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Review
. 2018 Dec 1;7(12):R294-R303.
doi: 10.1530/EC-18-0283.

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

Zhen-Yu Song  1 , Qiuming Yao  2 , Zhiyuan Zhuo  1 , Zhe Ma  1 , Gang Chen  1
Affiliations
Review

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

Zhen-Yu Song et al. Endocr Connect. .

Abstract

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.

Keywords: meta-analysis; mortality; prostate cancer; vitamin D.

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Figures

Figure 1
Figure 1
Flowchart of study selection in the meta-analysis.
Figure 2
Figure 2
Dose–response relationships between 25(OH)D and risk estimates of all-cause mortality and prostate cancer-specific mortality. (A) Risk estimates with 95% CI for the association between 25(OH)D and all-cause mortality. (B) Risk estimates with 95% CI for the association between 25(OH)D and prostate cancer-specific mortality.
Figure 3
Figure 3
Summary risk estimates of mortality in prostate cancer patients associated with 20 nmol/L increment in 25(OH)D level. (A) Funnel plot of risk estimates of all-cause mortality of prostate cancer with the increment of 20 nmol/L in 25(OH)D level. (B) Funnel plot of risk estimates of prostate cancer-specific mortality with the increment of 20 nmol/L in 25(OH)D level.
Figure 4
Figure 4
Sensitivity analysis by excluding studies by turns suggested that the pooled HRs were not significantly changed by any individual study. (A) Sensitivity analysis of the association between 25(OH)D and all-cause mortality of prostate cancer. (B) Sensitivity analysis of the association between 25(OH)D and prostate cancer-specific mortality.
Figure 5
Figure 5
Publication bias. (A) Publication bias of the association between 25(OH)D and all-cause mortality of prostate cancer. (B) Publication bias of the association between 25(OH)D and prostate cancer-specific mortality.
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