Obesity-Related Plasma Hemodilution and PSA Concentration Among Men With Prostate Cancer

Abstract

HE PREVALENCE OF OBESITY IN the United States has dramatically increased in the past decade. 1 Increased body mass index (BMI) has been linked to death from colon, breast, and many other cancers. 2 Although there are biological bases for increased risk of certain cancers in obese persons, 3 delayed diagnosis may provide an explanation for advanced stage of disease and poor outcome. Obesity presents technical problems for cancer detection, since adiposity may hinder physical examination and interfere with imaging and ancillary tests. 4 Likewise, obesity may negatively affect early diagnosis through assessment of serum concentrations of soluble tumor markers. For example, recent evidence suggests that prostate cancer screening may be adversely affected by increased BMI. 5 In the United States, most prostate cancer cases are diagnosed by needle biopsy of the prostate prompted by a high serum prostate-specific antigen (PSA) concentration. The ability to accurately detect prostate cancer can be compromised by any factor that decreases PSA concentration in the circulation. Multiple studies have found that obese men have lower PSA con-Author Affiliations are listed at the end of this article.

The inverse relationship between prostate specific antigen (PSA) and obesity

“…In agreement with this study, we observed strong associations between PSA concentration and both WC and BMI, and no equivalent significant associations with PSA mass in age-adjusted analyses ( Supplementary Table 4). However, in contrast to Banez et al (2007), we do not conclude that the PSA concentration-obesity association is solely due to hemodilution, but rather show that hormonal factors play a major role. We note that this conclusion is in agreement with the one-compartment PSA model ( Supplementary Fig.…”

Does Obesity-Related Hemodilution of Carcinoembryonic Antigen Exist in Non-Small Cell Lung Cancer Patients?

“…We demonstrated that high BMI patients had higher PV, in agreement with the results of previous investigations [ 4-6 ]. It was also previously demonstrated that the serum PSA concentration in obese individuals was lower compared with normal-weight individuals [ 4-6 ].…”

“…We demonstrated that high BMI patients had higher PV, in agreement with the results of previous investigations [ 4-6 ]. It was also previously demonstrated that the serum PSA concentration in obese individuals was lower compared with normal-weight individuals [ 4-6 ]. The hemodilution may therefore be a most considerable reason for the lower serum PSA concentrations among obese men with prostate cancer [ 4-6 ].…”

The illusion of prostate‐specific antigen decline in patients with metabolic syndrome and insulin resistance

“…Hence, the decline in PSA level in MS or IR can be explained by increased plasma volume. These results are in agreement with those found in previous studies that showed a stable PSA mass regardless of obesity [12,13]. An interesting finding was that plasma volume increased more in the group with only MS than in the group with only IR.…”