mL [OR, 2.43 (1.20-4.94); P = 0.01]. AA men demonstrated an association between 25-OH D < 12 ng/mL and Gleason ≥ 4+4 [OR, 4.89 (1.59-15.07); P = 0.006]. There was an association with tumor stage ≥ cT2b vs. ≤ cT2a [OR, 4.22 (1.52-11.74); P = 0.003].


CONCLUSIONS
In AA men, vitamin D deficiency was associated with increased odds of prostate cancer diagnosis on biopsy. In both EA and AA men, severe deficiency was positively associated with higher Gleason grade and tumor stage.
Authors' Affiliations: Northwestern University; University of Illinois at Chicago, Chicago; Cook County Health and Hospitals System, Chicago, Illinois; Cleveland Clinic, Cleveland, Ohio; and University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
Adam B
AB
Murphy
Yaw
Y
Nyame
Iman K
IK
Martin
William J
WJ
Catalona
Courtney M P
CM
Hollowell
Robert B
RB
Nadler
James M
JM
Kozlowski
Kent T
KT
Perry
Andre
A
Kajdacsy-Balla
Rick
R
Kittles
D000328:Adult; D000368:Aged; D001706:Biopsy; D005006:Ethnicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications
D014807:Vitamin D; C104450:25-hydroxyvitamin D; D017430:Prostate-Specific Antigen