Association between serum prostate-specific antigen level, liver function tests and lipid profile in healthy men

Serum Interleukin-17, Carcinoembryonic Antigen, and Prostate-Specific Antigen in High Lipid Profile Individuals

[Figure: see text] It is assumed that high lipid profile (HLP) causes chronic systemic inflammation, which ultimately leads to inflammatory diseases and cancers. The aim of the study was to investigate the serum concentration of proinflammatory/tumor markers of interleukin-17 (IL-17), carcinoembryonic antigen (CEA), and prostate-specific antigen (PSA) in HLP. HLP cases [F/M: 11/17 triglyceride (TG) >200 mg/dL, high-density lipoprotein (HDL) <50 mg/dL for females and HDL <40 mg/dL for males] and controls (F/M: 12/15, TG <200 mg/dL) were included. The volunteers with diabetes, high blood pressure, infection, cancer, inflammation, smoking addiction, drug consumption, and pregnancy were excluded. Serum TG, cholesterol, HDL and low-density lipoprotein were measured by routine biochemical procedures. The serum levels of IL-17, CEA, and PSA (only in men) were determined by enzyme-linked immunosorbent assay (ELISA). Independent samples t-test was used to compare the data in 2 groups and association between the variables tested by Pearson correlation. IL-17 in HLP group was statistically higher compared with the controls (3.43 ± 0.5 versus 2.28 ± 0.3 pg/mL, P < 0.001). The serum levels of CEA and PSA were not different in the HLP and controls. There was also a statistically positive linear association between TG and IL-17. In conclusion, abnormal high concentration of HLP and IL-17 could be a pathological condition and may cause to increase the chronic systemic inflammation and inflammatory diseases.

Association between Liver Fibrosis and Serum PSA among U.S. Men: National Health and Nutrition Examination Survey (NHANES), 2001-2010

BACKGROUND

To evaluate the association of liver fibrosis scores with PSA level among U.S. adult men overall and by race/ethnicity.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES), 2001-2010, were used. Males ages ≥40 years without a prostate cancer diagnosis and who had serum PSA, liver enzymes, albumin, and platelet counts measured as part of NHANES protocol were included. Liver fibrosis was measured using three scores: aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 index (FIB-4), and NAFLD fibrosis score (NFS). We assessed overall and race/ethnicity-stratified geometric mean PSA by fibrosis score using predictive margins by linear regression, and the association of abnormal fibrosis scores (APRI > 1, FIB-4 > 2.67, NFS > 0.676) and elevated PSA (>4 ng/mL) by logistic regression.

RESULTS

A total of 6,705 men were included. Abnormal liver fibrosis scores were present in 2.1% (APRI), 3.6% (FIB-4), and 5.6% (NFS). Men with higher fibrosis scores had lower geometric mean PSA (all P _trend < 0.02). Men with abnormal APRI had a lower odds of PSA > 4 ng/mL [adjusted OR (aOR) = 0.33; 95% confidence interval (CI), 0.11-0.96]. Compared with men with 0 abnormal scores, those with 2 or 3 abnormal fibrosis scores had a lower odds of PSA > 4 ng/mL (aOR = 0.55; 95% CI, 0.33-0.91). The patterns were similar by race/ethnicity.

CONCLUSIONS

Men of all race/ethnicities with higher liver fibrosis scores had lower serum PSA, and men with advanced fibrosis scores had a lower odds of an elevated PSA.

IMPACT

These findings support further research to inform the likelihood of delay in prostate cancer detection in men with abnormal liver function.

Prostate-specific antigen rising in Iranian men in correlation with body mass index, fasting blood sugar and blood lipid profile

Background

Prostate-specific antigen (PSA) is a serine protease that is secreted by prostate cells and it is useful as a tumor marker for prostate cancer.

Objectives

In this study, the relationship between some of metabolic factors and serum PSA level was investigated.

