Background: Recent studies have shown a negative association between body mass index (BMI) and prostate-specific antigen (PSA), a commonly used serum marker for the detection and diagnosis of prostate cancer. We have examined the association between several anthropometric measures and PSA in a nationally representative sample of men. Methods: We analyzed data from the 2001-2004 National Health and Nutrition Examination Survey. Participants in this study were men ages z40 years without previously diagnosed prostate cancer who had PSA measured. Height, weight, waist circumference, BMI, triceps skinfold, subscapular skinfold, and calculated total body water were examined categorically by quintiles using multiple linear regression models. All tests of significance were two sided. Results: Among white men, we report a trend for decreasing PSA with increasing weight, BMI, waist circumference, triceps skinfold thickness, and calculated total body water. Among Mexican American men, we found a trend for decreasing PSA with increasing BMI, and among black men we found a trend for decreasing PSA with increasing

ObjectiveExcessive weight gain frequently occurs in patients with hypothalamic tumors and lesions leading to hypothalamic obesity (HO).MethodsDigital brain magnetic resonance imaging (MRI) and clinical outcomes were studied retrospectively in a single center, including 45 children with postoperative lesions in the sellar region (41 craniopharyngiomas, 4 with Rathke's cleft cysts), ∼5 years post‐surgery, mean age 13.9 years. Four standard sections covering hypothalamic areas critical to energy homeostasis were used to assess lesions and calculate a hypothalamic lesion score (HLS); the association with HO was examined.ResultsCompared to subjects who did not develop HO (n = 23), subjects with HO (n = 22) showed more frequently lesions affecting the third ventricular floor, mammillary bodies, and anterior, medial (all P < 0.05), and most importantly posterior hypothalamus (P < 0.01). The HLS correlated significantly with BMI z‐score changes 12 and 30 months post‐surgery, even after adjusting for potential confounders of gender, age at surgery, surgery date, surgery BMI z‐score, hydrocephalus, and residual hypothalamic tumor (r = 0.34, P = 0.03; r = 0.40, P = 0.02, respectively). Diabetes insipidus was found to be an endocrine marker for HO risk.ConclusionsThe extent of damage following surgery in the sellar region can be assessed by MRI using a novel scoring system for early HO risk assessment.

Recent studies have shown that diabetic men have a lower risk of prostate cancer and that this association may be related to time since diagnosis. The authors examined the association between diabetes and prostate-specific antigen (PSA) levels, controlling for potential confounders, in a nationally representative cross-sectional survey of the US population (National Health and Nutrition Examination Survey 2001-2002). Diabetes classification was self-reported, and undiagnosed diabetes was determined with fasting plasma glucose measurements. Controlling for age, men with self-reported diabetes had a 21.6% lower geometric mean PSA level than men without diabetes. The difference increased with years since diagnosis (>10 years: 27.5% lower geometric mean PSA level). Overweight men who had had diabetes for more than 10 years had a predicted geometric mean PSA level 40.8% lower than that of nondiabetic, normal-weight men. These results are consistent with the hypothesis that long-term diabetes is associated with a lower risk of prostate cancer. The mechanism of this association may involve the regulation of PSA by androgens, although the authors are unable to confirm this assertion. Better understanding of the determinants of PSA level is needed to make the distinction between factors affecting the PSA test's accuracy and those altering the risk of prostate cancer.

Brain malformations were a more common cause of pediatric CDI than previously reported. These patients have a high rate of APHDs, and many have persistence of the PPBS. Idiopathic CDI is an uncommon diagnosis, and none of our patients were diagnosed with Langerhans cell histiocytosis or germinoma for more than 3 years from CDI diagnosis. Providers can consider less frequent magnetic resonance imaging after this time point. A systematic method of infundibular measurement on the initial magnetic resonance imaging may predict an underlying germinoma or Langerhans cell histiocytosis.