Reddy Janvitha, K A Arul Senghor, V M Vinodhini, Prasath N, Ravat Mansi
Biochemistry, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Sri Ramaswamy Memorial Institute of Science and Technology, Kattankulathur, IND.
Medical Biochemistry, Sri Ramaswamy Memorial Medical College Hospital and Research Centre, Sri Ramaswamy Memorial Institute of Science and Technology, Kattankulathur, IND.
Cureus. 2024 Dec 2;16(12):e74959. doi: 10.7759/cureus.74959. eCollection 2024 Dec.
Benign prostatic hyperplasia (BPH) is the most common form of lower urinary tract symptoms (LUTS). Vitamin D may be an effective way to treat BPH symptoms because it has anti-proliferative and anti-inflammatory characteristics. Thus, adequate vitamin D levels are vital for overall health. This study aimed to investigate the association of vitamin D with prostate health status in men and determine the diagnostic cut-off of vitamin D levels. Methods: This analytical cross-sectional study was conducted among men between 45 and 80 years of age who presented to the surgery or urology department with complaints of frequent urination and urinary tract infection. Based on their total prostate-specific antigen (PSA) levels, the participants were categorized into four groups - Group A (total PSA 0-3.9 ng/ml), Group B (total PSA 4-9.9 ng/ml), Group C (total PSA 10 - 19.9 ng/ml), and Group D (total PSA > 20 ng/ml). Total PSA was estimated by a dedicated Beckman Coulter hormone analyzer (UNICEL DXI 600, Beckman Coulter, Inc., California, US) via the chemiluminescence method. Serum vitamin D was estimated with dedicated reagents in the Bio-Rad ELISA (Bio-Rad Laboratories, Inc., California, US). An analysis of variance (ANOVA) post hoc test was utilized to compare quantitative variables. A correlation analysis proved the relation between vitamin D and total PSA. The receiver operating characteristic (ROC) curve was utilized to determine the diagnostic performance of the analyte of interest.
In this study, total PSA levels significantly increased in men over 75 years of age. The upper limit of total PSA increased with the age of the men. Total PSA levels were compared between the age groups of 40 to 49, 50 to 59, 60 to 69, and more than 70, and an increase in total PSA levels was observed in those between 60 and 69 years. Total PSA levels were also negatively correlated (r=- 0.31) with vitamin D in this age group. Moreover, vitamin D-deficient individuals had significantly increased total PSA levels (12.57±5.22 ng/ml). Further correlation analysis revealed a significant negative correlation of total PSA with vitamin D levels (r=- 0.245; p=0.022). ROC analysis had an area under the curve of 0.828 for Vitamin D at a cut-off of 20 ng/ml revealing a diagnostic sensitivity of 86% and specificity of 60%. Conclusion: Vitamin D deficiency is a potential biochemical marker of benign prostate hypertrophy. Vitamin D and total PSA are indicators of prostate health status in men. Screening of total PSA levels reflects the prostate health status of men and this needs to be potentiated with vitamin D supplementation.
良性前列腺增生（BPH）是下尿路症状（LUTS）最常见的形式。维生素D可能是治疗BPH症状的有效方法，因为它具有抗增殖和抗炎特性。因此，充足的维生素D水平对整体健康至关重要。本研究旨在调查男性体内维生素D与前列腺健康状况的关联，并确定维生素D水平的诊断临界值。
本分析性横断面研究在45至80岁因尿频和尿路感染主诉就诊于外科或泌尿外科的男性中进行。根据他们的总前列腺特异性抗原（PSA）水平，参与者被分为四组——A组（总PSA 0 - 3.9 ng/ml）、B组（总PSA 4 - 9.9 ng/ml）、C组（总PSA 10 - 19.9 ng/ml）和D组（总PSA > 20 ng/ml）。总PSA通过专用的贝克曼库尔特激素分析仪（UNICEL DXI 600，贝克曼库尔特公司，美国加利福尼亚州）采用化学发光法进行测定。血清维生素D使用伯乐酶联免疫吸附测定（ELISA）（伯乐实验室公司，美国加利福尼亚州）中的专用试剂进行测定。采用方差分析（ANOVA）事后检验来比较定量变量。相关性分析证实了维生素D与总PSA之间的关系。利用受试者工作特征（ROC）曲线来确定感兴趣分析物的诊断性能。
在本研究中，75岁以上男性的总PSA水平显著升高。总PSA的上限随男性年龄增加而升高。对40至49岁、50至59岁、60至69岁以及70岁以上年龄组的总PSA水平进行比较，发现60至69岁组的总PSA水平有所升高。在该年龄组中，总PSA水平也与维生素D呈负相关（r = -0.31）。此外，维生素D缺乏个体的总PSA水平显著升高（12.57±5.22 ng/ml）。进一步的相关性分析显示总PSA与维生素D水平呈显著负相关（r = -0.245；p = 0.022）。ROC分析显示，维生素D在临界值为20 ng/ml时曲线下面积为0.828，诊断敏感性为86%，特异性为60%。
维生素D缺乏是良性前列腺肥大的潜在生化标志物。维生素D和总PSA是男性前列腺健康状况的指标。总PSA水平的筛查反映了男性的前列腺健康状况，这需要通过补充维生素D来加强。
