Serum vitamin D concentration and prostate cancer risk: A nested case-control study
Serum vitamin D concentration and prostate cancer risk: A nested case-control study
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DOI：
10.1093/jnci/djn152
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发表时间：
2008-06-04
影响因子：
10.3
通讯作者：
Hayes, Richard B.
中科院分区：
文献类型：
--
作者：
Ahn, Jiyoung;Peters, Ulrike;Hayes, Richard B.
背景流行病学研究得出的维生素D状态与前列腺癌风险之间的关联不一致，很少有研究评估这种关联是否因疾病的侵袭性而异。我们在前列腺、肺、结直肠、前列腺和前列腺疾病的病例对照研究中调查了维生素D状态（通过血清25-羟基维生素D [25（OH）D]水平测定）与前列腺癌风险之间的关系，和卵巢癌筛查试验（PLCO）。方法本研究包括749例确诊为前列腺癌的患者，采血后8年，781例对照受试者按入组时年龄、自初始筛选后时间和入组日历年进行频率匹配。所有研究参与者均选自试验筛查组（包括年度标准化前列腺癌筛查）。采用条件Logistic回归分析，以季节性标准化血清25（OH）D浓度的五分位数估计调整后的比值比（OR）和95%置信区间（CI）。统计检验是双侧的。结果没有统计学意义的趋势，在整体前列腺癌的风险，观察到增加季节标准化血清25（OH）D水平。然而，血清25（OH）D浓度高于最低五分位数（Q1）与侵袭性疾病风险增加相关。（Gleason总和>= 7或临床分期III或IV）疾病（在调整匹配因素、研究中心和糖尿病史的模型中，Q2 vs Q1的OR = 1.20，95% CI = 0.80 - 1.81，Q3 vs Q1 =1.96，95% CI = 1.34 - 2.87，Q4 vs Q1 = 1.61，95% CI = 1.09 - 2.38，Q5 vs Q1 = 1.37，95% CI = 0.92 - 2.05; P趋势= 0.05）。血清25（OH）D升高五分位数的侵袭性前列腺癌发生率分别为406、479、780、633和544/10万人年。在探索性分析中，这些协会与积极的疾病是一致的，跨亚组定义的年龄，前列腺癌家族史，糖尿病，体重指数，剧烈的体力活动，钙的摄入量，研究中心，季节的血液收集，和assay batch.Conclusion这项大型前瞻性研究的结果不支持的假设，维生素D与前列腺癌的风险降低;事实上，较高的循环25（OH）D浓度可能与侵袭性疾病的风险增加有关。
Background Epidemiological studies have yielded inconsistent associations between vitamin D status and prostate cancer risk, and few studies have evaluated whether the associations vary by disease aggressiveness. We investigated the association between vitamin D status, as determined by serum 25-hydroxyvitamin D [25(OH)D] level, and risk of prostate cancer in a case-control study nested within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.Methods The study included 749 case patients with incident prostate cancer who were diagnosed 1-8 years after blood draw and 781 control subjects who were frequency matched by age at cohort entry, time since initial screening, and calendar year of cohort entry. All study participants were selected from the trial screening arm (which includes annual standardized prostate cancer screening). Conditional logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) by quintile of season-standardized serum 25(OH)D concentration. Statistical tests were two-sided.Results No statistically significant trend in overall prostate cancer risk was observed with increasing season-standardized serum 25(OH)D level. However, serum 25(OH)D concentrations greater than the lowest quintile (Q1) were associated with increased risk of aggressive (Gleason sum >= 7 or clinical stage III or IV) disease (in a model adjusting for matching factors, study center, and history of diabetes, ORs for Q2 vs Q1 = 1.20, 95% CI = 0.80 to 1.81, for Q3 vs Q1 =1.96, 95% CI = 1.34 to 2.87, for Q4 vs Q1 = 1.61, 95% CI = 1.09 to 2.38, and for Q5 vs Q1 = 1.37, 95% CI = 0.92 to 2.05; P-trend = .05). The rates of aggressive prostate cancer for increasing quintiles of serum 25(OH)D were 406, 479, 780, 633, and 544 per 100 000 person-years. In exploratory analyses, these associations with aggressive disease were consistent across subgroups defined by age, family history of prostate cancer, diabetes, body mass index, vigorous physical activity, calcium intake, study center, season of blood collection, and assay batch.Conclusion The findings of this large prospective study do not support the hypothesis that vitamin D is associated with decreased risk of prostate cancer; indeed, higher circulating 25(OH)D concentrations may be associated with increased risk of aggressive disease.