title: Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy.
abstract: OBJECTIVE
  Lower serum vitamin D levels have been associated with an 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 was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels.
  
  
  METHODS
  This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. 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 extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy.
  
  
  RESULTS
  Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01).
  
  
  CONCLUSIONS
  Insufficiency/deficiency of 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.
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Nyame
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ. a-murphy2@northwestern.edu.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Murphy
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Diana K
authors.initials: DK
authors.lastname: Bowen
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Gregory
authors.initials: G
authors.lastname: Jordan
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Ken
authors.initials: K
authors.lastname: Batai
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Michael
authors.initials: M
authors.lastname: Dixon
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Courtney M P
authors.initials: CM
authors.lastname: Hollowell
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kielb
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Meeks
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gann
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Virgilia
authors.initials: V
authors.lastname: Macias
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Andre
authors.initials: A
authors.lastname: Kajdacsy-Balla
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: William J
authors.initials: WJ
authors.lastname: Catalona
authors.affiliation: Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
authors.forename: Rick
authors.initials: R
authors.lastname: Kittles
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016017:Odds Ratio; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D