{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:27:13Z","timestamp":1785522433528,"version":"3.56.0"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T00:00:00Z","timestamp":1482883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5R01MD007105"],"award-info":[{"award-number":["5R01MD007105"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>African American men have higher incidence rates of aggressive prostate cancer, where high levels of calcium and serum vitamin D deficient levels play a role in the racial differences in incidence. In this study, we examined associations of serum vitamin D with aggressive prostate cancer to improve our understanding of higher susceptibility of aggressive disease in this racial cohort. From Howard University Hospital, 155 African American men with clinically-identified prostate cancer were identified; 46 aggressive cases, and 58 non-aggressive cases. Serum vitamin D was assessed from fasting blood samples, and total calcium intake was assessed using the Block Food Frequency Questionnaire. Vitamin D receptor polymorphisms from three different loci were genotyped; rs731236, rs1544410, and rs11568820. Multivariate logistic regression models were used to determine odds ratios (OR) and 95% confidence intervals (CI) comparing aggressive to non-aggressive prostate cancer. Vitamin D deficiency (&lt;20 ng\/mL) significantly increased risk of aggressive disease (OR: 3.1, 95% CI: 1.03\u20139.57, p-value = 0.04). Stratification by total calcium showed high calcium levels (\u2265800 mg\/day) modified this association (OR: 7.3, 95% CI: 2.15\u201347.68, p-interaction = 0.03). Genetic variant rs11568820 appeared to increase the magnitude of association between deficient serum vitamin D and aggressive prostate cancer (OR: 3.64, 95% CI: 1.12\u201311.75, p-value = 0.05). These findings suggest that high incidence of aggressive prostate cancer risk in African American men may be due in-part to deficient levels of serum vitamin D. Other factors, including genetics, should be considered for future studies.<\/jats:p>","DOI":"10.3390\/nu9010012","type":"journal-article","created":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T11:22:14Z","timestamp":1482924134000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Association between Serum 25-Hydroxy-Vitamin D and Aggressive Prostate Cancer in African American Men"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-3203","authenticated-orcid":false,"given":"Shakira","family":"Nelson","sequence":"first","affiliation":[{"name":"Cancer Prevention Fellow, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA"},{"name":"Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0317-1118","authenticated-orcid":false,"given":"Ken","family":"Batai","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiledum","family":"Ahaghotu","sequence":"additional","affiliation":[{"name":"Chief Medical Officer, Carney Hospital-Steward Health Systems, Dorchester, MA 02124, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Agurs-Collins","sequence":"additional","affiliation":[{"name":"Health Behavior Research Branch, Division of Cancer Control and Population Studies, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Kittles","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,12,28]]},"reference":[{"key":"ref_1","unstructured":"National Cancer Institute (2013). Surveillance Research Program, Surveillance Systems Branch, Surveillance, Epidemiology, and End Results (seer) Program Research Data (1973\u20132011), Available online: https:\/\/seer.cancer.gov\/statfacts\/html\/prost.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1007\/s10903-012-9710-7","article-title":"Family history of prostate cancer in a black population","volume":"15","author":"Nemesure","year":"2013","journal-title":"J. Immigr. Minor. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1056\/NEJMra021562","article-title":"Prostate cancer","volume":"349","author":"Nelson","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3322\/caac.21254","article-title":"Cancer statistics, 2015","volume":"65","author":"Siegel","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.2217\/pgs-2016-0089","article-title":"Can vitamin D supplementation reduce prostate cancer disparities?","volume":"17","author":"Batai","year":"2016","journal-title":"Pharmacogenomics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S0090-4295(99)00461-6","article-title":"Clinical characteristics in black and white men with prostate cancer in an equal access medical center","volume":"55","author":"Freedland","year":"2000","journal-title":"Urology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1002\/cncr.29309","article-title":"Treatment decisional regret among men with prostate cancer: Racial differences and influential factors in the North Carolina Health Access and Prostate Cancer Treatment Project (HCaP-NC)","volume":"121","author":"Morris","year":"2015","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1093\/jnci\/93.5.388","article-title":"Racial and ethnic differences in advanced-stage prostate cancer: The prostate cancer outcomes study","volume":"93","author":"Hoffman","year":"2001","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/1557988312437240","article-title":"Predictors of serum vitamin D levels in African American and European American men in Chicago","volume":"6","author":"Murphy","year":"2012","journal-title":"Am. J. Men Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1056\/NEJMcp1009570","article-title":"Clinical practice. Vitamin D insufficiency","volume":"364","author":"Rosen","year":"2011","journal-title":"N. Eng. