Yao Wentao, Wu Jiacheng, Wang Hongzhi, Jia Zongming, Zhou Yinyi, Yang Chendi, Xu Feng, Kong Ying, Huang Yuhua
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Urology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China.
Aging Male. 2025 Dec;28(1):2449341. doi: 10.1080/13685538.2024.2449341. Epub 2025 Jan 8.
This study aimed to elucidate the correlation of Visceral Adiposity Index (VAI) with prostate cancer (PCa) among men aged 40 years and older in the United States.
Analysis included multivariate linear and logistic regression, smoothing curve fitting, and threshold effect evaluation using 2003-2010 National Health and Nutrition Examination Survey (NHANES) data. The stability of this relationship across demographic groups was assessed via subgroup analyses and interaction tests.
Among 2,768 participants, those with elevated VAI displayed lower total prostate-specific antigen (tPSA) levels and reduced PCa risk. Each VAI unit elevation corresponded to a 0.075 ng/mL tPSA reduction [-0.075 (-0.145, -0.005)] and 18.8% PCa risk reduction [0.812 (0.687, 0.960)]. Top-quartile VAI individuals exhibited 0.282 ng/mL reduced tPSA [-0.282 (-0.557, -0.007)] and 49.7% reduced PCa risk [0.503 (0.282, 0.896)] relative to bottom-quartile counterparts. This inverse relationship was more pronounced in men ≥70 years. Moreover, VAI-tPSA in other races demonstrated a U-shaped pattern, with a 2.09 inflection point. At the same time, a Mexican American subgroup exhibited an inverted U-shape for VAI and PCa risk, with a 1.42 inflection point.
In men aged ≥70, VAI indicates an inverse PCa relationship. However, PSA-based PCa screening may be influenced in visceral-obese individuals aged <70.
本研究旨在阐明美国40岁及以上男性内脏脂肪指数（VAI）与前列腺癌（PCa）之间的相关性。
分析使用2003 - 2010年美国国家健康与营养检查调查（NHANES）数据，包括多变量线性和逻辑回归、平滑曲线拟合以及阈值效应评估。通过亚组分析和交互检验评估这种关系在不同人口统计学群体中的稳定性。
在2768名参与者中，VAI升高者的总前列腺特异性抗原（tPSA）水平较低，患PCa的风险降低。VAI每升高一个单位，tPSA降低0.075 ng/mL [-0.075（-0.145，-0.005）]，PCa风险降低18.8% [0.812（0.687，0.960）]。与四分位值最低的参与者相比，VAI处于最高四分位的个体tPSA降低0.282 ng/mL [-0.282（-0.557，-0.007）]，PCa风险降低49.7% [0.503（0.282，0.896）]。这种负相关关系在70岁及以上男性中更为明显。此外，其他种族的VAI - tPSA呈U形模式，拐点为2.09。同时，墨西哥裔美国人亚组的VAI与PCa风险呈倒U形，拐点为1.42。
在70岁及以上男性中，VAI表明与PCa呈负相关。然而，基于PSA的PCa筛查可能会受到70岁以下内脏肥胖个体的影响。
