Circulating vitamin D level and mortality in prostate cancer patients: a dose–response meta-analysis

Previous studies investigating the association of circulating 25-hydroxyvitamin D level with prognosis of prostate cancer yielded controversial results. We conducted a dose–response meta-analysis to elucidate the relationship. PubMed and EMBASE were searched for eligible studies up to July 15, 2018. We performed a dose–response meta-analysis using random-effect model to calculate the summary hazard ratio (HR) and 95% CI of mortality in patients with prostate cancer. Seven eligible cohort studies with 7808 participants were included. The results indicated that higher vitamin D level could reduce the risk of death among prostate cancer patients. The summary HR of prostate cancer-specific mortality correlated with an increment of every 20 nmol/L in circulating vitamin D level was 0.91, with 95% CI 0.87–0.97, P = 0.002. The HR for all-cause mortality with the increase of 20 nmol/L vitamin D was 0.91 (95% CI: 0.84–0.98, P = 0.01). Sensitivity analysis suggested the pooled HRs were stable and not obviously changed by any single study. No evidence of publications bias was observed. This meta-analysis suggested that higher 25-hydroxyvitamin D level was associated with a reduction of mortality in prostate cancer patients and vitamin D is an important protective factor in the progression and prognosis of prostate cancer.

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25-Hydroxyvitamin D level, vitamin D intake, and risk of stroke: A dose–response meta-analysis

Clinical Nutrition ◽

10.1016/j.clnu.2019.08.029 ◽

2020 ◽

Vol 39 (7) ◽

pp. 2025-2034 ◽

Cited By ~ 3

Author(s):

Han Shi ◽

Hanze Chen ◽

Yun Zhang ◽

Jinwei Li ◽

Kailei Fu ◽

...

Keyword(s):

Vitamin D ◽

Dose Response ◽

Meta Analysis ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D

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The association between pre-treatment serum 25-hydroxyvitamin D and survival in stage IV prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5036 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5036-5036

Author(s):

Pankaj G. Vashi ◽

Digant Gupta ◽

Kristen Trukova ◽

Gwendolyn M Lambert ◽

Carolyn Lammersfeld

Keyword(s):

Prostate Cancer ◽

Vitamin D ◽

Cancer Patients ◽

Patient Survival ◽

Stage Iv ◽

Vitamin D Insufficiency ◽

Newly Diagnosed ◽

Baseline Serum ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

5036 Background: Emerging evidence in the literature suggests a positive association between serum 25-hydroxyvitamin D [25(OH)D], a standard indicator of vitamin D status, and survival in certain types of cancer. We investigated this relationship in newly diagnosed stage IV prostate cancer patients. Methods: A case series of 54 newly diagnosed stage IV prostate cancer patients underwent a baseline serum 25(OH)D evaluation prior to receiving any treatment at our institution between Jan 2008 and Dec 2010. We defined vitamin D insufficiency as serum 25(OH)D levels of <=32 ng/ml. Patient survival was defined as the time between date of first patient visit and date of death from any cause/date of last contact. Cox regression was used to evaluate the prognostic significance of serum 25(OH)D after adjusting for age, prostate specific antigen (PSA) and functional status. Results: Mean age at diagnosis was 59.6 years. During a median follow-up of 23.6 months, 16 deaths occurred. The mean serum 25(OH)D was 30.1 ng/ml, among whom 38 (70.4%) were insufficient in vitamin D (<=32 ng/ml). Mean overall survival was 49.4 months (95% CI: 38.1-60.7). Mean survival was 32.6 months and 62.4 months for patients in <=32 ng/ml and >32 ng/ml groups respectively (p = 0.02). On univariate analysis, patients with levels >32 ng/ml had a significantly lower risk of mortality compared to those with levels <=32 ng/ml (HR=0.19; 95% CI: 0.04-0.87; p=0.03). On multivariate analysis controlling for age, performance status and PSA, patients with levels >32 ng/ml demonstrated significantly lower mortality (HR=0.13; 95% CI: 0.02-1.0; p=0.05) compared to those with levels <=32 ng/ml. Conclusions: Higher circulating levels of serum 25(OH)D were positively associated with survival in patients with metastatic prostate cancer. While these results need to be confirmed in prospective clinical trials, our study adds to the growing body of literature on the prognostic role of serum vitamin D in cancer. Given the high prevalence of vitamin D insufficiency in prostate cancer and the fact that this insufficiency is easily correctable by supplementation, we recommend early vitamin D assessment and intervention for a potential impact on patient survival.

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