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nrc3691","article-title":"The role of vitamin D in reducing cancer risk and progression","volume":"14","author":"Feldman","year":"2014","journal-title":"Nat. Rev. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1093\/jn\/136.4.1126","article-title":"Vitamin D and African americans","volume":"136","author":"Harris","year":"2006","journal-title":"J. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0140-6736(82)90214-8","article-title":"Increased skin pigment reduces the capacity of skin to synthesise vitamin D3","volume":"1","author":"Clemens","year":"1982","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1093\/jn\/135.10.2478","article-title":"Vitamin D intakes by children and adults in the United States differ among ethnic groups","volume":"135","author":"Moore","year":"2005","journal-title":"J. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"5","DOI":"10.2174\/1876396001509010005","article-title":"Is there pandemic vitamin D deficiency in the black population? A review of evidence","volume":"9","author":"Roberts","year":"2015","journal-title":"Open Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/j.1532-5415.2011.03476.x","article-title":"Correlates and prevalence of insufficient 25-hydroxyvitamin D status in black and white older adults: The health, aging and body composition study","volume":"59","author":"Shea","year":"2011","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1158\/1055-9965.EPI-13-1340","article-title":"Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: Results from the prostate cancer prevention trial","volume":"23","author":"Schenk","year":"2014","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_19","first-page":"1307","article-title":"Is vitamin D deficiency a risk factor for prostate cancer? (hypothesis)","volume":"10","author":"Schwartz","year":"1990","journal-title":"Anticancer Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.tem.2003.09.004","article-title":"Vitamin D and prostate cancer prevention and treatment","volume":"14","author":"Chen","year":"2003","journal-title":"Trends Endocrinol. Metab. TEM"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jsbmb.2012.11.012","article-title":"Vitamin D3 supplementation, low-risk prostate cancer, and health disparities","volume":"136","author":"Hollis","year":"2013","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1158\/1055-9965.EPI-05-0586","article-title":"A prospective study of calcium intake and incident and fatal prostate cancer","volume":"15","author":"Giovannucci","year":"2006","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1093\/ajcn\/81.5.1147","article-title":"Dairy, calcium, and vitamin D intakes and prostate cancer risk in the national health and nutrition examination epidemiologic follow-up study cohort","volume":"81","author":"Tseng","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_24","first-page":"442","article-title":"Calcium and fructose intake in relation to risk of prostate cancer","volume":"58","author":"Giovannucci","year":"1998","journal-title":"Cancer Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"G1193","DOI":"10.1152\/ajpgi.00237.2009","article-title":"Human duodenum responses to vitamin D metabolites of TRPV6 and other genes involved in calcium absorption","volume":"297","author":"Balesaria","year":"2009","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1210\/er.2008-0004","article-title":"Vitamin D and human health: Lessons from vitamin D receptor null mice","volume":"29","author":"Bouillon","year":"2008","journal-title":"Endoc. Rev."},{"key":"ref_27","first-page":"2852","article-title":"Reduced 1alpha-hydroxylase activity in human prostate cancer cells correlates with decreased susceptibility to 25-hydroxyvitamin D3-induced growth inhibition","volume":"61","author":"Hsu","year":"2001","journal-title":"Cancer Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"47608","DOI":"10.1074\/jbc.M107011200","article-title":"Ca2+ pools and cell growth. Evidence for sarcoendoplasmic Ca2+-atpases 2b involvement in human prostate cancer cell growth control","volume":"276","author":"Legrand","year":"2001","journal-title":"J. Biol. Chem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/oxfordjournals.aje.a114416","article-title":"A data-based approach to diet questionnaire design and testing","volume":"124","author":"Block","year":"1986","journal-title":"Am. J. