Vitamin D deficiency predicts prostate biopsy outcomes

Purpose: The association between vitamin D and prostate biopsy outcomes has not been evaluated. We examine serum vitamin D levels with prostate biopsy results in men with an abnormal prostate-specific antigen and/or digital rectal examination. Experimental Design: Serum 25-hydroxyvitamin D (25-OH D) was obtained from 667 men, ages 40 to 79 years, prospectively enrolled from Chicago urology clinics undergoing first prostate biopsy. Logistic regression was used to evaluate the associations between 25-OH D status and incident prostate cancer, Gleason score, and tumor stage. Results: Among European American (EA) men, there was an association of 25-OH D <12 ng/mL with higher Gleason score≥4+4 [OR, 3.66;95%confidence interval (CI), 1.41-9.50; P=0.008] and tumor stage [stage≥cT2b vs. ≤cT2a, OR, 2.42 (1.14-5.10); P=0.008]. In African American (AA) men, we find increased odds of prostate cancer diagnosis on biopsy with 25-OHD< 20 ng/mL [OR, 2.43 (1.20-4.94); P=0.01]. AA men demonstrated an association between 25-OH D < 12 ng/mL and Gleason ≥ 4+4 [OR, 4.89 (1.59-15.07); P=0.006]. There was an association with tumor stage≥cT2b vs.≤cT2a [OR, 4.22 (1.52-11.74); P= 0.003]. Conclusions: In AA men, vitamin D deficiency was associated with increased odds of prostate cancer diagnosis on biopsy. In both EA and AAmen, severe deficiency was positively associated with higher Gleason grade and tumor stage.