Ethnicity and Migration as Determinants of Human Prostate Size*

Abstract

The roles of ethnicity and migration in determining the size of human prostate zones during midlife were explored. Prostate size was measured by planimetric ultrasound in 163 men residing in Sydney who were either Australian non-Chinese (AR; n = 116) or Chinese migrants (ACM; n = 47) and had lived in Australia for a median of 7.3 yr (range, 0.2-25 yr). These were compared with Chinese men residing in China (CR; n = 210). Central and total prostate volumes were estimated by a single observer using the same equipment at both sites. After adjustment for age, central and total prostate volumes were significantly smaller, and plasma prostate-specific antigen and 5alpha-dihydrotestosterone (DHT) concentrations and International Prostate Syndrome Scores were significantly lower, in CR compared with either ACM or AR, whereas the scores of the latter two groups were similar. Almost all of the population difference in total prostate volumes could be accounted for by differences in central prostate volumes. The strongest correlates of age-adjusted prostate volume were prostate-specific antigen and DHT, the latter presumably reflecting the quantitative importance of prostatic stromal type II 5alpha-reductase activity to circulating DHT concentrations. Sex hormone-binding globulin concentrations were significantly higher in CR and significantly lower in ACM compared with those in AR, but the significance of these observations is unclear. These findings highlight the importance of the central zone of the prostate as well as provide evidence for an environmental factor influencing prostate growth. This factor operates over a relatively short time period compared with the evolution of prostate disease. Hence, this study provides evidence that ethnicity and geographical factors, such as migration, can influence the growth of the normal human prostate during midlife and may facilitate future studies of the origins and pathogenesis of human prostate disease.

Age, height, BMI and FBG predict prostate volume in ageing benign prostatic hyperplasia: Evidence from 5285 patients

“…The third growth period is the pathological enlargement of the prostate, which is the so‐called BPH . The enlargement of the prostate is influenced by age, race, environment, androgens and oestrogens …”

“…The size of the prostate varies by country. Studies have found that males in Asia, including China, India and Japan, have lower PV compared with the males in America or Australia . Interestingly, the size of the prostate grows with age.…”

Androgen administration in middle‐aged and ageing men: effects of oral testosterone undecanoate on dihydrotestosterone, oestradiol and prostate volume

“…Another interesting outcome of this study is the observation that, despite administration of exogenous testosterone, plasma dihydrotestosterone concentrations are reduced in proportion to reduction in prostate volume and plasma PSA concentrations. This is consistent with the suggestion that most blood plasma dihydrotestosterone arises from the prostate gland where type II 5α reductase is highly expressed and most incoming testosterone is avidly converted to dihydrotestosterone (Gisleskog et al ., 1998; Jin et al ., 1999). Hence in untreated middle‐aged and older men, circulating plasma dihydrotestosterone may be viewed as another convenient indicator of prostate size similar to the interpretation of plasma PSA (Jin et al ., 1999).…”

“…This is consistent with the suggestion that most blood plasma dihydrotestosterone arises from the prostate gland where type II 5α reductase is highly expressed and most incoming testosterone is avidly converted to dihydrotestosterone (Gisleskog et al ., 1998; Jin et al ., 1999). Hence in untreated middle‐aged and older men, circulating plasma dihydrotestosterone may be viewed as another convenient indicator of prostate size similar to the interpretation of plasma PSA (Jin et al ., 1999). Whether plasma dihydrotestosterone can be viewed as a non‐invasive, quantitative estimate of prostatic type II 5α reductase activity is an interesting and important question requiring further study.…”

Comparison of the response to treatment between Asian and Caucasian men with benign prostatic hyperplasia: Long‐term results from the combination of dutasteride and tamsulosin study

“…Moderate‐to‐severe LUTS are more prevalent in Asian men than in men in most Western countries 7 . Furthermore, men of Asian ethnicity living in Asia and the Far East have lower PV and PSA levels than Western and Caucasian men, and differences in the relationship between PV and PSA have been reported in populations from China, Taiwan, Korea and Japan 8–10 . Specifically, per volume unit of prostate gland, there might be a greater release of PSA compared with Caucasian men 11 …”