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1093\/oxfordjournals.aje.a116138","article-title":"An evaluation of a food frequency questionnaire for assessing dietary intake of specific carotenoids and vitamin E among low-income black women","volume":"134","author":"Coates","year":"1991","journal-title":"Am. J. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1007\/s00439-014-1472-y","article-title":"Common vitamin D pathway gene variants reveal contrasting effects on serum vitamin D levels in African Americans and European Americans","volume":"133","author":"Batai","year":"2014","journal-title":"Hum. Genet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1158\/1055-9965.EPI-11-0403","article-title":"Serum 25-hydroxy vitamin D and prostate cancer risk in a large nested case-control study","volume":"20","author":"Albanes","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1002\/pros.20570","article-title":"Vitamin D receptor (VDR) gene polymorphisms and haplotypes, interactions with plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D, and prostate cancer risk","volume":"67","author":"Mikhak","year":"2007","journal-title":"Prostate"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1158\/1078-0432.CCR-13-3085","article-title":"Vitamin D deficiency predicts prostate biopsy outcomes","volume":"20","author":"Murphy","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1002\/cam4.457","article-title":"Both serum 25-hydroxyvitamin D and calcium levels may increase the risk of incident prostate cancer in Caribbean men of African ancestry","volume":"4","author":"Jackson","year":"2015","journal-title":"Cancer Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1158\/1055-9965.EPI-12-0922-T","article-title":"Protective effects of low calcium intake and low calcium absorption vitamin D receptor genotype in the California collaborative prostate cancer study","volume":"22","author":"Rowland","year":"2013","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/jbmr.505","article-title":"Calcium intake and prostate cancer among African Americans: Effect modification by vitamin D receptor calcium absorption genotype","volume":"27","author":"Rowland","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/oxfordjournals.epirev.a018033","article-title":"Molecular epidemiology of vitamin D receptor gene variants","volume":"22","author":"Zmuda","year":"2000","journal-title":"Epidemiol. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1016\/S0022-5347(05)00958-4","article-title":"A systematic review of vitamin D receptor gene polymorphisms and prostate cancer risk","volume":"175","author":"Berndt","year":"2006","journal-title":"J. Urol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/em.20000","article-title":"Polymorphisms in the vitamin D receptor gene, ultraviolet radiation, and susceptibility to prostate cancer","volume":"43","author":"Bodiwala","year":"2004","journal-title":"Environ. Mol. Mutagen."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Steck, S.E., Arab, L., Zhang, H., Bensen, J.T., Fontham, E.T., Johnson, C.S., Mohler, J.L., Smith, G.J., Su, J.L., and Trump, D.L. (2015). Association between plasma 25-hydroxyvitamin D, ancestry and aggressive prostate cancer among African Americans and European Americans in pcap. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125151"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"9065","DOI":"10.1158\/0008-5472.CAN-06-0317","article-title":"Extracellular calcium as a candidate mediator of prostate cancer skeletal metastasis","volume":"66","author":"Liao","year":"2006","journal-title":"Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1093\/carcin\/bgp055","article-title":"Vitamin D-related genes, serum vitamin D concentrations and prostate cancer risk","volume":"30","author":"Ahn","year":"2009","journal-title":"Carcinogenesis"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/j.bbamcr.2012.12.011","article-title":"Calcium sensing receptor signalling in physiology and cancer","volume":"1833","author":"Brennan","year":"2013","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1016\/j.bbamcr.2015.11.017","article-title":"The calcium-sensing receptor and the hallmarks of cancer","volume":"1863","author":"Tennakoon","year":"2016","journal-title":"Biochim. Biophys. Acta"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:29:24Z","timestamp":1760210964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,28]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1]]}},"alternative-id":["nu9010012"],"URL":"https:\/\/doi.org\/10.3390\/nu9010012","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,28]]}}}