Scientific Online Resource System

Scripta Scientifica Medica

Is vitamin D associated with testosterone in benign prostate hyperplasia?

Bogdan Roussev, Daniela Gerova, Petar Kosev, Alexander Hinev, Dobrin Svinarov, Bistra Galunska

Abstract

Introduction. Benign prostate hyperplasia (BPH) affects about 50% of male population between 51-60 years and almost 90% of 81-90 aged males. It is considered that BPH pathogenesis involves epithelial cells and stromal tissue proliferation inside prostate gland and testosterone is one of the promoting factors of prostate cell growth. Evidences about the antiproliferative effects of vitamin D and the widespread vitamin D deficiency and insufficiency among Bulgarian population suggest a possible relation between vitamin D and testosterone in BPH patients.

Aim. To evaluate the vitamin D status and total testosterone (TT) levels in BPH patients and their associations with laboratory parameters such as prostate specific antigen (PSA) for prostate growth.

Materials and methods. A total of 37 male BPH patients (mean age 67,14±7,77 years) were enrolled in the study. In all patients, BPH was histologically proven. PSA and ТТ levels were analyzed immunochemically. The circulating form of vitamin D, 25-hydroxyvitamin D (25OHD) was assayed by liquid chromatography with mas-spectrometry detection (LC-MS/MS). Other covariates (BMI, age,) were collected by interview at the time of hospitalization. Classical biochemical parameters were assayed by routine spectrophotometric tests. Descriptive statistics, variation and non-parametric correlation analysis were used. The level of significance was set at p<0.05.

Results. The mean level of 25OHD for BPH patients was close to the lower reference limit of 50nmol/L recommended by the US Endocrine Society Guideline. The majority of BPH patients (56.8%) display 25OHD levels above 50nmol/L, 43.2% of them were vitamin D deficient (25OHD < 50nmol/L), 8.1% - with severe vitamin D deficiency (25OHD <25nmol/L), and only 6 patients (16.2%) had optimal 25OHD levels above the limit of 75 nmol/L. The mean serum TT levels of BPH patients were 10.74 ± 4.026 nmol/L, close to the lower limit of 10.4 nmol/L for normal TT, according to the recommendations of the Endocrine Society. A significant seasonal variations were found for 25OHD levels (p<0.05) between the cold and warm season. Similar seasonality was not established for TT. Two-thirds of BPH patients (62.9%) were with PSA values below the upper limit of the reference interval of 4 ng/ml. Higher 25OHD levels (59.21 ± 3.756 nmol/l, p= 0.06) were established for the group with PSA below the threshold of 4ng/ml. A moderate negative correlation (Spearman r= -0.6707, p<0.01) was found only for the vitamin D deficient group. In case of vitamin D sufficiency, a weak positive trend was detected.

Conclusion. Our study indicated vitamin D insufficiency in BPH patients according to the criteria of the Endocrine Society. Strong negative correlation between 25OHD and TT levels was found for vitamin D deficient BPH patients. Higher 25OHD were associated with lower PSA values indicating a potential favorable effect of 25OHD on slackening of BPH.


Keywords

25-hydroxyvitamin D, benigns prostate hiperplasia, Testosterone.

Full Text


References

Yalçınkaya S, Eren E, Eroglu M, Aydin O, Yilmaz N. Deficiency of vitamin D and elevated aldosterone in prostate hyperplasia. Adv Clin Exp Med. 2014;23(3):441-6.

Praveen R. Benign prostatic hyperplasia: updated review. Int. Res. J. Pharm. 2013;4 (3):45-51.

Espinosa G, Esposito R, Kazzazi A, Djavan B. Vitamin D and benign prostatic hyperplasia -- a review. Can J Urol. 2013;20(4):6820-5.

Haghsheno MA, Mellström D, Behre CJ, Damber JE, Johansson H, Karlsson M, et al. Low 25-OH vitamin D is associated with benign prostatic hyperplasia. J Urol. 2013;190(2):608-14.

