Korean J Urol.  2008 May;49(5):411-417. 10.4111/kju.2008.49.5.411.

Factors Influencing the Prostate-specific Antigen Levels after Adjusting Age and Prostate Volume in Korean Men

Affiliations
  • 1Department of Urology, College of Medicine, Soonchunhyang University, Seoul, Korea. wonjya@hosp.sch.ac.kr

Abstract

PURPOSE: We investigated the influence of the anthropometric and serological parameters on the prostate-specific antigen(PSA) levels after adjusting for age and the prostate volume in Korean men who visited a health promotion center.
MATERIALS AND METHODS
From January 2004 to July 2007, among the 18,352 men(age range: 30 to 79) who visited our health promotion center for general check-ups, 1,230(14.9%) men who wanted their prostate evaluated were included in this study. Thereafter, 151 men whose PSA level was over 4.0ng/ml, or their urinalysis revealed pyuria(>5 white blood cells (WBCs)/high power fields(HPF)) were excluded. The data of the remained 1,079 men was then analyzed. All the men underwent transrectal ultrasonography, detailed anthropometric measurements and serological tests. The correlation of the PSA level with the various anthropometric and serological parameters was investigated.
RESULTS
On the univariate analysis after adjusting for age and the prostate volume, the PSA level showed statistically significant positive correlation with the WBC, the red blood cell(RBC) and platelet(PLT) counts/micron l, and the PSA level was negatively correlated with height, weight, the body surface area(BSA), the body mass index(BMI), gamma-glutamyltransferase (GGT), and creatinine clearance(Ccr). On multivariate analysis, age, the prostate volume and the RBC/PLT counts/micron l were positively correlated with the PSA level, and the BSA was negatively correlated with the PSA levels, whereas the BMI was not.
CONCLUSIONS
Irrespective of age, the prostate volume and the BSA were the independent factor influencing the PSA level, that is, the larger the BSA, the lower the PSA.

