Abstract
BACKGROUND: The impact of serum 25-hydroxyvitamin D [25(OH)D] on prostate cancer (PCa) development remains inconclusive. This investigation aimed to evaluate the association between 25(OH)D concentrations and PCa prevalence using data from a nationally representative cohort. METHODS: A cross-sectional analysis was performed using data from individuals aged 40 years and older who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. Comprehensive demographic and clinical information, including 25(OH)D levels and PCa status, was obtained. Multivariate logistic regression models were utilized to determine the association between serum 25(OH)D concentrations and PCa prevalence. RESULTS: This study analyzed data from 17,989 individuals, with a mean age of 61.1 ± 12.8 years and an average serum 25(OH)D concentration of 68.3 ± 23.3 nmol/L. PCa was diagnosed in 3.3% (n = 848) of participants. After full adjustment for potential confounders, elevated serum 25(OH)D concentrations were positively associated with the prevalence of PCa (p for trend = 0.007). Each 10-unit increment in serum 25(OH)D was linked to a 7% increase in PCa prevalence. Curve fitting analysis demonstrated a linear, positive association between serum 25(OH)D levels and PCa frequency. This trend remained consistent across all sensitivity analyses, including restriction to participants aged ≥ 60 years, exclusion of outlier serum 25(OH)D values (> mean + 3SD), and complete-case analysis. Stratified analysis indicated that this association was notably stronger among individuals with cardiovascular disease (OR, 1.16 [95% CI, 1.08-1.24]; p for interaction = 0.025). CONCLUSION: In adults over 40 in the U.S., higher serum 25(OH)D concentrations were positively correlated with PCa prevalence, with cardiovascular disease potentially modifying this relationship. Regulating serum 25(OH)D levels may contribute to mitigating PCa prevalence.