在大型嵌套病例对照研究中，解散与前列腺癌的发生率和死亡的不一致的维生素D关联
Disentangling discordant vitamin D associations with prostate cancer incidence and fatality in a large, nested case-control study
影响因子:5.90000
分区:医学2区 Top / 公共卫生1区
发表日期:2024 Aug 14
作者:
Lola Etiévant, Mitchell H Gail, Demetrius Albanes
摘要
在α-生育酚，β-胡萝卜素预防（ATBC）研究中，对前列腺癌嵌套的病例对照和生存数据的已发表的分析表明，具有较高基线维生素D [25（OH）D]浓度较高的男性具有（I）的（I）增加了前列腺癌的风险和（II）降低前列腺癌的效果。在ATBC研究中嵌套的病例对照数据中，重新分析的基线血清维生素D与前列腺癌风险和前列腺癌特异性死亡（1000例和1000例入射前列腺癌病例）相关。分别使用了条件逻辑回归和COX比例危害模型，以估计前列腺特异性死亡的风险和危害比的优势比，整体和疾病的侵略性。我们使用α-生育酚（维生素E），β-胡萝卜素和视黄醇（维生素A）的基线血清测量进行了这些病例对照分析，并将整个ATBC研究队列（n = 29 085）与这些基线癌症的封闭及其分析及其分析的分析性分析次数估算，以估算这些基线的癌症癌症的闭合性。最初出版，具有相反的风险和死亡协会。相比之下，对α-生育酚，β-胡萝卜素和视黄醇的分析产生了一致的相关性，以使前列腺癌发生率和前列腺癌特异性死亡。我们找到了嵌套的前列腺癌病例对照数据中的伪影的证据，也没有发现或在致命分析中发现或碰撞偏见。因此，本发现支持维生素D和前列腺癌特异性生存之间有效的逆（即有益）关联，需要进一步评估，包括可能在对照试验中。
Abstract
Published analyses of prostate cancer nested case-control and survival data in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort suggested that men with higher baseline vitamin D [25(OH)D] concentrations have both (i) increased prostate cancer risk and (ii) decreased prostate cancer-specific fatality.To investigate possible factors responsible for a spurious association with prostate cancer fatality, we reanalysed baseline serum vitamin D associations with prostate cancer risk and prostate cancer-specific fatality in case-control data nested within the ATBC Study (1000 controls and 1000 incident prostate cancer cases). Conditional logistic regression and Cox proportion hazard models were used, respectively, to estimate odds ratios for risk and hazard ratios for prostate cancer-specific fatality, overall and by disease aggressiveness. We replicated these case-control analyses using baseline serum measurements of alpha-tocopherol (vitamin E), beta-carotene and retinol (vitamin A), and used the entire ATBC Study cohort (n = 29 085) to estimate marginal associations between these baseline vitamins and prostate cancer incidence and fatality following blood collection.Vitamin D analyses agreed closely with those originally published, with opposite risk and fatality associations. By contrast, the analyses of alpha-tocopherol, beta-carotene and retinol yielded concordant associations for prostate cancer incidence and prostate cancer-specific fatality.We found evidence of neither artefacts in the nested prostate cancer case-control data set nor detection or collider biases in the fatality analyses. The present findings therefore support a valid inverse (i.e. beneficial) association between vitamin D and prostate cancer-specific survival that warrants further evaluation, including possibly in controlled trials.Published by Oxford University Press on behalf of the International Epidemiological Association 2024.