Risk of prostate cancer in African-American men: Evidence of mixed effects of dietary quercetin by serum vitamin D status

BACKGROUND

African-American (AA) men experience higher rates of prostate cancer (PCa) and vitamin D (vitD) deficiency than white men. VitD is promoted for PCa prevention, but there is conflicting data on the association between vitD and PCa. We examined the association between serum vitD and dietary quercetin and their interaction with PCa risk in AA men.

METHODS

Participants included 90 AA men with PCa undergoing treatment at Howard University Hospital (HUH) and 62 controls participating in HUH's free PCa screening program. We measured serum 25-hydroxy vitD [25(OH)D] and used the 98.2 item Block Brief 2000 Food Frequency Questionnaires to measure dietary intake of quercetin and other nutrients. Case and control groups were compared using a two-sample t-test for continuous risk factors and a Fisher exact test for categorical factors. Associations between risk factors and PCa risk were examined via age-adjusted logistic regression models.

RESULTS

Interaction effects of dietary quercetin and serum vitD on PCa status were observed. AA men (age 40-70) with normal levels of serum vitD (>30 ng/ml) had a 71% lower risk of PCa compared to AA men with vitD deficiency (OR = 0.29, 95%CI: 0.08-1.03; P = 0.055). In individuals with vitD deficiency, increased dietary quercetin showed a tendency toward lower risk of PCa (OR = 0.91, 95%CI: 0.82-1.00; P = 0.054, age-adjusted) while men with normal vitD were at elevated risk (OR = 1.23, 95%CI: 1.04-1.45).

CONCLUSION

These findings suggest that AA men who are at a higher risk of PCa may benefit more from vitD intake, and supplementation with dietary quercetin may increase the risk of PCa in AA men with normal vitD levels. Further studies with larger populations are needed to better understand the impact of the interaction between sera vitD levels and supplementation with quercetin on PCa in AA men.

Medical examiner asthma death autopsies: a distinct subgroup of asthma deaths with implications for public health preventive strategies

OBJECTIVE

Asthma deaths have been increasing in the United States and worldwide. We studied medical examiner asthma death autopsy (MEADA) records for the state of Maryland, compared selected characteristics with state and national total asthma deaths (TADs), and comprehensively reviewed relevant literature to define characteristics of asthma deaths and to provide insight for the design of future preventive strategies directed at this subgroup.

DESIGN

Protocols for autopsy and clinical data.

SETTING

The Office of the Chief Medical Examiner of the State of Maryland.

SUBJECTS

All MEADAs in the state of Maryland from 1988 through 1992.

MAIN OUTCOME MEASURES

Descriptive analysis.

RESULTS

Maryland MEADAs (63 cases) represented 16.62% of Maryland TADs (379 cases). Most common characteristics of individuals on whom autopsies were performed: inner-city residence; single; black male; 15 to 54 years old; history of asthma; no other significant medical condition; fatal episode more likely to begin at home; pronounced dead at hospital; time of death between midnight and 6 AM; no particular seasonality; and typical gross and/or microscopic pathology. Analysis also revealed that 17.46% of deceased asthma patients had a history of drug abuse; 12.69% had positive toxicology for drugs of abuse; 9.52% were infants and young children up to 4 years old, all of whom were found, unresponsive, at home; and white females comprised the highest number of TADs but the lowest number of MEADAs.

CONCLUSION

Asthma education programs focused on asthmatic inner-city black males, especially those with a history of drug abuse, and on parents of inner-city asthmatic infants and children may be a useful preventive strategy. International, national, and regional MEADA databases may also be of use in the design and monitoring of preventive strategies directed at this subgroup.

Suicide in the State of Maryland, 1970-80

A univariate and multivariate analysis of factors associated with suicide for residents of the State of Maryland was conducted. The investigation was statistically oriented in its approach, examining the relationships of age, race, sex, marital status, and month of death with suicide. Besides the usual death rates, percentages, and age-specific rates, a discriminant analysis was performed to test this approach. Data were obtained on all suicides of Maryland residents, regardless of where the deaths occurred. Univariate analysis showed that the relationships between suicide and age, race, sex, and marital status are consistent with those in the literature. No significant relationship appeared to exist between the month of death and suicide. During multivariate analysis, the discriminant function correctly predicted 80 percent of all the deaths, 74 percent of suicides, and 80 percent of all other causes, in their respective categories.