Department of Urology, Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
Cancer Causes Control. 2012 Aug;23(8):1377-85. doi: 10.1007/s10552-012-9948-3. Epub 2012 Jun 16.
To examine the risk of prostate cancer in relation to pre-diagnostic serum levels of vitamin D (25OHD(2) and 25OHD(3)), PTH, and calcium.
Nine hundred forty-three incident prostate cancer cases were identified in the Malmö Diet and Cancer Study cohort, and each was matched with one control using incidence density matching with age as the underlying timescale. We also matched for calendar time and age at inclusion. Logistic regression analysis yielded odds ratios with 95 % confidence intervals for different quartiles and deciles. All analyses were repeated stratified for age and body mass index (BMI).
We found a weak trend toward increasing prostate cancer risk with rising vitamin D levels (p-trend across quartiles, 0.048). Dividing the cohort into deciles showed a nonlinear association. Compared to decile one, the prostate cancer risk was highest in deciles seven and eight, which corresponded to vitamin D levels of 91-97 nmol/L (1.68; 1.06-2.68), and 98-106 nmol/L (1.80; 1.13-2.85). In the other deciles, there was no association between prostate cancer risk and vitamin D levels. Albumin-adjusted calcium was positively associated with an increased risk for prostate cancer among men aged 55-65 with a BMI <25 (2.07; 1.08-3.97). No association was observed between pre-diagnostic PTH and subsequent prostate cancer incidence, and the stratified analyses revealed no other convincing relationships.
This study suggests a possible weak positive nonlinear association between vitamin D and the risk of prostate cancer.
研究与前列腺癌发病相关的维生素 D（25OHD(2) 和 25OHD(3)）、甲状旁腺激素（PTH）和钙的预诊断血清水平。
在马尔默饮食与癌症研究队列中，确定了 943 例前列腺癌新发病例，并使用基于年龄的密度匹配方法，按年龄作为潜在时间尺度，为每个病例匹配一名对照。我们还按日历时间和纳入时的年龄进行了匹配。使用 logistic 回归分析得出了不同四分位和十分位数的比值比及其 95%置信区间。所有分析均按年龄和体重指数（BMI）进行分层重复。
我们发现随着维生素 D 水平的升高，前列腺癌的发病风险呈上升趋势（四分位组间趋势，p=0.048）。将队列分为十分位数显示出非线性关联。与十分位一相比，十分位七和十分位八的前列腺癌风险最高，对应的维生素 D 水平分别为 91-97 nmol/L（1.68；1.06-2.68）和 98-106 nmol/L（1.80；1.13-2.85）。在其他十分位中，维生素 D 水平与前列腺癌风险之间没有关联。对于 BMI<25 的 55-65 岁男性，白蛋白校正后的钙与前列腺癌风险呈正相关（2.07；1.08-3.97）。预诊断的甲状旁腺激素与随后的前列腺癌发病之间没有关联，分层分析也没有发现其他有说服力的关系。
本研究表明，维生素 D 与前列腺癌风险之间可能存在微弱的正非线性关联。
