ObjectivesTo study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting.Materials and MethodsWe conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis.ResultsThere were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (≤4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (p<0.05).ConclusionThese findings support the concept that the baseline PSA level varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity may also need to be taken into account when investigating serum PSA concentrations in the multiethnic Asian population.
Caucasian tertiary centre, were recruited prospectively. The men completed the International Prostate Symptom Score and a 3-day FVC. Men having had bladder outlet surgery and/or receiving anticholinergics were excluded. We computed the nocturia ratio, i.e. the nocturnal urine volume/ 24-h urine volume, nocturia index, predicted nocturnal voids and NBC index (NBCI), and analysed comparisons and correlations. RESULTSIn all, 93 Asian and 200 Caucasian men were recruited prospectively, with a similar age and overall severity of LUTS. The nocturia ratio was larger in the Caucasian men, whereas the NBCI was larger in the Asians ( P < 0.001). The prevalence of nocturnal polyuria in men aged ≥ 60 years (nocturia ratio ≥ 0.3) was significantly higher in the Caucasian population. Conversely, the prevalence of reduced NBC appeared to be higher in the Asians (based on a NBCI of > 2; P < 0.001). CONCLUSIONSThe patterns of nocturia and FVC variables differed significantly in age-matched Asian and Caucasian groups. There are also possible ethnic differences in the causes of nocturia, with nocturnal polyuria being more prevalent in Caucasians.
ObjectivesTo determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting.Materials and MethodsWe conducted a cross-sectional study of 1021 men aged 40–79 years with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses.ResultsThere were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p < 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity.ConclusionSeverity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS.
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