Gao Jialin, Wei Wei, Wang Gang, Zhou Honglan, Fu Yaowen, Liu Nian
Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China.
Ther Clin Risk Manag. 2018 Jan 9;14:95-104. doi: 10.2147/TCRM.S149325. eCollection 2018.
Though many studies have been performed to elucidate the association between circulating vitamin D and prostate cancer, no conclusive result is available. We carried out a dose-response meta-analysis to quantitatively examine the association of circulating 25-hydroxyvitamin D (25[OH]D) concentration with prostate cancer.
Only prospective studies examining the associations of circulating 25[OH]D concentration with prostate cancer were eligible for the meta-analysis. A random-effect meta-analysis was done first, to calculate the summary relative risk (RR) and 95% confidence intervals (CIs) comparing the higher concentration with the lower concentration of 25[OH]D. A dose-response meta-analysis using random-effects model was then carried out to evaluate the nonlinearity and calculate the summary RR caused per 10 ng/mL increment.
Nineteen prospective cohort or nested case-control studies were included. Higher 25[OH]D concentration was significantly correlated with elevated risk of prostate cancer (RR =1.15, 95% CI 1.06-1.24). No nonlinear relationship was found between 25[OH]D concentration and risk of prostate cancer (=0.654). Dose-response meta-analysis showed that the summary RR caused per 10 ng/mL increment in circulating 25[OH]D concentration was 1.04 (95% CI 1.02-1.06). Subgroup analysis also found a modest dose-response relationship. Funnel plot and Egger's test did not detect publication bias.
The findings suggest that highest 25[OH]D concentration is correlated with elevated risk of prostate cancer and a modest dose-response effect exists in this association; however, more studies are needed.
尽管已经进行了许多研究来阐明循环维生素D与前列腺癌之间的关联，但尚无定论。我们进行了一项剂量反应荟萃分析，以定量研究循环25-羟基维生素D（25[OH]D）浓度与前列腺癌之间的关联。
只有那些研究循环25[OH]D浓度与前列腺癌关联的前瞻性研究才有资格纳入荟萃分析。首先进行随机效应荟萃分析，以计算比较25[OH]D高浓度与低浓度时的汇总相对风险（RR）和95%置信区间（CI）。然后进行随机效应模型的剂量反应荟萃分析，以评估非线性关系并计算每增加10 ng/mL所导致的汇总RR。
纳入了19项前瞻性队列或巢式病例对照研究。较高的25[OH]D浓度与前列腺癌风险升高显著相关（RR =1.15，95%CI 1.06 - 1.24）。未发现25[OH]D浓度与前列腺癌风险之间存在非线性关系（=0.654）。剂量反应荟萃分析表明，循环25[OH]D浓度每增加10 ng/mL所导致的汇总RR为1.04（95%CI 1.02 - 1.06）。亚组分析也发现了适度的剂量反应关系。漏斗图和Egger检验未检测到发表偏倚。
研究结果表明，最高的25[OH]D浓度与前列腺癌风险升高相关，且这种关联存在适度的剂量反应效应；然而，还需要更多的研究。