Keyword

Prostate-specific antigen; Body surface area; Body mass index

MeSH Terms

Male
Humans

Reference

1.Pinsky PF., Kramer BS., Crawford ED., Grubb RL., Urban DA., Andriole GL, et al. Prostate volume and prostate-specific antigen levels in men enrolled in a large screening trial. Urology. 2006. 68:352–6.
Article
2.Mochtar CA., Kiemeney LA., van Riemsdijk MM., Barnett GS., Laguna MP., Debruvne FM, et al. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol. 2003. 44:695–700.
Article
3.Bosch JL., Hop WC., Bangma CH., Kirkels WJ., Schroder FH. Prostate specific antigen in a community-based sample of men without prostate cancer: correlations with prostate volume, age, body mass index and symptoms of prostatism. Prostate. 1995. 27:241–9.
Article
4.Ku JH., Kim ME., Lee NK., Park YH., Ahn JO. Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men. Urology. 2003. 61:132–6.
Article
5.Ku JH., Jeon YS., Kim ME., Lee NK., Park YH., Ahn JO. Influence of age, rate of obesity, hepatic function and renal function on serum prostate-specific antigen in men older than 50 years. Korean J Urol. 2001. 42:1284–90.
6.Kim DS., Kim ME., Lee NK., Park YH., Ahn JO., Ku JH. Characteristics of serum prostate-specific antigen in healthy Korean men under 50 years old: influence of hepatic function, renal function and other chemical constituents of blood on serum prostate-specific antigen. Korean J Urol. 2002. 43:146–52.
7.Xie LP., Bai Y., Zhang XZ., Zheng XY., Yao KS., Xu L, et al. Obesity and benign prostatic enlargement: a large observational study in China. Urology. 2007. 69:680–4.
Article
8.Cho JS., Kim CI., Seong DH., Kim HS., Kim YS., Kim SJ, et al. Cut-off point of large prostate volume for the patients with benign prostatic hyperplasia. Korean J Urol. 2005. 46:1246–50.
9.Werny DM., Thompson T., Saraiya M., Freedman D., Kottiri BJ., German RR, et al. Obesity is negatively associated with prostate-specific antigen in U.S. men, 2001-2004. Cancer Epidemiol Biomarkers Prev. 2007. 16:70–6.
Article
10.Sohn JC., Lim MS., Chang HS., Park CH., Kim CI. The association of body mass index and prostate-specific antigen. Korean J Urol. 2007. 48:1121–4.
Article
11.Freedland SJ., Platz EA., Presti JC Jr., Aronson WJ., Amling CL., Kane CJ, et al. Obesity, serum prostate specific antigen and prostate size: implications for prostate cancer detection. J Urol. 2006. 175:500–4.
Article
12.Thompson IM., Leach R., Troyer D., Pollock B., Naylor S., Higgins B. Relationship of body mass index and prostate specific antigen in a population-based study. Urol Oncol. 2004. 22:127–31.
Article
13.Fowke JH., Signorello LB., Chang SS., Matthews CE., Bucho-wski MS., Cookson MS, et al. Effects of obesity and height on prostate-specific antigen (PSA) and percentage of free PSA levels among African-American and Caucasian men. Cancer. 2006. 107:2361–7.
Article
14.Banez LL., Hamilton RH., Partin AW., Vollmer RT., Sun L., Rodriguez C, et al. Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer. JAMA. 2007. 298:2275–80.
Article
15.Putnam SD., Cerhan JR., Parker AS., Bianchi GD., Wallace RB., Cantor KP, et al. Lifestyle and anthropometric risk factors for prostate cancer in a cohort of Iowa men. Ann Epidemiol. 2000. 10:361–9.
Article
16.Fowke JH., Motley SS., Cookwon MS., Concepcion R., Chang SS., Wills ML, et al. The association between body size, prostate volume and prostate-specific antigen. Prostate Cancer Prostatic Dis. 2007. 10:137–42.
Article
17.Dahle SE., Chokkalingam AP., Gao YT., Deng J., Stanczyk FZ., Hsing AW. Body size and serum levels of insulin and leptin in relation to the lisk of benign prostatic hyperplasia. J Urol. 2002. 168:599–604.
18.Uzzo RG., Wei JT., Waldbaum RS., Perlmutter AP., Byrne JC., Vaughan ED Jr. The influence of prostate size on cancer detection. Urology. 1995. 46:831–6.
Article
19.Christensson A., Laurell CB., Lilja H. Enzymatic activity of prostate-specific antigen and its reactions with extracellular serine proteinase inhibitors. Eur J Biochem. 1990. 194:755–63.
Article
20.Lilja H., Christensson A., Dahlen U., Matikainen MT., Nilsson O., Pettersson K, et al. Prostate-specific antigen in serum occurs predominantly in complex with alpha 1-antichymo-trypsin. Clin Chem. 1991. 37:1618–25.
Article
21.Kubota Y., Sasagawa I., Sinzawa H., Kunii T., Itoh K., Miura H, et al. Serum levels of free and total prostate-specific antigen in males with liver cirrhosis. Eur Urol. 1999. 36:409–12.
Article
22.Mast AE., Enghild JJ., Pizzo SV., Salvesen G. Analysis of the plasma elimination kinetics and conformational stabilities of native, proteinase-complexed, and reactive site cleaved serpins: comparison of alpha 1-proteinase inhibitor, alpha 1-antichymo-trypsin, antithrombin III, alpha 2-antiplasmin, angiotensinogen, and ovalbumin. Biochemistry. 1991. 30:1723–30.
23.Perlmutter DH., Glover GI., Rivetna M., Schasteen CS., Fallon RJ. Identification of a serpin-enzyme complex receptor on human hepatoma cells and human monocytes. Proc Natl Acad Sci USA. 1990. 87:3753–7.
Article
24.Kolb-Bachofen V., Schlepper-Schafer J., Vogell W., Kolb H. Electron microscopic evidence for an asialoglycoprotein receptor on Kupffer cells: localization on lectin-mediated endocytosis. Cell. 1982. 29:859–66.
25.Jin B., McCaughan GW., Handelsman DJ. Effects of liver disease and transplantation on the human prostate. J Androl. 1999. 20:559–65.
26.Kabalin JN., Hornberger JC. Prostate-specific antigen is not excreted by human kidney or eliminated by routine hemodialysis. Urology. 1991. 37:308–10.
27.Danisman A., Kilic S., Kukul E., Yakupoglu G., Guntekin E., Baykara M, et al. Do renal failure and hemodialysis have any effect on the elimination of free and total prostate-specific antigen? Eur Urol. 2000. 37:579–81.
28.Partin AW., Piantadosi S., Subong EN., Kelly CA., Hortopan S., Chan DW, et al. Clearance rate of serum-free and total PSA following radical retropubic prostatectomy. Prostate. 1996. 7(Suppl):35–9.
Article
29.Bjork T., Ljungberg B., Piironen T., Abrahamsson PA., Pettersson K., Cockett AT, et al. Rapid exponential elimination of free prostate-specific antigen contrasts the slow, capacity-limited elimination of PSA complexed to alpha 1-antichymo-trypsin from serum. Urology. 1998. 51:57–62.
30.Stephan C., Jung K., Brux B., Lein M., Sinha P., Schnorr D, et al. ACT-PSA and complexed PSA elimination kinetics in serum after radical retropubic prostatectomy: proof of new complex forming of PSA after release into circulation. Urology. 2000. 55:560–3.
Article
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr