The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men
The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men
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DOI：
10.1111/j.1464-410x.2009.08646.x
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发表时间：
2009-11-01
影响因子：
4.5
通讯作者：
Porter, Michael
中科院分区：
文献类型：
--
作者：
Culp, Stephen;Porter, Michael
目的为了确定美国肥胖男性血清总前列腺特异性抗原(PSA)水平降低是否影响前列腺癌筛查结果，因为体重指数(BMI)的增加与PSA水平呈负相关，但这种关联对前列腺癌PSA筛查结果的影响尚不清楚。根据BMI的正常(18.5-24.9 kg/m2)、超重(25-29.9 kg/m2)和肥胖(30-39.9)三个BMI类别，对符合前列腺癌筛查条件的男性(年龄40-75岁，BMI 18.5-39.9 kg/m2，PSA和Lt；20 ng/mL)进行Logistic回归分析，以估计PSA水平“异常”(4.0或2.5 ng/mL)的几率。在控制了年龄和种族后，有一个统计学上显著的趋势，即随着BMI的增加，血清总PSA水平<gt；=4.0 ng/ml的可能性降低。当男性按种族分层时，这种影响只在白人非西班牙裔男性中明显，这一组中的肥胖男性患前列腺特异性抗原水平异常的可能性比体重指数正常者低46%(优势比0.54%，95%可信区间0.31-0.91P=0.024)。无论是非裔美国人还是西班牙裔男性，都没有明显的趋势。此外，不分种族，血清总PSA阈值为2.5 ng/mL，没有明显的趋势。结论：非西班牙裔白人男性的PSA水平约为BMI正常者的一半。这些结果可能会影响用血清总PSA进行前列腺癌筛查。需要进一步的研究来更好地确定少数族裔亚群中BMI和PSA的关联。
OBJECTIVETo determine if lower serum total prostate specific antigen (PSA) levels in obese American men affect prostate-cancer screening results, as an increased body mass index (BMI) is inversely associated with PSA level, but the effect of this association on PSA screening results for prostate cancer is unknown.SUBJECTS AND METHODSWe analysed the most recent National Health and Nutrition Examination Surveys (NHANES 2001-2002, 2003-2004, and 2005-2006), a nationally representative cross-sectional sample of non-institutionalized adults aged >= 20 years. Logistic regression was used to estimate the odds of an 'abnormal' PSA level (4.0 or 2.5 ng/mL) based on BMI categories of normal (18.5-24.9 kg/m2), overweight (25-29.9) and obese (30-39.9) in men who were eligible for prostate-cancer screening with serum total PSA tests (age 40-75 years, BMI 18.5-39.9 kg/m2, PSA < 20 ng/mL).RESULTSIn all, 3152 participants with no known prostate cancer, representing 46 million American men, were eligible for prostate-cancer screening. After controlling for age and race, there was a statistically significant trend of a lower likelihood of having a serum total PSA level of >= 4.0 ng/mL with increased BMI. When men were stratified by race, this effect was apparent only in white non-Hispanic men, with obese men in this group having a 46% lower likelihood of having an 'abnormal' PSA level (odds ratio 0.54, 95% confidence interval 0.31-0.91; P = 0.024) than those with a normal BMI. There was no observable trend in either African-American or Hispanic men. In addition, there was no observable trend with a serum total PSA threshold of 2.5 ng/mL, regardless of race.CONCLUSIONSObese white non-Hispanic men are about half as likely as those with a normal BMI to have a PSA level of >= 4.0 ng/mL. These results might affect prostate-cancer screening with serum total PSA. Further studies are needed to better define the association of BMI and PSA in racial minority subgroups.