Mermall H, Sothern R B, Kanabrocki E L, Quadri S F, Bremner F W, Nemchausky B A, Scheving L E
Pathology and Laboratory Medicine, Hines Veterans Affairs Hospital, Illinois, USA.
Urology. 1995 Jul;46(1):45-53. doi: 10.1016/S0090-4295(99)80157-5.
To study the circadian relationship between serum prostate-specific antigen (PSA) and total testosterone in men without clinically evident prostate disease.
Blood samples were collected every 3 hours for 24 hours (eight per subject) from 11 clinically healthy men, ages 46 to 72 years. PSA was also monitored once a week for 6 weeks in 16 additional healthy men. PSA, testosterone, and age were correlated by linear regression, and 3-hourly PSA and testosterone values normalized to percent of individual mean were analyzed for circadian rhythm by the least squares fit of a 24-hour cosine.
Mean PSA correlated positively (P < 0.001) and testosterone correlated negatively (P = 0.014) with age and inversely with each other (P < 0.001). The mean circadian range of change (ROC) from lowest to highest values for PSA was 0.37 +/- 0.07 ng/mL (28 +/- 9%), and for testosterone it was 202 +/- 23 ng/dL (53 +/- 7%). The mean ROC over 6 weeks was 0.32 +/- 0.04 ng/mL. A significant circadian rhythm was found for PSA (P = 0.011, amplitude = 5.4 +/- 1.8%, acrophase = 5:02 AM; 95% limits, 2:40 to 7:24 PM) and testosterone (P < 0.001, amplitude = 9.4 +/- 1.8%, acrophase = 8:38 AM; 95% limits, 7:12 to 10:04 AM).
The temporal relationship between circadian rhythms in PSA and testosterone suggests different physiologic states over the 24 hours, which may be of chronopharmacologic interest with regard to dosing time of drugs or hormonal treatments intended to affect prostate growth and function. Within-day variation in PSA is of little diagnostic significance and does not prevent accurate clinical classification when a single specimen is used.
研究无临床明显前列腺疾病男性血清前列腺特异性抗原（PSA）与总睾酮之间的昼夜关系。
从11名年龄在46至72岁的临床健康男性中，每3小时采集一次血样，共采集24小时（每位受试者采集8次）。另外16名健康男性每周监测一次PSA，持续6周。通过线性回归分析PSA、睾酮和年龄之间的相关性，并通过24小时余弦的最小二乘法拟合，分析每3小时的PSA和睾酮值相对于个体平均值的百分比的昼夜节律。
平均PSA与年龄呈正相关（P < 0.001），睾酮与年龄呈负相关（P = 0.014），且两者呈负相关（P < 0.001）。PSA从最低值到最高值的平均昼夜变化范围（ROC）为0.37±0.07 ng/mL（28±9%），睾酮为202±23 ng/dL（53±7%）。6周内的平均ROC为0.32±0.04 ng/mL。发现PSA（P = 0.011，振幅 = 5.4±1.8%，峰值相位 = 上午5:02；95%置信区间，下午2:40至7:24）和睾酮（P < 0.001，振幅 = 9.4±1.8%，峰值相位 = 上午8:38；95%置信区间，上午7:12至10:04）存在显著的昼夜节律。
PSA和睾酮昼夜节律之间的时间关系表明24小时内存在不同的生理状态，这对于旨在影响前列腺生长和功能的药物或激素治疗的给药时间可能具有时辰药理学意义。当使用单个标本时，PSA的日内变化对诊断意义不大，且不影响准确的临床分类。
