Obesity Is Negatively Associated with Prostate-Specific Antigen in U.S. Men, 2001-2004

Werny, David M.; Thompson, Trevor; Saraiya, Mona; Freedman, David S.; Kottiri, Benny J.; German, Robert R.; Wener, Mark H.

doi:10.1158/1055-9965.epi-06-0588

Cited by 130 publications

(120 citation statements)

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“…8,9,11 These findings were also confirmed by our study. Interestingly we did not find any statistically significant association between PSA and the use of NSAIDs, statins or thiazide diuretics as found by Chang et al 7 Different ways of defining smoking status, and various sociodemographic, clinical factors and medications examined in these 2 studies may partially account for this difference.…”

Section: Discussionsupporting

confidence: 87%

“…5,6 Epidemiological studies have also shown that PSA can be affected by several heath characteristics including obesity, diabetes and certain medications such as NSAIDs, statins and thiazide diuretics. [7][8][9] Scant data exist on the association between smoking and PSA levels. Gelmann et al reported that current and former smokers had a statistically significantly lower PSA and fPSA levels compared with never smokers.…”

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confidence: 99%

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Association Between Smoking Status, and Free, Total and Percent Free Prostate Specific Antigen

Thompson

Joseph

et al. 2012

Journal of Urology

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Purpose-There are scant data available on the relationship between smoking and total prostate specific antigen, free prostate specific antigen and percent-free prostate specific antigen. Given the high prevalence of smoking and the frequency of prostate specific antigen screening, it is important to determine any association between smoking and prostate specific antigen values using nationally representative data.Materials and Methods-Included in the final study population were 3,820 men 40 years old or older who participated in the 2001-2006 NHANES (National Health and Nutrition Examination Survey) and met the eligibility criteria for prostate specific antigen testing. The distributions of total, free and percent free prostate specific antigen were estimated by sociodemographic and clinical characteristics. Multivariate linear regression models were fit to determine the adjusted relationship between smoking and total and percent free prostate specific antigen while simultaneously controlling for these characteristics.Results-For all ages combined the median total and free prostate specific antigen levels were 0.90 (0.81-0.90) and 0.26 (0.25-0.28) ng/ml, respectively. Multivariate linear regression analysis showed that total prostate specific antigen was 7.9% and 12.2% lower among current and former smokers, respectively, than among never smokers. High body mass index and diabetes were also statistically significantly associated with a lower total prostate specific antigen. Approximately a third of the men had a percent free prostate specific antigen less than 25%. Current smokers had a significantly lower percent free prostate specific antigen than former smokers.Conclusions-Our finding that smoking is inversely associated with total prostate specific antigen may have potential implications for the interpretation of prostate specific antigen levels in men who are current or former smokers. Given the high prevalence of smoking, obesity and diabetes, additional research on the combined effect of these health risk factors is warranted. Keywords HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAlthough the mortality benefit from screening with PSA is uncertain, 1,2 PSA based screening has resulted in a downward stage shift to more organ confined prostate cancer at the time of diagnosis. 3 The often used PSA cut point of greater than 4.0 ng/ml detects the majority of prostate cancers. However, the specificity of the PSA test is low and has led to a high rate of false-positive results, particularly among older men with BPH. Percent-free PSA (the ratio of fPSA-to-tPSA) testing has been used as an adjunct to PSA tests to enhance the specificity and decrease the number of unnecessary biopsies. 4 It has been recognized that age, race, BPH, prostate size and prostatitis can influence PSA levels. 5,6 Epidemiological studies have also shown that PSA can be affected by several heath characteristics including obesity, diabetes and certain medications such as NSAIDs, statins and...

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Section: Discussionsupporting

confidence: 87%

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confidence: 99%

Association Between Smoking Status, and Free, Total and Percent Free Prostate Specific Antigen

Thompson

Joseph

et al. 2012

Journal of Urology

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“…The results of our study suggested that a relevant reduction in PSA might be restricted to obese men (À14%), which in part might be attributable to the effect of hemodilution (30). The PSA reduction was comparable with the reduction found in previous studies: À9% to À19% (2,3,6,8,31). Likewise, the risk of localized prostate cancer was reduced in obese compared with normal-weight men (À8%, when assuming a BMI difference of 10 kg/m 2 ) according to the metaanalyses of MacInnis et al (32).…”

Section: Discussionsupporting

confidence: 84%

Association of Diabetes and Body Mass Index with Levels of Prostate-Specific Antigen: Implications for Correction of Prostate-Specific Antigen Cutoff Values?

