Association between prostate‐specific antigen and serum testosterone: A systematic review and meta‐analysis

Abstract

Background Serum testosterone assays are an important tool in the clinical evaluation of a number of endocrine disorders including male hypogonadism. However, serum testosterone has a limited role in real clinical use due to its inaccuracy. We aimed to assess the association between prostate‐specific antigen (PSA) and testosterone as well as the effects of various types of testosterone replacement therapy (TRT) for PSA level. Methods Two electronic databases were screened: PubMed (1966 through December 2018) and Cochrane Library (1993 through December 2018). The first strategy compared the overall increase in PSA following testosterone treatment compared with placebo. The second strategy analyzed the overall association between PSA and testosterone among the observational studies. Results In the first strategy, 22 articles were included in the final analysis. In the second strategy, 18 studies were included. Testosterone replacement therapy (TRT) showed a significant change in PSA level compared to that in the placebo group (mean difference [MD]: 0.13, 95% CI: 0.01‐0.25, P = .04). Compared to placebo, only intramuscular (IM) TRT shows a significant change in PSA level group (MD: 0.16, 95% CI: 0.01‐0.30, P = .04), as neither the oral nor topical type showed a significant change in PSA. In the second strategy analysis, there was no overall correlation found between PSA and testosterone (z = 0.04, 95% CI: −0.04 to 0.12, P = .04; r = 0.039). However, in the subgroup of non‐BPH (benign prostate hyperplasia), a significant correlation between PSA and testosterone (z = 0.07, 95% CI: 0.01‐0.13, P = .009; r = 0.089) was found. Conclusions We found that TRT, particularly IM TRT, significantly changed the PSA level compared with the placebo group. Furthermore, there was a significant correlation between PSA and testosterone in patients with non‐BPH. According to these findings, we suggest the possibility of PSA as a surrogate marker of testosterone.

Studies on the Occurrence of Prostate Cancer in Gujrat, Punjab, Pakistan and its Association with Testosterone Level

“…The level of PSA was higher in males of old age group of prostate cancer as compared to normal case as indicated in Figure 3. Furthermore, the results of our study were confirmed by the (Kim et al, 2020) that explained higher level of PSA was seen in prostate patients as (P<0.05). Higher level of PSA can result in prostate gland cells tumors and complications during hypogonadisom as (P<0.05).…”

Efficacy and Safety of Human Chorionic Gonadotropin Monotherapy for Men With Hypogonadal Symptoms and Normal Testosterone

“…As a result, we retrospectively analyzed 31 charts of men treated with hCG monotherapy for hypogonadal symptoms and evaluated changes in hormones, symptoms, and side effects. We found that hCG monotherapy improved hypogonadal symptoms without the undesirable side effects of hCG (gynecomastia, headache, and gastrointestinal complaints) or exogenous testosterone (polycythemia or thromboembolic events) [ 6 , 7 ]. While we did not observe a significant increase in testosterone level, previous literature shows that hCG was able to increase patient T levels; therefore, the lack of increase in T levels could be attributed to the low dose of hCG in our study [ 8 - 10 ].…”

Gut Microbiota Composition across Normal Range Prostate-Specific Antigen Levels

“…The androgen receptor (AR) target gene, known as prostate-specific antigen (PSA), has been recently reported as a possible marker of AR expression due to the correlation between PSA expression and the transcription of additional AR genes [2,3]. Our previous meta-analysis suggested that normal-range PSA levels could serve as a surrogate indicator of serum testosterone, and another prior study comprising a cohort of apparently healthy men showed that normal-range PSA levels, possibly reflective of androgen activity, could predict subclinical and clinical cardiovascular diseases [4,5].…”