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.
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.
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-α 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.
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.
This is a preview of subscription content
Subscribe to Journal
Get full journal access for 1 year
only $24.75 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Schenk JM, Till CA, Tangen CM, Goodman PJ, Song X, Torkko KC et al. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 2014; 23: 1484–1493.
Kristal AR, Till C, Song X, Tangen CM, Goodman PJ, Neuhauser ML et al. Plasma vitamin D and prostate cancer risk: results from the selenium and vitamin E cancer prevention trial. Cancer Epidemiol Biomarkers Prev 2014; 23: 1494–1504.
Nyame YA, Murphy AB, Bowen DK, Jordan G, Batai K, Dixon M et al. Associations between serum vitamin D and adverse pathology in men undergoing radical prostatectomy. J Clin Oncol 2016; 34: 1345–1349.
Blutt SE, McDonnell TJ, Polek TC, Weigel NL . Calcitriol-induced apoptosis in lncap cells is blocked by overexpression of bcl-2. Endocrinology 2000; 141: 10–17.
Zhao XY, Ly LH, Peehl DM, Feldman D . Induction of androgen receptor by 1alpha,25-dihydroxyvitamin D3 and 9-cis retinoic acid in lncap human prostate cancer cells. Endocrinology 1999; 140: 1205–1212.
Blutt SE, Allegretto EA, Pike JW, Weigel NL . 1,25-dihydroxyvitamin D3 and 9-cis-retinoic acid act synergistically to inhibit the growth of lncap prostate cells and cause accumulation of cells in G1. Endocrinology 1997; 138: 1491–1497.
Haghsheno M-A, Mellström D, Behre C-J, Damber J-E, Johansson H, Karlsson M et al. Low 25-OH vitamin D is associated with benign prostatic hyperplasia. J Urol 2013; 190: 608–614.
Del Valle HB, Yaktine AL, Taylor CL, Ross AC . Dietary reference intakes for calcium and vitamin D. National Academies Press: Washington, D.C., 2011.
Ahonen MH, Tenkanen L, Teppo L, Hakama M, Tuohimaa P . Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (finland). Cancer Causes Control 2000; 11: 847–852.
Murphy AB, Nyame Y, Martin IK, Catalona WJ, Hollowell CMP, Nadler RB et al. Vitamin D deficiency predicts prostate biopsy outcomes. Clin Cancer Res 2014; 20: 2289–2299.
Hashimoto M, Shimizu N, Sugimoto K, Hongoh S, Minami T, Nozawa M et al. Efficacy of adding dutasteride to α-blocker therapy treated benign prostatic hyperplasia patients with small volume prostate (<30 ml). Low Urin Tract Symptoms 2016 (e-pub ahead of print).
McConnell JD, Roehrborn CG, Bautista OM, Andriole GL, Dixon CM, Kusek JW et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003; 349: 2387–2398.
Espinosa G, Esposito R, Kazzazi A, Djavan B . Vitamin D and benign prostatic hyperplasia — a review. Can J Urol 2013; 20: 6820–6825.
Penna G, Fibbi B, Amuchastegui S, Corsiero E, Laverny G, Silvestrini E et al. The vitamin D receptor agonist elocalcitol inhibits il-8-dependent benign prostatic hyperplasia stromal cell proliferation and inflammatory response by targeting the rhoa/rho kinase and nf-kappab pathways. Prostate 2009; 69: 480–493.
Freedman LP . Transcriptional targets of the vitamin D3 receptor-mediating cell cycle arrest and differentiation. J Nutr 1999; 129: 581S–586S.
Sintov AC, Yarmolinsky L, Dahan A, Ben-Shabat S . Pharmacological effects of vitamin D and its analogs: recent developments. Drug Discov Today 2014; 19: 1769–1774.
Peehl DM, Skowronski RJ, Leung GK, Wong ST, Stamey TA, Feldman D . Antiproliferative effects of 1,25-dihydroxyvitamin D3 on primary cultures of human prostatic cells. Cancer Res 1994; 54: 805–810.
Murthy S, Agoulnik IU, Weigel NL . Androgen receptor signaling and vitamin D receptor action in prostate cancer cells. Prostate 2005; 64: 362–372.
Yee SW, Campbell MJ, Simons C . Inhibition of vitamin D3 metabolism enhances VDR signalling in androgen-independent prostate cancer cells. J Steroid Biochem Mol Biol 2006; 98: 228–235.
Moreno J, Krishnan AV, Feldman D . Molecular mechanisms mediating the anti-proliferative effects of vitamin D in prostate cancer. J Steroid Biochem Mol Biol 2005; 97: 31–36.
Terris MK, Afzal N, Kabalin JN . Correlation of transrectal ultrasound measurements of prostate and transition zone size with symptom score, bother score, urinary flow rate, and post-void residual volume. Urology 1998; 52: 462–466.
Colli E, Rigatti P, Montorsi F, Artibani W, Petta S, Mondaini N et al. BXL628, a novel vitamin D3 analog arrests prostate growth in patients with benign prostatic hyperplasia: a randomized clinical trial. Eur Urol 2006; 49: 82–86.
Wada K, Tanaka H, Maeda K, Inoue T, Noda E, Amano R et al. Vitamin D receptor expression is associated with colon cancer in ulcerative colitis. Oncol Rep 2009; 22: 1021–1025.
Freedland SJ, Isaacs WB, Platz EA, Terris MK, Aronson WJ, Amling CL et al. Prostate size and risk of high-grade, advanced prostate cancer and biochemical progression after radical prostatectomy: a search database study. J Clin Oncol 2005; 23: 7546–7554.
Nielsen NO, Bjerregaard P, Rønn PF, Friis H, Andersen S, Melbye M et al. Associations between vitamin D status and type 2 diabetes measures among inuit in greenland may be affected by other factors. PLoS One 2016; 11: e0152763.
Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L et al. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab 2006; 91: 2562–2568.
Xu Y, Shao X, Yao Y, Xu L, Chang L, Jiang Z, Lin Z . Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: new findings from an updated meta-analysis. J Cancer Res Clin Oncol 2014; 140: 1465–1477.
Murphy AB, Kelley B, Nyame YA, Martin IK, Smith DJ, Castaneda L et al. Predictors of serum vitamin D levels in african american and european american men in chicago. Am J Mens Health 2012; 6: 420–426.
This work was supported by the following grants: 1R01MD007105-01 (R Kittles); IK2CX000926-01 (AB Murphy), W81XWH-10-1-0532 pd22E (AB Murphy), P50 CA090386-10S1 (WJ Catalona) and the Prostate SPORE (P50 CA180995).
The authors declare no conflict of interest.
About this article
Cite this article
Murphy, A., Nyame, Y., Batai, K. et al. Does prostate volume correlate with vitamin D deficiency among men undergoing prostate biopsy?. Prostate Cancer Prostatic Dis 20, 55–60 (2017). https://doi.org/10.1038/pcan.2016.41
Future Journal of Pharmaceutical Sciences (2020)
Cholecalciferol for the prophylaxis against recurrent urinary tract infection among patients with benign prostatic hyperplasia: a randomized, comparative study
World Journal of Urology (2019)