Materials and Methods

In this cross-sectional study, patients with urinary symptoms or for screening of the prostate cancer (after 50 years of age or 40 years with a family history of prostate cancer), were evaluated. Collected data included metabolic syndrome factors such as cholesterol (Chol), triglycerides (TG), fasting blood sugar (FBS), and body mass index (BMI), serum PSA level, prostate volume and age.

Results

481 patients were enrolled to this study with the average age of 60.69 ± 9.72 years and the average PSA level of 1.70 ng/ml. Data analysis showed that there was a significant relationship between serum PSA level with age (P < 0.001, r = 0.30) and prostate volume (P < 0.001, r = 0.29). There were not significant relationship between serum PSA level with TG (P = 0.57, r = 0.026), Chol (P = 0.57, r = -0.025), FBS (P = 0.054, r = 0.088), and BMI (P = 0.89, r = 0.006).

Conclusions

This study showed that, with increasing age and prostate volume, serum PSA level increased, and an increase in the levels of cholesterol, TG, FBS and BMI did not have significant effect on serum PSA level.

Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

Lifestyle-related risk factors such as hyperglycemia and dyslipidemia have been associated with several cancers. However, studies exploring their link with prostate cancer (PCa) clinicopathological characteristics are sparse and inconclusive. Here, we investigated the associations between serum metabolic markers and PCa clinicopathological characteristics. The study comprised 14,294 men from the Swedish Apolipoprotein MOrtality RISk (AMORIS) cohort who were diagnosed with PCa between 1996 and 2011. Univariate and multivariable logistic regression were used to investigate the relation between glucose, triglycerides and total cholesterol and PCa risk categories, PSA, Gleason score, and T-stage. Mean age at time of PCa diagnosis was 69 years. Men with glucose levels >6.9 mmol/L tend to have PSA<4 μg/L, while those with glucose levels of 5.6-6.9 mmol/L had a greater odds of PSA>20 μg/L compared to PSA 4.0-9.9 μg/L. Hypertriglyceridemia was also positively associated with PSA>20 μg/L. Hyperglycemic men had a greater odds of intermediate- and high-grade PCa and advanced stage or metastatic PCa. Similarly, hypertriglyceridemia was positively associated with high-grade PCa. There was also a trend toward an increased odds of intermediate risk localized PCa and advanced stage PCa among men with hypertriglyceridemia. Total cholesterol did not have any statistically significant association with any of the outcomes studied. Our findings suggest that high serum levels of glucose and triglycerides may influence PCa aggressiveness and severity. Further investigation on the role of markers of glucose and lipid metabolism in influencing PCa aggressiveness and severity is needed as this may help define important targets for intervention.

Toxicity of Smokeless Tobacco Extract after 184-Day Repeated Oral Administration in Rats

The use of smokeless tobacco (ST) is growing rapidly and globally. The consumption of ST is associated with an increased risk for developing chronic diseases, such as diabetes, hypercholesterolemia, and myocardial infarction, and has led to many public health problems. It is very important to access the toxicity of ST. This experiment presents data from 184-day toxicology studies in Sprague-Dawley (SD) rats designed to characterize the chronic effects of a smokeless tobacco extract (STE). The control group and treatment groups were matched for a range of nicotine levels. Animals were given STE by oral gavage with doses of 3.75 (low-dose), 7.50 (mid-dose) and 15.00 (high-dose) mg·nicotine/kg body weight/day for 184 days, followed by 30 days for recovery. Variables evaluated included body weights, feed consumption, clinical observations, clinical and anatomic pathology (including organ weights), and histopathology. Decreased body weights and organ weights (heart, liver and kidney) were found in animals in the mid-dose and high-dose groups. STE also showed moderate and reversible toxicity in esophagus, stomach, liver, kidney and lung.

Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia

Purpose

To investigate the effect of metabolic syndrome (MetS) on the response to medical therapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment.

