The actual lowering effect of metabolic syndrome on serum prostate-specific antigen levels is partly concealed by enlarged prostate: results from a large-scale population-based study

To clarify the actual lowering effect of metabolic syndrome (MetS) on serum prostate-specific antigen (PSA) levels in a Chinese-screened population.

A total of 45,540 ostensibly healthy men aged 55-69 years of old who underwent routine health check-ups at Beijing Shijitan Hospital from 2008 to 2015 were included in this study. All subjects underwent detailed clinical evaluations. PSA mass density was calculated (serum PSA level × plasma volume ÷ prostate volume) for simultaneously adjusting plasma volume and prostate volume. According to the modified NCEP-ATP III criteria, subjects were dichotomized by the presence of MetS, and the differences in PSA density and PSA mass density were compared between groups. Linear regression analysis was used to evaluate the effect of MetS on serum PSA levels.

When larger prostate volume in men with MetS was adjusted, both the PSA density and PSA mass density in subjects with MetS were significantly lower than that in subjects without MetS, and the estimated difference in mean serum PSA level between subjects with and without MetS was greater than that before prostate volume was adjusted. In multivariate regression model, the presence of MetS was independently associated with an 11.3% decline in serum PSA levels compared with subjects without MetS. In addition, the increasing number of positive MetS components was significantly and linearly associated with the declining in serum PSA levels.

The actual lowering effect of MetS on serum PSA levels was partly concealed by the enlarged prostate in men with MetS, and the presence of MetS was independently associated with lower serum PSA levels. Urologists need to be aware of the effect of MetS on serum PSA levels and discuss this subject with their patients. This article is protected by copyright. All rights reserved.

BJU international. 2016 Aug 04 [Epub ahead of print]

Sicong Zhao, Ming Xia, Jianchun Tang, Yong Yan

Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China., Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China., Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China., Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

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