Association between Liver Fibrosis and Serum PSA among U.S. Men: National Health and Nutrition Examination Survey (NHANES), 2001–2010

Wang, Anqi; Lazo, Mariana; Carter, H. Ballentine; Groopman, John D.; Nelson, William G.; Platz, Elizabeth A.

doi:10.1158/1055-9965.epi-19-0145

Cited by 12 publications

(7 citation statements)

References 39 publications

(48 reference statements)

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“…As obesity may be considered a probable confounder for lipids and PCa [14], we also performed an additional adjustment for body mass index (BMI) in all the MVMR models, using genetic association data for BMI from UK Biobank [17]. Lp(a) is assembled in the liver [31], whereas liver function/disease has been proposed to influence PCa detection and outcomes [32,33]. Genetic associations for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were thereby adjusted in a MVMR model including Lp(a) and total PCa.…”

Section: Sensitivity Analysismentioning

confidence: 99%

The relationship between lipoprotein A and other lipids with prostate cancer risk: A multivariable Mendelian randomisation study

et al. 2022

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Background Numerous epidemiological studies have investigated the role of blood lipids in prostate cancer (PCa) risk, though findings remain inconclusive to date. The ongoing research has mainly involved observational studies, which are often prone to confounding. This study aimed to identify the relationship between genetically predicted blood lipid concentrations and PCa. Methods and findings Data for low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), apolipoprotein A (apoA) and B (apoB), lipoprotein A (Lp(a)), and PCa were acquired from genome-wide association studies in UK Biobank and the PRACTICAL consortium, respectively. We used a two-sample summary-level Mendelian randomisation (MR) approach with both univariable and multivariable (MVMR) models and utilised a variety of robust methods and sensitivity analyses to assess the possibility of MR assumptions violation. No association was observed between genetically predicted concentrations of HDL, TG, apoA and apoB, and PCa risk. Genetically predicted LDL concentration was positively associated with total PCa in the univariable analysis, but adjustment for HDL, TG, and Lp(a) led to a null association. Genetically predicted concentration of Lp(a) was associated with higher total PCa risk in the univariable (ORweighted median per standard deviation (SD) = 1.091; 95% CI 1.028 to 1.157; P = 0.004) and MVMR analyses after adjustment for the other lipid traits (ORIVW per SD = 1.068; 95% CI 1.005 to 1.134; P = 0.034). Genetically predicted Lp(a) was also associated with advanced (MVMR ORIVW per SD = 1.078; 95% CI 0.999 to 1.163; P = 0.055) and early age onset PCa (MVMR ORIVW per SD = 1.150; 95% CI 1.015,1.303; P = 0.028). Although multiple estimation methods were utilised to minimise the effect of pleiotropy, the presence of any unmeasured pleiotropy cannot be excluded and may limit our findings. Conclusions We observed that genetically predicted Lp(a) concentrations were associated with an increased PCa risk. Future studies are required to understand the underlying biological pathways of this finding, as it may inform PCa prevention through Lp(a)-lowering strategies.

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Section: Sensitivity Analysismentioning

confidence: 99%

The relationship between lipoprotein A and other lipids with prostate cancer risk: A multivariable Mendelian randomisation study

et al. 2022

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“…Wang et al noted that men with higher liver fibrosis scores had lower serum PSA. Liver dysfunction on a chronic basis can reduce testosterone levels, causing reduced PSA production ( 24 ). Song et al investigated the correlation between PSA and dietary protein intake and found a non-linear correlation.…”

Section: Discussionmentioning

confidence: 99%

The relationship between serum albumin and prostate-specific antigen: A analysis of the National Health and Nutrition Examination Survey, 2003–2010

