Abstract
African American men have higher incidence rates of aggressive prostate cancer, where high levels of calcium and serum vitamin D deficient levels play a role in the racial differences in incidence. In this study, we examined associations of serum vitamin D with aggressive prostate cancer to improve our understanding of higher susceptibility of aggressive disease in this racial cohort. From Howard University Hospital, 155 African American men with clinically-identified prostate cancer were identified; 46 aggressive cases, and 58 non-aggressive cases. Serum vitamin D was assessed from fasting blood samples, and total calcium intake was assessed using the Block Food Frequency Questionnaire. Vitamin D receptor polymorphisms from three different loci were genotyped; rs731236, rs1544410, and rs11568820. Multivariate logistic regression models were used to determine odds ratios (OR) and 95% confidence intervals (CI) comparing aggressive to non-aggressive prostate cancer. Vitamin D deficiency (<20 ng/mL) significantly increased risk of aggressive disease (OR: 3.1, 95% CI: 1.03–9.57, p-value = 0.04). Stratification by total calcium showed high calcium levels (≥800 mg/day) modified this association (OR: 7.3, 95% CI: 2.15–47.68, p-interaction = 0.03). Genetic variant rs11568820 appeared to increase the magnitude of association between deficient serum vitamin D and aggressive prostate cancer (OR: 3.64, 95% CI: 1.12–11.75, p-value = 0.05). These findings suggest that high incidence of aggressive prostate cancer risk in African American men may be due in-part to deficient levels of serum vitamin D. Other factors, including genetics, should be considered for future studies.
Highlights
IntroductionAmerican (EA) counterpart [2,3,4]
Amongst men in the United States, prostate cancer is the most common malignancy.While incidence rates of prostate cancer have decreased over the years [1], studies have shown AfricanAmerican (AA) men to develop prostate cancer at a rate 1.5–1.9 times higher than their EuropeanNutrients 2017, 9, 12; doi:10.3390/nu9010012 www.mdpi.com/journal/nutrientsAmerican (EA) counterpart [2,3,4]
Our results demonstrated that men diagnosed with aggressive prostate cancer and deficient in 25(OH)D, had a significant increase in risk compared to non-aggressive cases deficient in 25(OH)D (OR: 3.1, 95% confidence intervals (CI): 1.03–9.57, p-value: 0.04) (Table 2A)
Summary
American (EA) counterpart [2,3,4] These racial differences are further emphasized by the increased diagnosis of aggressive prostate cancer [4,5]. Demographic characteristics, such as family history, socioeconomic status, access to medical care, other comorbidities, and diet and lifestyle have been shown to contribute to the increased burden of prostate cancer in AA men [2,6,7,8]. Commonly seen in ethnic groups with dark skin, such as AA men, reduces the amount of UVB radiation absorbed in the skin, decreasing the concentration of 25(OH)D and increasing susceptibility to developing vitamin D deficiencies [14,15,16]. Molecular studies suggest deficiencies in vitamin D overtime may lead to progression from pre-clinical to clinically aggressive forms of prostate cancer [21]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.