Vuolo L, Di Somma C, Faggiano A, Colao A. Vitamin D and Cancer Front Endocrinol (Lausanne). 2012; 3: 58.

Kristal AR, Arnold KB, Schenk JM, Neuhouser MJ, Goodman P, Penson DF, et al. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the Prostate Cancer Prevention Trial. Am J Epidemiol 2008;167: 925.

Usoro AJ, Obot AS, Ekaidem IS, Akaiso OE, Udoh AE, Akinloye O. Serum Testosterone, 17β-Estradiol and PSA Levels in Subjects with Prostate Disorders. Indian J Clin Biochem. 2015;30(1):59-65.

Putra IB, Hamid AR, Mochtar CA, Umbas R. Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia. Prostate Int. 2016;4(2):43-8.

Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011;43(3):223-5.

Chul YU, Jin KY, Byung YY. Association between serum 25-hydroxyvitamin D levels and total testosterone levels in Korean adult men. Bone Abstracts 2016;5:276.

Jorde R, Grimnes G, Hutchinson MS, Kjærgaard M, Kamycheva E, Svartberg J. Supplementation with vitamin D does not increase serum testosterone levels in healthy males. Horm Metab Res. 2013;45(9):675-81.

Galunska B, Gerova D, Kosev P, Anakievski D, Hinev A. Serum 25-hydroxy vitamin D levels in Bulgarian patients with prostate cancer: a pilot study. Clin Lab. 2015;61(34):329-35.

Roth HJ, Schmidt-Gayk H, Weber H, Niederau C. Accuracy and clinical implications of seven 25-hydroxyvitamin D methods compared with liquid chromatography-tandem mass spectrometry as a reference. Ann ClinBiochem. 2008;45(2):153-9.

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-281.

Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142-1152.

Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005;135:317-322.

Macdonald HM. Contributions of sunlight and diet to vitamin D status. Calcif Tissue Int. 2013;92(2):163-76.

Vuistiner P, Rousson V, Henry H, Lescuyer P, Boulat O, Gaspoz JM. Population-Based Model to Consider the Effect of Seasonal Variation on Serum 25OHD and Vitamin D Status. Biomed Res Int. 2015;2015:168-189.

Wehr E, Pilz S, Boehm BO, März W, Obermayer-Pietsch B. Association of vitamin D status with serum androgen levels in men. Clin Endocrinol (Oxf). 2010;73(2):243-8.

Andersson AM, Carlsen E, Petersen JH, Skakkebaek NE. Variation in levels of serum inhibin B, testosterone, estradiol, luteinizing hormone, follicle-stimulating hormone, and sex hormone-binding globulin in monthly samples from healthy men during a 17-month period: possible effects of seasons. J Clin Endocrinol Metab. 2003;88(2):932-7.

Svartberg J, Jorde R, Sundsfjord J, Bønaa KH, Barrett-Connor E. Seasonal variation of testosterone and waist to hip ratio in men: the Tromsø study. J Clin Endocrinol Metab. 2003;88(7):3099-104.

Tak YJ, Lee JG, Kim YJ, Park NC, Kim SS, Lee S. Serum 25-hydroxyvitamin D levels and testosterone deficiency in middle-aged Korean men: a cross-sectional study. Asian J Androl. 2015;17(2):324-8.

Holick M, Binkley N. Bischoff-Ferrari H, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline J Clin Endocrinol Metab 2011; 96(7):1911-1930.

Crescioli C, Villari D, Forti G, Ferruzzi P, Petrone L, Vannelli GB, et al. Des (1-3) IGF-I-stimulated growth of human stromal BPH cells is inhibited by a vitamin D3 analogue. Mol Cell Endocrinol. 2002;198(1-2):69-75.

Carson C 3rd, Rittmaster R. The role of dihydrotestosterone in benign prostatic hyperplasia. Urology. 2003;61(4 Suppl 1):2-7.

Crescioli C, Maggie M, Vannelli GB, Luconi M, Salerno R, Barni T, et al. Effect of a vitamin D3 analogue on keratinocyte growth factor-induced cell proliferation in benign prostate hyperplasia. J Clin Endocrinol Metab. 2000;85(7):2576-83.

Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting Int J Clin Pract. 2010;64(6):682-696.

Zhang W, Zheng X, Wang Y, Xiao H. Vitamin D Deficiency as a Potential Marker of Benign Prostatic Hyperplasia. Urology, 2016;S0090-4295(16)30308-9.

Nimptsch K, Platz EA, Willett WC, Giovannucci E. Association between plasma 25-OH vitamin D and testosterone levels in men. Clin Endocrinol (Oxf). 2012;77(1):106-12.

Vaishya R. Vijay V, Agarwal AK, Jahangir J. Resurgence of vitamin D: Old wine in new bottle. J Clin Orthop Trauma. 2015;6(3):173-83.

Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011;25(4):681-91.

Park DS, Hong JY, Hong YK, Lee SR, Hwang JH, Kang MH, et al. Correlation between serum prostate specific antigen level and prostate volume in a community-based cohort: large-scale screening of 35,223 Korean men. Urology 2013;82:1394-1399.

Mochtar CA, Kiemeney LA, van Riemsdijk MM, Barnett GS, Laguna MP, Debruyne FM, et al. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol 2003;44:695-700.

Jorde R, Grimnes G, Hutchinson MS, Kjærgaard M, Kamycheva E, Svartberg J. Supplementation with vitamin D does not increase serum testosterone levels in healthy males. Horm Metab Res. 2013;45(9):675-81.

Pitman MS, Cheetham PJ, Hruby GW, Katz AE. Vitamin D deficiency in the urological population: a single center analysis. J Urol. 2011;186:1395-1399.

Roth HJ, Schmidt-Gayk H, Weber H, Niederau C. Accuracy and clinical implications of seven 25-hydroxyvitamin D methods compared with liquid chromatography-tandem mass spectrometry as a reference. Ann Clin Biochem. 2008;45(2):153-9.

Maguire O, Pollock C, Martin P, Owen A, Smyth T, Doherty D, et al. Regulation of CYP3A4 and CYP3A5 expression and modulation of "intracrine" metabolism of androgens in prostate cells by liganded vitamin D receptor. Mol Cell Endocrinol. 2012;364(1-2):54-64.

Colli E, Rigatti P, Montorsi F, Artibani W, Petta S, Mondaini N, et al. BXL628, a novel vitamin D3 analog arrests prostate growth in patients with benign prostatic hyperplasia: a randomized clinical trial. Eur Urol. 2006;49(1):82-6.

Kim SK, Seok H, Park HJ, Jeon HS, Kang SW, Lee BC, et al. Inhibitory effect of curcumin on testosterone induced benign prostatic hyperplasia rat model. BMC Complement Altern Med. 2015;15:380.

Lee DM, Tajar A, Pye SR, Boonen S, Vanderschueren D, Bouillon R, et al. Association of hypogonadism with vitamin D status: the European Male Ageing Study European Journal of Endocrinology 2012;166 77-85.

Kennel KA, Drake MT, Hurley DL. Vitamin D Deficiency in Adults: When to Test and How to Treat. Clin Proc. 2010;85(8):752-758.




DOI: http://dx.doi.org/10.14748/ssm.v48i4.1772
Array
About The Authors

Bogdan Roussev
Medical University of Varna
Bulgaria

Department of Biochemistry, Molecular Medicine and Nutrigenomics

Daniela Gerova
Medical University of Varna
Bulgaria

Department of General Medicine and Clinical Laboratory

 

Petar Kosev
Medical University of Varna
Bulgaria

Department of Surgery

Alexander Hinev
Medical University of Varna
Bulgaria

Department of Surgery

Dobrin Svinarov
Medical University - Sofia
Bulgaria

Clinical Laboratory & Clinical Pharmacology, Alexander Hospital

Bistra Galunska
Medical University of Varna
Bulgaria

Department of Biochemistry, Molecular Medicine and Nutrigenomics

Font Size


|