Yan

Chen

et al. 2023

Front. Public Health

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BackgroundPrevious studies have shown that serum albumin is associated with prostate cancer (PCa), but not with prostate-specific antigen (PSA) levels in populations without PCa history. Therefore, we analyzed secondary data provided by the National Health and Nutrition Examination Survey (NHANES) (2003–2010).MethodsIn total, 5,469 participants were selected from the NHANES database (2003–2010). Serum albumin and PSA levels were serially considered independent and dependent variables, serially. A number of covariates were included in this study, including demographic, dietary, physical examination, and comorbidity data. Using weighted linear regression model and smooth curve fitting, the linear and non-linear relationship between serum albumin and PSA was investigated.ResultsAfter modulating underlying interference factors, the weighted multivariate linear regression analysis revealed that serum albumin did not independently predict PSA levels (β = −0.009 95%CI: −0.020, 0.002). Nevertheless, a non-linear relationship was found between serum albumin and PSA, with a point of 41 g/L. Left of the inflection point, the effect size, 95%CI, and P-value were 0.019 (log2 transformation) (−0.006, 0.043) and 0.1335, respectively. We found a negative association between serum albumin and PSA on the right side of the inflection point, with effect size, 95%CI, and a P-value of −0.022 (log2 transformation) (−0.037, −0.007), 0.0036.ConclusionIn summary, serum albumin and PSA levels are not linearly related. When serum albumin levels exceed 41 g, serum albumin levels are negatively associated with PSA levels.

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“…However, given the large population-based study sample, we considered this definition to be the most suitable for this study. We used the non-invasive fibrosis score to predict AF which has been previously used in NHANES studies, as it was impossible to perform liver biopsies or even fibro-scans in such a large cohort[34]; however, it is not the gold-standard. We did not use the AST/ ALT ratio or aspartate aminotransferase to platelet ratio index (APRI) to diagnose AF given their heavy reliance on AST values, which are known to be affected by alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

Characterization of patients with both alcoholic and nonalcoholic fatty liver disease in a large United States cohort

Khoudari

Singh

Noureddin

et al. 2019

WJH

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BACKGROUNDNonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome (MetS) and is characterized by steatosis in the absence of significant alcohol consumption. However, MetS and significant alcohol intake coexist in certain individuals which may lead to the development of BAFLD.AIMTo assess the clinical characteristics of patients with both alcoholic and NAFLD (BAFLD) in a large cohort in the United States.METHODSAdults from the National Health and Nutrition Examination Survey between 2003-2014 were included. NAFLD was diagnosed based on elevated alanine aminotransferase (ALT) and being overweight or obese in the absence of other liver diseases. BAFLD patients met the criteria for NAFLD but also had either MetS or type 2 diabetes and consumed excessive amounts of alcohol. Univariable and multivariable analysis were performed to assess differences between NAFLD and BAFLD and to compare severity based on a validated fibrosis score (FIB4 index).RESULTSThe prevalence of NAFLD was at 25.9% (95%CI; 25.1-26.8) and that of BAFLD was 0.84% (0.67, 1.02) which corresponds to an estimated 1.24 million Americans affected by BAFLD. Compared to NAFLD, patients with BAFLD were more likely to be male, smokers, have higher ALT, aspartate aminotransferase, triglycerides, and lower platelets; P < 0.01 for all. More importantly, after adjusting for MetS components, BAFLD patients were significantly more likely to have advanced fibrosis [adjusted OR (95%CI) based on FIB4 index > 2.67 was 3.2 (1.4, 7.0), P = 0.004].CONCLUSIONA significant percentage of the American general population is afflicted by BAFLD and these patients tend to have more advanced liver fibrosis.

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Association between Liver Fibrosis and Serum PSA among U.S. Men: National Health and Nutrition Examination Survey (NHANES), 2001–2010

Cited by 12 publications

References 39 publications

The relationship between lipoprotein A and other lipids with prostate cancer risk: A multivariable Mendelian randomisation study

The relationship between lipoprotein A and other lipids with prostate cancer risk: A multivariable Mendelian randomisation study

The relationship between serum albumin and prostate-specific antigen: A analysis of the National Health and Nutrition Examination Survey, 2003–2010

Characterization of patients with both alcoholic and nonalcoholic fatty liver disease in a large United States cohort

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