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The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men.
BJU Int. 2009 Nov; 104(10):1457-61.BI

Abstract

OBJECTIVE

To 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 METHODS

We 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 > or =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/m(2)), 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/m(2), PSA <20 ng/mL).

RESULTS

In 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 > or =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.

CONCLUSIONS

Obese white non-Hispanic men are about half as likely as those with a normal BMI to have a PSA level of > or =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.

Authors+Show Affiliations

Department of Urology, University of Washington, Seattle, WA 98195, USA. shculp@mdanderson.orgNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19522868

Citation

Culp, Stephen, and Michael Porter. "The Effect of Obesity and Lower Serum Prostate-specific Antigen Levels On Prostate-cancer Screening Results in American Men." BJU International, vol. 104, no. 10, 2009, pp. 1457-61.
Culp S, Porter M. The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men. BJU Int. 2009;104(10):1457-61.
Culp, S., & Porter, M. (2009). The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men. BJU International, 104(10), 1457-61. https://doi.org/10.1111/j.1464-410X.2009.08646.x
Culp S, Porter M. The Effect of Obesity and Lower Serum Prostate-specific Antigen Levels On Prostate-cancer Screening Results in American Men. BJU Int. 2009;104(10):1457-61. PubMed PMID: 19522868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men. AU - Culp,Stephen, AU - Porter,Michael, Y1 - 2009/06/12/ PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2009/12/16/medline SP - 1457 EP - 61 JF - BJU international JO - BJU Int VL - 104 IS - 10 N2 - OBJECTIVE: To 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 METHODS: We 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 > or =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/m(2)), 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/m(2), PSA <20 ng/mL). RESULTS: In 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 > or =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. CONCLUSIONS: Obese white non-Hispanic men are about half as likely as those with a normal BMI to have a PSA level of > or =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. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/19522868/The_effect_of_obesity_and_lower_serum_prostate_specific_antigen_levels_on_prostate_cancer_screening_results_in_American_men_ L2 - https://doi.org/10.1111/j.1464-410X.2009.08646.x DB - PRIME DP - Unbound Medicine ER -