Aggressive Prostate Cancer in blacks with low vitamin D – 7X more likely if added Calcium
Association between Serum 25-Hydroxy-Vitamin D and Aggressive Prostate Cancer in African American Men
Nutrients 2017, 9(1), 12; doi:10.3390/nu9010012 (registering DOI)
Shakira M. Nelson 1,2,* , Ken Batai 3, Chiledum Ahaghotu 4, Tanya Agurs-Collins 5 and Rick A. Kittles 3
1 Cancer Prevention Fellow, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA
2 Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA
3 Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ 85721, USA
4 Chief Medical Officer, Carney Hospital-Steward Health Systems, Dorchester, MA 02124, USA
5 Health Behavior Research Branch, Division of Cancer Control and Population Studies, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
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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.