Materials and Methods

This was a cohort study of 100 patients, 47 with MetS and 53 without MetS, referred to either the primary care unit or referral hospital with BPH who had moderate lower urinary tract symptoms of prostate involvement and were candidates for medical treatment. Our main outcome was response to medical treatment with prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on the basis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariance was used to compare BPH treatment response in patients with and without MetS before and after receiving treatment.

Results

The mean volume of the prostate was significantly higher in MetS patients than in patients without MetS (57±32.65 mL compared with 46.00±20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetS showed a reduction in the symptom score of only 6 units (p<0.001). Regarding the components of MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), and waist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventional study.

Conclusions

The results of the present study showed that MetS can negatively affect the response to medical treatment of BPH. Therefore, it is necessary to consider MetS in selecting patients with BPH for drug therapy.

Relationship between prostate-specific antigen, age, and body mass index in a prostate cancer screening population

BACKGROUND

Recent studies questioning the benefit of prostate-specific antigen (PSA) screening have increased the need for evaluating factors contributing to variance in levels and their clinical relevance. An inverse relationship between body mass index (BMI) and PSA has been illustrated, however the clinical implications have not been specified. We performed a retrospective review of patients screened through our free screening clinic to delineate any relationship between PSA and BMI in an attempt to understand its possible clinical significance.

METHODS

The authors retrospectively reviewed data collected in relation to PSA values and patient characteristics from a community outreach program supplying information and screening for prostate cancer between June of 2003 and August of 2009.

RESULTS

Mean BMI of our patient population was 28.7 m/kg(2) (SD 5.4) and our mean PSA value was 1.28 (SD 1.77). Our data indicate a small, but statistically significant decrease in PSA for an increasing BMI with a 0.026 decrease in PSA for every unit increase in BMI.

CONCLUSIONS

Our study confirms the previously reported inverse relationship between PSA value and BMI. The significance of this finding and its impact on the value do not seem to indicate a rationale to change the accepted abnormal value in obese patients and should be used in the context of the clinical scenario and other PSA altering factors.

Relationships between Prostate-Specific Antigen, Prostate Volume, and Components of Metabolic Syndrome in Healthy Korean Men

Purpose

Metabolic syndrome (MS) plays a potential role in the etiology of benign prostatic hyperplasia (BPH). Recent studies have reported on an association between MS and BPH. However, there has been no consensus on recent results. This study was conducted to evaluate the associations among prostate-specific antigen (PSA), prostate volume (PV), and metabolic components in men who visited our health promotion center.

Materials and Methods

During the period from January 2005 to December 2010, 521 consecutive men (age range, 40 to 70 years) who underwent transrectal ultrasonography were enrolled in this retrospective study. The health screening program includes blood pressure, body measurements (height, weight, waist circumference, body mass index), biochemical analysis (serum glucose, total cholesterol, triglycerides, high-density and low-density lipoprotein cholesterol, fasting plasma glucose, tumor markers), stool and urine analysis, and a detailed clinical examination.

Results

The serum PSA level and PV were significantly higher in patients with MS than in patients without MS, retrospectively (p<0.001, p<0.001). Patients with more than one metabolic component were significantly more likely to have a larger PV and higher serum PSA level. The serum PSA level and PV were increased in a similar manner with the increasing sum of MS components (p<0.0001, p<0.0001).

Conclusions

The MS components were associated with larger PV and higher serum PSA level. Therefore, each MS component could be an important factor in BPH development and management.

Trends and co-trends of prostate-specific antigen and body mass index in a screened population

OBJECTIVES

This report investigated whether annual changes in body mass index (BMI) are associated with the opposite changes in prostate-specific antigen (PSA). Previous studies have confirmed lower PSA levels among men with higher BMI.

METHODS

Normal linear mixed models were used to characterize annual PSA, BMI and the ratio of PSA to BMI profiles for 2641 men undergoing prostate cancer screening for up to 8 years as part of a San Antonio screening study.

