Prostate-specific antigen age-specific reference ranges and the effect of metabolic syndrome factors in a Thai population

Authors

  • Chatiwat Piyarom Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Preamrudee Chaisuwirat Blood Bank, Army Institute of Pathology, Bangkok, Thailand
  • Satit Siriboonrid Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Nattapong Binsri Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Sarayut Kanjanatarayon Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Weerayut Wiriyabanditkul Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
  • Vittaya Jiraanankul Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.52786/isu.a.43

Keywords:

PSA, age specific PSA, prostate cancer, metabolic syndrome

Abstract

Objectives: An appropriate prostate specific antigen (PSA) cut-off value in Thailand has not been investigated, nor has an age-specific PSA reference range. This study aims to evaluate the correlation between metabolic syndrome, metabolic factors, and age specific PSA level.

Materials and Methods: A cross-sectional study in men who underwent medical checkups from September 2019 to December 2019. The 95th percentile PSA value was applied to the normal age-specific reference range. Correlations between PSA levels and a variety of factors were determined using linear regression.

Results: A total of 507 men met the criteria to be included in the analysis. Age-specific PSA reference ranges for men aged 40-49, 50-59, and 60-70 years were 0-2.3, 0-3.4, and 0-4.2 ng/ml, respectively. The multivariate adjusted geometric mean PSA model indicated that the factors related to PSA were age, higher body mass index (BMI) and serum fasting blood sugar (FBS) ≥ 100 mg/dl. The age group 50-59 and 60-70 have a 43% and 99% increase in mean PSA compared to the age group 40-49, respectively (p < 0.001). A higher BMI was associated with lower PSA (p < 0.001). And the serum FBS ≥ 100 mg/dl showed a 15% reduction in mean PSA compared to FBS < 100 mg/dl (p = 0.018).

Conclusion: The age-specific PSA reference in Thai men was lower than reported in a previous study. Use of the lower PSA cut-off may increase the sensitivity of prostate cancer screening. This study demonstrates that age, BMI, and FBS may all influence the clinical interpretation of serum PSA levels. Screening for prostate cancer using PSA should be carried out with caution in those who have those risk factors.

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References

National Cancer Institute Department of Medical Services Ministry of Public Health Thailand. Hospital-Based Cancer Registry 2019. Bangkok: New Thammada Press (Thailand); 2020.

Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 1993;270:860-4.

Shakir NA, George AK, Siddiqui MM, Rothwax JT, Rais-Bahrami S, Stamatakis L, et al. Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy. J Urol 2014;192:1642-8.

Jiraanankul V ,Choeypan N, Thunyaharn S, LerdpraiwanW.Prevalenceoffluoroquinolone-resistant Enterobacteriaceae in the normal rectal flora of patients undergoing transrectal prostate biopsy in Phramongkutklao Hospital, Thailand . J Southeast Asian Med Res 2018:1:1-6.

Hatakeyama S, Yoneyama T, Tobisawa Y, Ohyama C. Recent progress and perspectives on prostate cancer biomarkers. Int J Clin Oncol 2017;22:214-21.

Hsing AW, Devesa SS. Trends and patterns of prostate cancer: what do they suggest? Epidemiol Rev 2001;23:3-13.

Lin KJ, Pang ST, Chang YH, Wu CT, Chuang KL, Chuang HC, et al. Age-related reference levels of serum prostate-specific antigen among Taiwanese men without clinical evidence of prostate cancer. Chang Gung Med J 2010;33:182-7.

Shah S, Jha B, Khanal MP. Effects of aging and ethnicity on serum free prostate specific antigen. Asian Pacific J Cancer Prev 2011;12:2509-12.

Alberti KGMM, Eckel RH, Grundy SM, Grundy SM, Zimmet PZ, Cleeman JI, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Associa- tion; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5.

Tande AJ, Platz EA, Folsom AR. The metabolic syndrome is associated with reduced risk of prostate cancer. Am J Epidemiol 2006;164:1094-102.

