VITAMIN D AND ANDROGENS IN PROSTATE DISEASE PATIENTS
Journal Title: World Journal of Pharmaceutical and Medical Research - Year 2018, Vol 4, Issue 5
Abstract
Aim: To study the relationship between vitamin-D status, androgens and clinical determinants for benign and malignant prostate diseases. Materials and methods: This prospective single-centred study includes 54 benign prostatic hyperplasia patients age-matched with 88 prostate cancer patients, selected by serum prostate specific antigen levels, digital rectal examination, and systemic transrectal tru-cut prostate biopsies. The cancer patients were stratified by the risk for biochemical recurrence after definite local treatment and by tumour’s Gleason score. Total and free testosterone, dehydroepiandrosterone sulphate, androstenedione, sex-hormone binding globulin, 25-hydroxyvitamin-D, and vitamin-D binding protein were measured. Results: Vitamin-D deficiency was more frequent in cancer patients vs noncancerous (69.4% vs 43.4%). Negative correlation (r=-0.255, p<0.05) and decrease (p=0.07) with the tumour grade was found for 25-hydroxyvitamin-D. Similar relationships were detected for free and total testosterone (p=0.08) and free androgen index (r=-0.262, p<0.05). Risk stratification revealed a decrease in 25-hydroxyvitamin-D (p<0.05) and vitamin-D binding protein (ns), while sex-hormone-binding protein (p<0.01) and prostate specific antigen/total testosterone ratio (p<0.05) were increased. Negative correlation between 25-hydroxyvitamin-D (r=-0.21, p=0.05) and free androgen index (r=-0.23, p<0.05) with the risk was detected. ROC curve analysis revealed that among tested steroids 25-hydroxyvitamin-D exhibited highest area under curve (AUC 0.69, p<0.001). Multifactorial regression analysis indicated prostate specific antigen (β=0.49, p<0.0001) and 25-hydroxyvitamin-D (β=-0.24, p<0.04) as statistically significant variables related to tumour grade. Conclusion: It might be hypothesized that prostate cancer is associated with disturbances in steroid metabolism. Development of steroid constellations, focused on vitamin-D, could be helpful for the assessment of disease progression and aggressiveness.
Authors and Affiliations
Bistra Tzaneva Galunska
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