Diagnostic value of prostate-specific antigen (PSA) and free prostate specific antigen (fPSA) in women with ovulatory and anovulatory polycystic ovary syndrome

Prostatic-specific antigen (PSA) levels in patients with polycystic ovary syndrome (PCOS): a meta-analysis

Purpose

The polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder, clinically characterized by oligo-ovulation/chronic anovulation, menstrual irregularities, hyperandrogenism (such as hirsutism, acne), hyperinsulinemia, and obesity. Prostatic-specific antigen (PSA) has been identified as a potential new marker in PCOS women. Although the precise role of PSA in PCOS patients still remains undetermined, PSA might serve as a useful clinical marker and might even represent a new diagnostic criterion of hyperandrogenemia in females of PCOS.

Methods

A meta-analysis was performed in the study to identify the association between the polycystic ovary syndrome and prostatic-specific antigen. To identify eligible original articles, we searched a range of computerized databases, including Medline via PubMed, EMBASE, CNKI and Web of Science with a systematic searching strategy. The characteristics of each study and standard mean differences (SMD) with corresponding confidence intervals (CIs) were calculated and subgroup analysis was performed to analyze heterogeneity.

Results

A total of 532 patients from seven articles were included in the meta-analysis. We identified a significant relationship between polycystic ovary syndrome and prostatic-specific antigen, with a pooled SMD of 0.81 (95% CI: 0.58 to 1.04; P < 0.01). The pooled data were calculated with the random-effects model as a moderate significant heterogeneity was found among the studies.

Conclusions

The meta-analysis suggested that there was a significant association between the polycystic ovary syndrome and prostatic-specific antigen and we should not ignore the role of PSA in the PCOS patients in clinical.

A Study on Omentin-1 and Prostate Specific Antigen in Women on Treatment for Polycystic Ovary Syndrome

Omentin-1 and prostate specific antigen (PSA) are known to be markers of insulin resistance and hyperandrogenism respectively in polycystic ovary syndrome (PCOS). This study aimed to assess the changes in serum omentin-1 and PSA levels in PCOS patients while on treatment. Serum omentin-1, PSA, BMI and Ferriman gallwey score (FG score) were measured in 80 women with PCOS. The subjects were treated depending on their presenting complaints. The parameters were analysed at baseline and after 3 months of treatment viz. lifestyle modification (Group I), oral contraceptive pills (OCP) (Group II), clomiphene citrate (Group III), medroxy progesterone acetate (Group IV) or metformin (Group V) and was compared using paired-t test. Group II showed significant increase in serum omentin-1 (271.7 ± 112.2 vs 378.1 ± 242 ng/ml; P = 0.025) and decrease in serum PSA (0.014 ± 0.02 vs 0.005 ± 0.008 ng/ml; P = 0.027) after 3 cycles of OCP. Group I and IV also showed a decrease in serum PSA while FG score decreased in group II and group III. There was a negative correlation observed between serum omentin-1 and BMI. To conclude, PCOS women showed increase in serum omentin-1 levels after 3 cycles of OCP while serum PSA decreased after 3 months of lifestyle modification or on treatment with OCP or medroxy progesterone acetate.

Prostate specific antigen (PSA) in diagnosis of polycystic ovarian syndrome - a new insight

INTRODUCTION

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder and cause of androgen excess in women. Prostate specific antigen (PSA) could be a new marker of hyperandrogenism in PCOS.

OBJECTIVE

The aim of the study was to assess the concentration PSA (total PSA - TPSA and free PSA - fPSA) in 165 patients with PCOS and 40 healthy female controls, the relationship between PSA (TPSA and fPSA) and hormonal parameters and to determine the performance of PSA in diagnosis of PCOS.

RESULTS

Total PSA was higher in PCOS group versus controls. The fPSA was below the lower detection levels among all patients. The median value of FAI was 4.31 in PCOS patients versus 1.79 in controls, p < 0.001. There was a correlation of TPSA and tT (r= 0.173, p = 0.027) and TPSA and FAI (r = 0.2603, p = 0.001). AUC for FAI was 82.1%, threshold 2.56 nmol/l, for tT AUC 80.5%, threshold 0.54 ng/ml, for TPSA AUC 66.3%, threshold 0.005 ng/ml. The ROC analysis for A AUC 62.7%, threshold 3.95 ng/ml.

CONCLUSION

PCOS women have higher serum concentration of TPSA than controls. TPSA positively correlate with T and FAI, which is the best marker for hyperandrogenic states and has better accuracy for tT and total PSA serum levels in diagnostic of PCOS.

Prostate-Specific Antigen as a Marker of Hyperandrogenism in Women and Its Implications for Antidoping

BACKGROUND

Since its discovery in the 1970s, prostate-specific antigen (PSA) has become widely known as a biomarker of prostate cancer in males but has often been overlooked in female malignancies. Although the serum concentration of PSA differs between men and women by about 1000-fold, studies have suggested that PSA concentrations drastically differ among healthy females and those who exhibit increased androgen production.

CONTENT

There have been reports of increased PSA expression in women exhibiting hyperandrogenic states, including polycystic ovary syndrome and hirsutism, as well as marked increases in a subset of breast cancer patients. These findings have not only revealed the remarkable diagnostic potential of PSA in a diverse range of clinical conditions but also point to its potential of becoming a useful biomarker of steroid hormone doping among female athletes. Recently, highly sensitive assays that can measure PSA at low limits of detection have been developed, which will aid in the discrimination of PSA between these different conditions.

SUMMARY

The overall aim of this review is to revisit the expression of PSA in hormonally-regulated tissues and in female malignancies, and to demonstrate how the regulation of PSA permits its use in antidoping initiatives.