Xiang YZ, Xiong H, Cui ZL, Jiang SB, Xia QH, Zhao Y, Li GB, Jin XB. The association between metabolic syndrome and the risk of prostate cancer, high-grade prostate cancer, advanced prostate cancer, prostate cancer-specific mortality and biochemical recurrence. J Exp Clin Cancer Res 2013;32:9.

Gacci M, Russo GI, De Nunzio C, Sebastianelli A, Salvi M, Vignozzi L, Tubaro A, Morgia G, Serni S. Meta-analysis of metabolic syndrome and prostate cancer. Prostate Cancer Prostatic Dis 2017;20:146-55.

Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Parretta E, et al. Effect of metabolic syndrome and its components on prostate cancer risk: meta-analysis. J Endocrinol Invest 2013;36:132-9.

Pierce BL. Why are diabetics at reduced risk for prostate cancer? A review of the epidemiologic evidence. Urol Oncol Semin Orig Invest 2012;30:735-43.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112: 2735-52.

Liu ZY, Sun YH, Xu CL, Gao X, Zhang LM, Ren SC. Age-specific PSA reference ranges in Chinese men without prostate cancer. Asian J Androl 2009;11: 100-3.

Lee SE, Kwak C, Park MS, Lee CH, Kang W, Oh SJ. Ethnic differences in the age-related distribution of serum prostate-specific antigen values: a study in a healthy Korean male population. Urology 2000;56: 1007-10.

Oesterling JE, Kumamoto Y, Tsukamoto T, Girman CJ, Guess HA, Masumori N, et al. Serum prostate-specific antigen in a community-based population of healthy Japanese men: lower values than for similarly aged white men. Br J Urol 1995;75:347-53.

Saw S, Aw TC. Age-related reference intervals for free and total prostate-specific antigen in a Singaporean population. Pathology 2000;32:245-9.

Tande AJ, Platz EA, Folsom AR. The metabolic syndrome is associated with reduced risk of prostate cancer. Am J Epidemiol 2006;164:1094-102.

Werny DM, Thompson T, Saraiya M, Freedman D, Kottiri BJ, German RR, et al. Obesity is negatively associated with prostate-specific antigen in U.S. men, 2001-2004. Cancer Epidemiol Biomarkers Prev 2007;16:70-6.

Tritipwanit S, Chotikawanich E, Nualyong C, Leewansangtong S, Taweemonkongsap T, Phinthusophon K. Diagnostic Accuracy of BMI and PSA Density in Screening Prostate Cancer Patients in the PSA Diagnostic Gray Zone (4-10 ng/ml). Thai J Urol 2015;36:1-10.

Andersson B, Mårin P, Lissner L, Vermeulen A, Björntorp P. Testosterone concentrations in women and men with NIDDM. Diabetes Care 1994;17:405-11.

Waters KM, Henderson BE, Stram DO, Wan P, Kolonel LN, Haiman CA. Association of diabetes with prostate cancer risk in the multiethnic cohort. Am J Epidemiol 2009;169:937-4.

Sarma AV, Hotaling J, Dunn RL, Cleary PA, Braffett BH, Kim C, et al. Poor glycemic control is associated with reduced prostate specific antigen concentrations in men with type 1 diabetes. J Urol 2015;193:786-93.

Bernal-Soriano M, Lumbreras B, Hernández-Aguado I, Pastor-Valero M, López-Garrigos M Parker L. Untangling the association between prostate-specific antigen and diabetes: a systematic review and meta-analysis. Clin Chem Lab Med 2020;59:11-26.

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Published

2022-06-17

How to Cite

Piyarom, C. ., Chaisuwirat, P. ., Siriboonrid, S. ., Binsri, N. ., Kanjanatarayon, S. ., Wiriyabanditkul, W. ., & Jiraanankul, V. . (2022). Prostate-specific antigen age-specific reference ranges and the effect of metabolic syndrome factors in a Thai population. Insight Urology, 43(1), 6–12. https://doi.org/10.52786/isu.a.43

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