Yang Won Jae
Asian J Androl. 2013 Nov;15(6):770-2. doi: 10.1038/aja.2013.77. Epub 2013 Aug 5.
This study aimed to determine if lower serum total prostate-specific antigen (PSA) levels in obese Korean men affect prostate cancer (PCa) screening, as an increased body mass index (BMI) is inversely associated with the PSA level. Between March 2007 and December 2012, 22 208 native Korean men who were eligible to receive a serum PSA test were recruited. Logistic regression was used to estimate the odds of an 'abnormal' PSA (≥2.5 or ≥4.0 ng ml(-1)) in these men (age: 45-75 years, PSA <10 ng ml(-1)) based on BMI, which was categorized as normal (BMI <25 kg m(-2)) and obese (BMI ≥25 kg m(-2)). In all, 20 509 men (92.3%) were included in the study after applying the inclusion criteria. After controlling for age, there was a statistically significant trend towards a lower likelihood of having a serum PSA level ≥2.5 ng ml(-1) with an increased BMI, with obese men having an 18% lower likelihood (odds ratio: 0.823, 95% confidence interval: 0.743-0.912; P<0.001) compared to men with a normal BMI. Obese men were approximately 82% as likely to have a PSA level ≥2.5 ng ml(-1) as men with a normal BMI. These results might affect PCa screening using serum total PSA. Further studies are needed to better define these results in clinical biopsy practice.
本研究旨在确定肥胖韩国男性较低的血清总前列腺特异性抗原（PSA）水平是否会影响前列腺癌（PCa）筛查，因为体重指数（BMI）升高与PSA水平呈负相关。在2007年3月至2012年12月期间，招募了22208名符合接受血清PSA检测条件的韩国本土男性。采用逻辑回归分析，根据BMI将这些男性（年龄：45 - 75岁，PSA <10 ng/ml）分为正常（BMI <25 kg/m²）和肥胖（BMI≥25 kg/m²）两组，评估其PSA“异常”（≥2.5或≥4.0 ng/ml）的几率。应用纳入标准后，共有20509名男性（92.3%）纳入研究。在控制年龄因素后，BMI升高时血清PSA水平≥2.5 ng/ml的可能性存在统计学显著下降趋势，与BMI正常的男性相比，肥胖男性的可能性降低了18%（优势比：0.823，95%置信区间：0.743 - 0.912；P<0.001）。肥胖男性PSA水平≥2.5 ng/ml的可能性约为BMI正常男性的82%。这些结果可能会影响使用血清总PSA进行的PCa筛查。需要进一步研究以在临床活检实践中更好地明确这些结果。
