Post-treatment Levels of Plasma 25- And 1,25-dihydroxy Vitamin D and Mortality in Men With Aggressive Prostate Cancer

[pjoshea13]

New Australian study below [1].

What does "post-treatment" mean? Vitamin D samples were collected "4.9 to 8.6 years after diagnosis".

Our vitamin D resevoir is what is usually monitored: 25-dihydroxy Vitamin {aka 25-D, 25(OH)D, calcidiol}. The hormonal form, which can vary throughout the day is 1,25-dihydroxy Vitamin D {aka 1,25-D, 1,25(OH)D, calcitriol}.

We do not learn anything about deficiency levels, but at least this is Australia & not Sweden. Instead we have traditional quartiles. How low was quartile 1? How high was quartile 4? Perhaps someone has access to the full paper?

Why measure 1,25-D? One might have a high 25-D level, but calcium intake can inhibit conversion to bioactive 1,25-D. On the other hand, fructose intake can increase 1,25-D production. So there is a case for preferring 1,25-D. However, the average for samples taken at different times might have been more useful.

"... there were 198 deaths from any cause and 41 from PC in the study period ..."

"Plasma 1,25(OH)2D was inversely associated with all-cause mortality (HR for highest relative to lowest quartile = 0·45 ...), and PC-specific mortality (HR = 0·40 ...)."

"These associations were apparent only in men with aggressive PC: all-cause mortality HR = 0·28 ... and PC-specific mortality HR = 0·26 ..."

"The inverse association between post-treatment plasma 1,25(OH)2D levels and all-cause and PC-specific mortality in men with aggressive PC, suggest a possible beneficial effect of vitamin D supplementation in these men."

-Patrrick

[1] pubmed.ncbi.nlm.nih.gov/323...

Sci Rep

. 2020 May 8;10(1):7736. doi: 10.1038/s41598-020-62182-w.

Post-treatment Levels of Plasma 25- And 1,25-dihydroxy Vitamin D and Mortality in Men With Aggressive Prostate Cancer

Visalini Nair-Shalliker 1 2 3 , Albert Bang 4 , Sam Egger 4 , Mark Clements 5 , Robert A Gardiner 6 , Anne Kricker 7 , Markus J Seibel 8 , Suzanne K Chambers 9 , Michael G Kimlin 10 , Bruce K Armstrong 4 11 , David P Smith 4 7 9

Affiliations collapse

Affiliations

1 Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia. [e-mail].

2 Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. [e-mail].

3 Department of Clinical Medicine, Macquarie University, Sydney, Australia. [e-mail].

4 Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.

5 Karolinka Institute, Stockholm, Sweden.

6 University of Queensland, Brisbane, Australia.

7 Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.

8 Bone Research Program, ANZAC Research Institute, and Concord Medical School, The University of Sydney, Sydney, Australia.

9 Faculty of Management, University Technology of Sydney, Sydney, Australia.

10 Health Research Institute, University of the Sunshine Coast, Queensland, Australia.

11 School of Population Health, University of Western Australia, Perth, Western Australia, Australia.

PMID: 32385370 DOI: 10.1038/s41598-020-62182-w

Abstract

Vitamin D may reduce mortality from prostate cancer (PC). We examined the associations of post-treatment plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations with PC mortality. Participants were PC cases from the New South Wales Prostate Cancer Care. All contactable and consenting participants, at 4.9 to 8.6 years after diagnosis, were interviewed and had plasma 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) measured in blood specimens. Cox regression allowing for left-truncation was used to calculate adjusted mortality hazards ratios (HR) and 95% confidence intervals (95% CI) for all-cause and PC-specific mortality in relation to vitamin D levels and other potentially-predictive variables. Of the participants (n = 111; 75·9% response rate), there were 198 deaths from any cause and 41 from PC in the study period. Plasma 25(OH)D was not associated with all-cause or PC-specific mortality (p-values > 0·10). Plasma 1,25(OH)2D was inversely associated with all-cause mortality (HR for highest relative to lowest quartile = 0·45; 95% CI: 0·29-0·69), and PC-specific mortality (HR = 0·40; 95% CI: 0·14-1·19). These associations were apparent only in men with aggressive PC: all-cause mortality HR = 0·28 (95% CI·0·15-0·52; p-interaction = 0·07) and PC-specific mortality HR = 0·26 (95% CI: 0·07-1.00). Time spent outdoors was also associated with lower all-cause (HR for 4th relative to 1st exposure quartile = 0·42; 95% CI: 0·24-0·75) and PC-specific (HR = 0·48; 95% CI: 0·14-1·64) mortality, although the 95% CI for the latter was wide. The inverse association between post-treatment plasma 1,25(OH)2D levels and all-cause and PC-specific mortality in men with aggressive PC, suggest a possible beneficial effect of vitamin D supplementation in these men.

[Garp41]

Patrick,

Great find.

Is 1,25(OH)2D the same as D3?

If not, how do we get 1,25(OH)2D levels up?

Doug

[pjoshea13 in reply to Garp41]

Doug,

My strategy for increasing calcitriol, the hormonally active "1,25-" form of vitamin D3, is:

1] I sweeten my morning coffee with fructose

2] I avoid calcium supplements

3] I avoid phosphates from deli meats & soft drinks.

4] I keep meat portions low to limit phosphorous intake.

5] I take 7,000 IU cholecalciferol daily to maintain a calcidiol level (the "25-" form of D3) of ~65.

I have old posts that explain the above.

-Patrick

[Garp41 in reply to pjoshea13]

Thanks Patrick

[pjoshea13]

Oops! It's an open access paper (thankyou you-know-who!):

nature.com/articles/s41598-...

They measured 25-D as nmol/L. Divide by 2.5 to get ng/mL.

So, these Aussies had D levels almost as dismal as the Swedes:

Q1 to 21.5 ng/mL ... deficiency

Q2 to 26.4 ... insufficiency

Q3 to 32.1 ... milder insufficiency

Q4 to 70 ... sufficiency

The 1,25-D levels are the important ones here. Same conversion factor for pmol/L to pg/mL.

Q1 to 26.9 pg/mL

Q2 to 33.5

Q3 to 42.6

Q4 to 105.6

-Patrick

[LearnAll]

My recent VIT D 25 hydroxy came at 55 ng/ml . I eat a lot of veggies and fruits and that might be helpful. Now, strted 30 minutes a day SunBathing. Lockdown makes time available for this.

NOTE: Higher than 100 ng/ml Vit D level is considered TOXIC. It accumulates in liver.

[Hidden]

How do you get so much D3 in? Vitamins or prescription treatment?

[immunity1]

Thanks for article. Also the benefits of countering the effects of ADT causing osteoporosis or skeletal weakening has been described and is logical. I take 1.25mg VitD3 orally monthly, plus plenty of sun exposure on our farm.