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4 September 2008
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PSA levels reduced by metabolic syndrome and diabetes markers
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MedWire News: Metabolic disturbances resulting from metabolic syndrome or diabetes may reduce prostate-specific antigen (PSA) levels and so affect the ability to detect early-stage prostate cancer, warn US investigators.
While clinical prostate cancer has been associated with metabolic syndrome, centralized obesity, leptin levels, and insulin resistance in some studies, previous research has indicated that obese men have slightly lower PSA levels than other men.
To examine the possible mechanisms of this reduction, J Fowke, from Vanderbilt University Medical Center in Nashville, Tennesee, and colleagues collected information on demographics, anthropomorphic measures, and cancer risk factors for 121 African American (AA) and 121 Caucasian (CA) men free of cancer or diabetes.
The team measured total serum PSA, leptin, adiponectin, C-peptide, and glycosylated hemoglobin (HbA1c) levels in the participants using a range of laboratory assays, and examined associations between PSA levels and the obesity-related biomarkers.
All of the patients were aged between 40 and 78 years.
Adjusted PSA levels were significantly higher in AA men than CA men, at 0.9 ng/ml versus 0.7 ng/ml. The median body mass index in both groups was 26.5 kg/m2.
The results, published in the journal Prostate Cancer and Prostatic Diseases, show that, among AA men, PSA levels decreased with increasing quartiles of C-peptide levels, from 0.99 ng/ml to 0.93 ng/ml, 0.75 ng/ml, and 053 ng/ml, respectively. In contrast, in CA men, PSA levels decreased with increasing quartiles of HbA1c, from 0.84 ng/ml to 0.73 ng/ml, 0.77 ng/ml, and 0.45 ng/ml, respectively.
In a model that took into account age, time since last meal, and body mass index, the team found that, in CA men, HbA1c was the only biomarker significantly associated with log-transformed PSA levels, while C-peptide was the only biomarker significantly associated in AA men.
They write: "In conclusion, we found that HbA1c and C-peptide were associated with lower PSA levels among CA or AA men. This suggests that factors related to insulin activity may be affecting PSA levels used to detect early-stage prostate cancer."
Prostate Cancer Prostatic Dis 2008; 11: 264-269
http://www.nature.com/pcan/journal/v11/n3/abs/4501022a.html
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