RESULTS

Among the 1898 participants (71.9%) who never received a prostate biopsy during the study and the 585 participants (22.1%) who had one or more biopsies, all negative for prostate cancer, BMI was higher for Hispanics than other racial groups, lower for older men at study entry, and increased every year during the study; and PSA and PSA/BMI ratios were higher for older men at study entry and increased each year on study (all P values<.05). Among the 158 men (6.0%) eventually diagnosed with prostate cancer, no trends in BMI were statistically significant, but PSA and PSA/BMI ratios were higher on average for older men at study entry and increased each year on study (both P values<.05). Correlations between BMI and PSA changes per year were negative but not statistically significantly different from zero.

CONCLUSIONS

The individual man scrutinizing his PSA and weight year to year can expect a slight annual increase in both, but changes in PSA from one year to the next cannot be attributed to weight gain or loss.

Body mass index and serum lipid profile influence serum prostate-specific antigen in Chinese men younger than 50 years of age

This study is to assess the potential factors that could affect the serum prostate-specific antigen (PSA) level in healthy younger men. We evaluated the associations of age, body mass index (BMI) and serum lipid profile with serum PSA level in 6774 Chinese men (aged 20-49 years) who received a routine health examination. Eligible men were classified into 10-year age groups. BMI was categorized as underweight (<18.5), normal (18.5-22.9), overweight (23.0-24.9), obese (25.0-29.9) and very obese (>30) according to the redefined World Health Organization (WHO) criteria for the Asia-Pacific region. PSA levels were compared among groups as well. In multiple linear regression analysis, PSA was positively correlated with age (P<0.0001). Negative correlations existed between PSA and BMI (P<0.0001) and triglyceride level (P=0.01). No relationship could be found between PSA and serum cholesterol (P=0.711) or high-density lipoprotein (HDL; P =0.665). In addition, we found that serum PSA levels increased with age and decreased with BMI. Our study demonstrates that age, BMI and triglyceride levels influence the PSA level in men <50 years of age.

Body mass index adjusted prostate-specific antigen and its application for prostate cancer screening

OBJECTIVES

The prostate cancer prevention trial (PCPT) prostate cancer risk calculator was developed to aid physicians in counseling men for consideration of prostate biopsy based on prostate-specific antigen (PSA) and other clinical risk factors. This study investigated the role of body mass index (BMI) in this assessment.

MATERIALS AND METHODS

BMI category was defined as < 25 (under/normal weight), 25.0-29.9 (overweight), 30.0-34.9 (obese [OB] I), 35.0-39.9 (OB II), and ≥ 40 (OB III). BMI-adjusted PSA for a man was determined by multiplying his PSA to the ratio of the geometrical mean of PSA for BMI < 25 to the geometrical mean of PSA for his BMI category. Operating characteristics of PSA and BMI-adjusted PSA were compared with PCPT risks using area underneath the receiver operating characteristic curve (AUC). Statistical tests of differences between AUCs for different diagnostic tests were performed with the nonparametric U-statistic method.

RESULTS

BMI-adjusted PSA equaled to unadjusted PSA multiplying 1.09, 1.20, 1.50, and 1.71 for men in overweight, OBI, OBII, and OBIII categories, respectively. The AUC for BMI-adjusted PSA values (0.84) did not differ from PSA; that of the PCPT calculator with BMI-adjusted PSA (0.87) did not differ from the calculator with PSA. Of 2816 men with a PSA less than or equal to 2.5 ng/mL who did not undergo biopsy, 126 (4.5%) would have a BMI-adjusted PSA exceeding 2.5 ng/mL.

CONCLUSIONS

Because of lower levels of PSA, overweight and obese men may have diminished cancer detection opportunities when undergoing PSA-based screening.

Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men

The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL(-1). The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA [fasting glucose x fasting insulin]/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/[log (fasting insulin) + log (fasting glucose)]). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncan's multiple comparison test (P < 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P < 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P < 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.