Observed effect of age and body mass index on total and complexed PSA: Analysis from a national screening program

Barqawi, Al B.; Golden, Brian K.; O’Donnell, Colin; Brawer, Michael K.; Crawford, E. David

doi:10.1016/j.urology.2004.10.074

Cited by 86 publications

(69 citation statements)

References 29 publications

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“…[1][2][3] Some have proposed this as a mechanism for later detection of prostate cancer in obese men. 8,9 As PSA is regulated by androgen, investigators have hypothesized that lower PSA concentration may result from decreased androgenic activity in obese men. 9,10 However, men with higher BMI also have larger plasma volumes, which could decrease serum concentration of soluble tumor markers-a phenomenon known as hemodilution.…”

Section: Discussionmentioning

confidence: 99%

Obesity–PSA relationship: a new formula

Hekal

Ibrahiem

2009

Prostate Cancer Prostatic Dis

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To clinically apply the inverse PSA-body mass index (BMI) correlation and enhance PSA sensitivity in obese cases, a new formula is warranted. An innovated BMI-PSA equation is designed. PSA-BMI adjusted formula (named Hekal's equation): measured total PSA (ng ml À1 ) multiplied by age (years) and divided by BMI of the patient. The formula is applied over a randomly chosen 1000 cases of different PSA, BMI, age and trans-rectal ultrasound biopsy results, the yield of new PSA is correlated with pathology and age-specific PSA adjustment values. Among the 988 cases with complete data, obesity (BMI: 30-35 kg m À2 ) in 236 cases (23.8%) and 79 cases (7.9%) have BMI435 kg m À2 . Mean PSA was 5.8 ng ml À1 (s.d.±8.4 ng ml À1 ). Cases stratified based on their age (every 10 years). The new equation was applied. Obesity is detected in 33.5 and 43.6% of fifth and sixth decade of life respectively (P ¼ 0.02), with low measured PSA values (2.1, 3.8 ng ml À1 , respectively). By such PSA measurement biopsy may be omitted, missing 53.3% of malignant cases. In contrast, PSA adjusted were 4 and 9.3 ng ml À1 within the same group of patients. With such values, the decision of a biopsy could not be missed for the targeted groups. Specificity and sensitivity of adjusted PSA values at cutoff point 4 ng ml À1 was 41.7 and 70%, respectively. Based on our results, the new PSA-BMI adjusted formula is reproducible, easy applied formula. With such a formula the higher sensitivity of PSA in obese patients could be achieved. The misleading low PSA in obese cases in the fifth and sixth decade will be corrected.

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Section: Discussionmentioning

confidence: 99%

Obesity–PSA relationship: a new formula

Hekal

Ibrahiem

2009

Prostate Cancer Prostatic Dis

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“…However, PSA levels seem to be influenced by a number of demographic, life-style, and health characteristics, which might deserve careful attention in the interpretation of test results. In a recent study from the United States, an inverse association between diabetes and PSA levels was observed (1), and several studies reported inverse associations between body mass index (BMI) and PSA levels (1)(2)(3)(4)(5), while others showed lower mean (6) or median (7,8) PSA in higher BMI groups. However, the role of severity, duration, and therapy of diabetes are yet to be explored as more detailed data are still lacking.…”

Section: Introductionmentioning

confidence: 98%

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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“…PSA is influenced by the prostate size or androgens (8,9). Age, ethnicity, and obesity also influence PSA levels (10)(11)(12). None of the currently used PSA cut-offs consistently identify PCa and exclude non-PCa (11).…”

Section: Discussionmentioning

confidence: 99%

“…One of the biggest drawbacks of the PSA test is that various factors can influence the PSA level (8)(9)(10)(11)(12). Therefore, the authors examined the effects of various factors on PSA levels in a screening population, and finally devised the PSA-MR. PSA-MR is simply defined as the (i) PSA-D multiplied by the plasma volume or (ii) total PSA amount in circulation per prostate volume.…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of prostate-specific antigen mass ratio for prediction of prostate cancer detection on a repeated prostate biopsy

Lee

Hong

et al. 2014

Int. braz j urol.

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To assess the clinical utility of the prostate-specific antigen mass ratio (PSA--MR), a newly developed PSA derivative, simply defined as the (i) PSA density (PSA-D) multiplied by the plasma volume or (ii) total PSA amount in circulation per prostate volume, for predicting prostate cancer (PCa) among men undergoing repeated prostate biopsy (PBx). Materials and Methods:Patients (n = 286), who underwent a repeated PBx, were analyzed. The various parameters associated with PCa detection were noted in each patient. PSA-MR was also calculated.Results: PCa was detected in 63 (22.0%) of 286 patients. PSA-MR was the independent predictor in the univariate-and multivariate logistic regression analyses (OR = 3.448, p = 0.001 and OR = 13.430, p = 0.033, respectively). A nomogram that incorporated PSA--MR was considered a useful tool (predictive accuracy: 79.2%, 95% CI: 0.726-0.858, p < 0.001). Furthermore, a nomogram that incorporated PSA-MR would have avoided 59.6% of unnecessary repeated PBx. The predictive accuracy of PSA-MR was also superior to that of PSA or PSA-D (p = 0.013 and 0.009, respectively). Conclusions: PSA-MR was an independent predictor, and its consideration would have avoided 59.6% of unnecessary repeated PBx for PCa detection. PSA-MR was also superior than PSA or PSA-D. Our results support the use of PSA-MR to facilitate counseling with patients after a negative initial PBx, and use of PSA-MR might reduce further unnecessary biopsies.

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Observed effect of age and body mass index on total and complexed PSA: Analysis from a national screening program

Cited by 86 publications

References 29 publications

Obesity–PSA relationship: a new formula

Obesity–PSA relationship: a new formula

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

Clinical utility of prostate-specific antigen mass ratio for prediction of prostate cancer detection on a repeated prostate biopsy

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