McGrowder Donovan, Tulloch-Reid Marshall K, Coard Kathleen C M, McCaw-Binns Afette M, Ferguson Trevor S, Aiken William, Harrison Leroy, Anderson Simon G, Jackson Maria D
Department of Pathology, Faculty of Medical Sciences, 462834The University of the West Indies, Mona, Jamaica.
Epidemiology Research Unit, Caribbean Institute for Health Research, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica.
Cancer Control. 2022 Jan-Dec;29:10732748221131225. doi: 10.1177/10732748221131225.
25 hydroxyvitamin D [25(OH)D] and serum calcium have been associated with incident prostate cancer (PCa). However, there is limited data on whether these metabolites predict survival in men of African descent, a population disproportionately affected by PCa. We studied the relationship of 25(OH)D at PCa diagnosis with all-cause and cancer-specific mortality among Jamaican men and examined whether serum calcium modified any associations.
Serum 25(OH)D from 152 Jamaican men with incident PCa within the Prostate Cancer Risk Evaluation (PROSCARE) study were re-evaluated approximately 11 years after enrollment. 25(OH)D analyses were stratified using the using Holick criteria. PCa-specific and all-cause mortality were examined in Kaplan-Meier survival curves and Cox regression models adjusted for age, body mass index (BMI), smoking and Gleason score. Restricted cubic splines evaluated nonlinear associations. Serum calcium was assessed as an effect modifier of the association between 25(OH)D and mortality.
Of cases with available 25(OH)D, 64 men with PCa survived, 38 deaths were PCa specific and 36 died of other causes. At baseline, 9.9% of cases were vitamin D deficient and 61.2% were vitamin D sufficient. Compared to 25(OH)D sufficient men, those with 25(OH)D <20.0 ng/mL concentrations were associated with higher PCa-specific mortality (adjusted HR, 4.95; 95% CI, 1.68, 14.63, = .004) and all-cause mortality (adjusted HR, 2.40; 95%CI, 1.33, 4. 32, = .003). Serum calcium was not associated with survival and did not modify any associations with 25(OH)D.
25(OH)D deficiency at PCa diagnosis predicted decreased survival for overall and PCa-specific cancer in Caribbean men of African ancestry.
25羟维生素D[25(OH)D]和血清钙与前列腺癌（PCa）的发生有关。然而，关于这些代谢产物是否能预测非洲裔男性（该人群受PCa影响的比例过高）的生存率，数据有限。我们研究了PCa诊断时25(OH)D与牙买加男性全因死亡率和癌症特异性死亡率之间的关系，并检验了血清钙是否会改变任何关联。
在前列腺癌风险评估（PROSCARE）研究中，对152名新发PCa的牙买加男性的血清25(OH)D在入组约11年后进行重新评估。使用霍利克标准对25(OH)D分析进行分层。在Kaplan-Meier生存曲线和经年龄、体重指数（BMI）、吸烟和 Gleason评分调整的Cox回归模型中检查PCa特异性死亡率和全因死亡率。受限立方样条评估非线性关联。血清钙被评估为25(OH)D与死亡率之间关联的效应修饰因子。
在有可用25(OH)D的病例中，64名PCa男性存活，38例死亡为PCa特异性死亡，36例死于其他原因。基线时，9.9%的病例维生素D缺乏，61.2%的病例维生素D充足。与25(OH)D充足的男性相比，25(OH)D浓度<20.0 ng/mL的男性与更高的PCa特异性死亡率（调整后HR，4.95；95%CI，1.68，14.63，P = 0.004）和全因死亡率（调整后HR，2.40；95%CI，1.33，4.32，P = 0.003）相关。血清钙与生存率无关，也未改变与25(OH)D的任何关联。
PCa诊断时的25(OH)D缺乏预示着非洲裔加勒比男性总体癌症和PCa特异性癌症的生存率降低。