Müller

Raum

Rothenbacher

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: In a recent study, an inverse association between diabetes and prostate-specific antigen (PSA) levels was observed, and several studies reported lower PSA levels in groups with higher body mass index. However, all of the studies were conducted in populations with intensive PSA screening and the role of diabetes severity, duration, and therapy are yet to be explored. Methods: Associations of diabetes duration and treatment, hemoglobin A1c, and BMI with PSA levels were assessed among 778 men ages 50 to 74 years, randomly chosen from the 2000 to 2002 baseline recruitment of a large population-based cohort study in Germany (prevalence of diabetes, 17%), using linear regression analyses.

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“…Whether or not there was any difference in genetic background or dietary lifestyle between the Japanese patients in our study and the Korean patients in the previous study 18 remains unclear. Both population-based studies 26,27 and studies of patients with clinically localized PCa treated by RP 5 have found that obese men have lower PSA levels compared with nonobese men. Hemodilution and low androgenic activity are reported to have an inverse relationship with obesity and serum PSA levels.…”

Section: Discussionmentioning

confidence: 99%

Impact of body mass index on clinicopathological outcome and biochemical recurrence after radical prostatectomy

Narita

Mitsuzuka

Yoneyama

et al. 2013

Prostate Cancer Prostatic Dis

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BACKGROUND: Accumulating evidence suggests that obesity is associated with tumor progression in prostate cancer (PCa) patients after radical prostatectomy (RP). We conducted a retrospective multicenter study to determine the effect of body mass index (BMI) on the clinicopathological characteristics and biochemical recurrence of PCa in Japanese men who underwent RP. METHODS: The medical records of 1257 men with PCa treated by RP without neoadjuvant therapy at four medical institutes between 2001 and 2009 were retrospectively reviewed. Patients were categorized into four groups using the World Health Organization (WHO) BMI classification and BMI quartiles. Associations of the various BMI categories with clinicopathological characteristics and biochemical recurrences were statistically evaluated. Biochemical recurrence was defined as a PSA level of 40.2 ng ml -1 . RESULTS: Of the 1257 patients, 230 (18.3%) experienced biochemical recurrence during the median follow-up period of 49 months. The median BMI was 23.8 kg m -2 , and 1.4% patients were underweight, 65.4% were of normal weight, 30.9% were overweight and 2.4% were obese (WHO classification). Preoperative PSA levels and PSA density (PSAD) tended to decrease as BMI increased. Pathological characteristics did not differ significantly among BMI categories. As per the WHO classification and quartile categories, biochemical recurrence rate was comparable among the BMI groups. After adjusting for other pre-and postoperative covariables, multivariate Cox proportional hazards analysis revealed that a high BMI did not have an independent impact on biochemical recurrence-free survival. CONCLUSIONS: Underweight Japanese PCa patients treated by RP had higher preoperative PSA levels and PSAD. High BMI was not associated with adverse pathological findings or increased biochemical recurrence rate in Japanese PCa patients treated with RP. Racial differences may exist in the relationship between obesity and outcomes of RP in PCa patients.

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Obesity Is Negatively Associated with Prostate-Specific Antigen in U.S. Men, 2001-2004

Cited by 130 publications

References 46 publications

Association Between Smoking Status, and Free, Total and Percent Free Prostate Specific Antigen

Association Between Smoking Status, and Free, Total and Percent Free Prostate Specific Antigen

Association of Diabetes and Body Mass Index with Levels of Prostate-Specific Antigen: Implications for Correction of Prostate-Specific Antigen Cutoff Values?

Impact of body mass index on clinicopathological outcome and biochemical recurrence after radical prostatectomy

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