Huo Xiao, Wang Zhi, Huang Nan, Zhang Jie
Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Huazhong University of Science and Technology, Wuhan, China.
Sci Rep. 2025 May 6;15(1):15828. doi: 10.1038/s41598-025-00853-2.
The relationship between diabetes and prostate-specific antigen (PSA) levels is complex, with potential implications for prostate cancer screening. This study examined the association between glycemic control and total PSA (tPSA) levels in patients with diabetes. We analyzed data from the 2001-2010 NHANES to assess the relationship between glycated hemoglobin (HbA1c) and tPSA in adults with diabetes, categorizing HbA1c as < 7% (good glycemic control) or ≥ 7% (poor glycemic control). Multivariable regression models were used, adjusting for key demographic, clinical, and lifestyle factors, including age, race/ethnicity, marital status, body mass index (BMI), smoking status, alcohol use, hypertension, coronary artery disease (CAD), and insulin use. Adjustments for multiple comparisons were considered using the Bonferroni correction, and missing data were handled using multiple imputation. Participants with poor glycemic control were younger, less likely to be married or partnered, and had higher rates of insulin use but lower hypertension incidence than those with good glycemic control (P < 0.05). The median tPSA level was greater in the good control group (1.10 ng/mL vs. 0.90 ng/mL; P = 0.0014). Multivariate analysis revealed no overall association between HbA1c and tPSA (β = -0.022, P = 0.917). However, significant inverse associations were observed across subgroups, including those aged ≤ 59 years (β = -0.71, P = 0.033), married individuals (β = -0.55, P < 0.001), participants without CAD (β = -0.49, P = 0.015), and insulin users (β = -0.80, P = 0.031). Although no significant overall association was found between glycemic control and tPSA levels, subgroup analyses revealed an inverse relationship between HbA1c and tPSA in younger individuals (≤ 59 years), insulin users, and those without CAD. These findings suggest that glycemic control may have subgroup-specific effects on prostate health in individuals with diabetes.
糖尿病与前列腺特异性抗原（PSA）水平之间的关系较为复杂，这对前列腺癌筛查可能具有潜在影响。本研究探讨了糖尿病患者血糖控制与总PSA（tPSA）水平之间的关联。我们分析了2001 - 2010年美国国家健康与营养检查调查（NHANES）的数据，以评估糖尿病成年患者糖化血红蛋白（HbA1c）与tPSA之间的关系，将HbA1c分为<7%（血糖控制良好）或≥7%（血糖控制不佳）。使用多变量回归模型，对关键的人口统计学、临床和生活方式因素进行了调整，包括年龄、种族/民族、婚姻状况、体重指数（BMI）、吸烟状况、饮酒情况、高血压、冠状动脉疾病（CAD）以及胰岛素使用情况。使用Bonferroni校正法对多重比较进行了调整，并采用多重填补法处理缺失数据。血糖控制不佳的参与者比血糖控制良好的参与者更年轻，结婚或有伴侣的可能性更小，胰岛素使用率更高，但高血压发病率更低（P < 0.05）。血糖控制良好组的tPSA水平中位数更高（1.10 ng/mL对0.90 ng/mL；P = 0.0014）。多变量分析显示HbA1c与tPSA之间无总体关联（β = -0.022，P = 0.917）。然而，在各亚组中观察到了显著的负相关，包括年龄≤59岁的人群（β = -0.71，P = 0.033）、已婚个体（β = -0.55，P < 0.001）、无CAD的参与者（β = -0.49，P = 0.015）以及胰岛素使用者（β = -0.80，P = 0.031）。尽管血糖控制与tPSA水平之间未发现显著的总体关联，但亚组分析显示，在较年轻个体（≤59岁）、胰岛素使用者以及无CAD的人群中，HbA1c与tPSA之间存在负相关关系。这些发现表明，血糖控制可能对糖尿病患者的前列腺健康具有亚组特异性影响。
