Association of Metabolic Factors and Prostate-Specific Antigen Levels with Prostate Volume in Medical Check-ups

Eun Hee Nah; Han-Ik Cho; Joong-Chan Choi

doi:10.3343/lmo.2014.4.4.212

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Nah, Cho, and Choi: Association of Metabolic Factors and Prostate-Specific Antigen Levels with Prostate Volume in Medical Check-ups

Original Article

Lab Med Online 2014;4(4):212-217.

Published online: 20 October 2014

DOI: https://doi.org/10.3343/lmo.2014.4.4.212

Association of Metabolic Factors and Prostate-Specific Antigen Levels with Prostate Volume in Medical Check-ups

Eun Hee Nah, M.D.^1,, Han-Ik Cho, M.D.², Joong-Chan Choi, M.D.³

¹Department of Laboratory Medicine, Korea Association of Health Promotion, Seoul, Korea

²Korea Association of Health Promotion, Seoul, Seoul, Korea

³Department of Radiology, Korea Association of Health Promotion, Seoul, Korea

Corresponding author: Eun Hee Nah Department of Laboratory Medicine, Korea Association of Health Promotion, 335 Hwagok-ro, Gangseo-gu, Seoul 157-704, Korea Tel: +82-2-2600-2000, Fax: +82-2-2696-4500, E-mail: cellonah@hanmail.net

Received 23 October 2013 Revised 27 December 2013 Accepted 27 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA.

Methods

We selected 3,915 health examinees aged _>40 yr with a PSA level _<4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV ≥30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis.

Results

The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23–24.9 kg/m², 25–29.9 kg/m², and ≥30 kg/m² had higher odds ratios of 1.580 (95% confidence interval, 1.171–2.131; P=0.003), 1.767 (1.332–2.344; P<0.001), and 2.024 (1.042–3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m².

Conclusions

Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.

Keywords: Prostate enlargement, Metabolic syndrome, Prostate-specific antigen

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Table 1.

Demographic characteristics of subjects

Characteristics	No (%)
Age (yr)
Mean_±SD	56.7_±9.1
40–49	871 (22.2)
50–59	1,531 (39.1)
60–69	1,138 (29.1)
≥70	375 (9.6)
PSA (ng/mL)
Mean±SD	1.069±.697
<1.0	2,287 (58.4)
1.0–1.999	1,228 (31.4)
2.0–2.999	289 (7.4)
3.0–3.999	111 (2.8)
Prostate volume (mL)
Mean±SD	20.96±7.74
<10	54 (1.4)
10–20	2,036 (52.0)
20–30	1,377 (35.2)
>30	448 (11.4)
Abbreviation: PSA, prostate-specifi	ic antigen.

Table 2.

Association of prostate volume with metabolic characteristics and PSA in patients with normal prostate volume

Variables	R²	B (95% CI)	β	t	P value
PSA	0.072	2.077 (1.811–2.343)	0.252	15.307	_<0.001
Age	0.104	0.103 (0.085–0.122)	0.179	10.899	_<0.001
WC	0.113	0.064 (0.042–0.086)	0.094	5.728	_<0.001

P value derived from multiple linear regression analysis. Abbreviations: PSA, prostate-specific antigen; WC, waist circumference; CI, confidence interval.

Table 3.

Characteristics of subjects with and without prostate enlargement

	No prostate enlargement (N₌3,467)	Prostate enlargement (N₌448)	P value
Age (yr)	55.8_±8.8	63.1_±8.5	_<0.001
BMI (kg/m²)	24.6_±2.7	24.8_±2.6	0.081
WC (cm)	84.2_±7.4	85.4_±6.9	0.001
SBP (mmHg)	123.5±21.6	126.1±13.6	0.015
DBP (mmHg)	76.1±9.1	76.0±8.9	0.810
TC (mg/dL)	194.0±35.1	185.0±32.1	<0.001
HDL-C (mg/dL)	53.7±11.3	53.1±11.1	0.360
LDL-C (mg/dL)	115.0±32.3	107.9±29.0	<0.001
Triglyceride (mg/dL)	129.7±91.2	121.2±70.7	0.057
FBS (mg/dL)	102.3±22.6	102.5±20.1	0.861
PSA (ng/mL)	0.986±0.616	1.712±0.919	<0.001

P values were determined using the Student t-test. Abbreviations: BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; FBS, fasting blood sugar; PSA, prostate-specific antigen.

Table 4.

Association of prostate enlargement with PSA and demographic and metabolic variables

Variables	OR (95% CI)	P value
Age (yr)
40–49	1	<0.001
50–59	2.224 (1.426–3.468)	<0.001
60–69	4.886 (3.175–7.519)	_<0.001
≥70	8.441 (5.285–13.482)	<0.001
BMI (kg/m²)
_<23	1	0.001
23–24.9	1.580 (1.171–2.131)	0.003
25–29.9	1.767 (1.332–2.344)	<0.001
_≥30	2.024 (1.042–3.933)	0.038
TC (mg/dL)
<200	1
_≥200	0.647 (0.510–0.822)	_<0.001
PSA (ng/mL)
<1.0	1	<0.001
1.0–1.999	3.169 (2.454–4.092)	<0.001
2.0–2.999	8.189 (5.881–11.403)	<0.001
3.0–3.999	13.914 (8.879–21.804)	<0.001

P value derived from logistic regression analysis. This model was adjusted for age, body mass index (BMI), waist circumference, blood pressure, blood lipid, fasting blood glucose, and PSA. Abbreviations: PSA, prostate-specific antigen; OR, odds ratio; CI, confidence interval; BMI, body mass index; TC, total cholesterol.

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