Does prostate volume correlate with Vitamin D deficiency among men undergoing prostate biopsy?

Objectives:Recent studies demonstrate Vitamin D is inversely correlated with BPH and prostate cancer (PCA) incidence. We aim to clarify the associations of Vitamin D with prostate volume.Methods:This is an observational study investigating the associations of serum PSA, PSA density and prostate volume with serum 25-hydroxyVitamin D (25-OH D) in PCA patients and men with negative biopsies seen in outpatient urology clinics in Chicago, IL, USA. There were 571 men (40-79 years old) with elevated PSA or abnormal digital rectal examination with available prostate volume recorded from initial biopsy. The primary outcomes were the unadjusted associations of serum 25-OH D deficiency with prostate volume. The secondary outcomes were the adjusted associations using linear and logistic regression analysis.Results:On univariate analysis, serum 25-OH D<20 ng ml-1 inversely correlated with prostate volume among all men undergoing transrectal ultrasonography (P=0.02), and this relationship remained significant for men with negative biopsy on stratified analysis. In adjusted models, controlling for age, serum PSA, 5-a reductase inhibitors use, obesity and PCA diagnosis, prostate volume was inversely associated with Vitamin D (P<0.05) using serum Vitamin D as a continuous and categorical variable. Logistic regression model also demonstrated an inverse association between Vitamin D (continuous and categorical) and prostate volume ≥40 grams.Conclusion:Serum 25-OH D levels are inversely associated with overall prostate volume and enlarged prostate gland (≥40 grams), especially in men with benign prostatic disease. Given the largely non-Toxic effect of supplementation, consideration should be given to assessing Vitamin D levels in men with benign prostatic disease in addition, to malignant prostatic disease.