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Prostate-Specific Antigen May Be Inversely Related to

Body Mass Index


Laurie Barclay, MD
Medscape Medical News 2005. 2005 Medscape
Jan. 26, 2005 Prostate-specific antigen (PSA) is inversely related to body mass index
(BMI), according to a preliminary communication published Jan. 24 in the Early View online
issue of Cancer.
"Recent studies of men with prostate carcinoma suggest that obesity may be associated with
more advanced-stage disease and lower overall survival rates," write Jacques Baillargeon,
PhD, from the University of Texas Health Science Center in San Antonio, and colleagues.
"One possible link between BMI and prostate carcinoma prognosis may be disease
ascertainment. PSA is widely used to screen for prostate carcinoma."
Between 2001 and 2004, 2,779 men without prostate carcinoma were enrolled in a
population-based study sponsored by the San Antonio Center of Biomarkers of Risk, a clinical
and epidemiologic center of the Early Detection Research Network of the National Cancer
Institute.
After adjustment for race, ethnicity, and age, the mean PSA value decreased in a linear
fashion from 1.01 ng/mL in normal-weight men to 0.69 ng/mL in obese (class III) men. A
substantial decrease in PSA level occurred with each increase in BMI category. The authors
suggest that lower circulating levels of androgens and increased levels of estrogens in obese
men could affect PSA production due to the androgen response element in the PSA promoter
region.
"Lower levels of PSA in obese and overweight men could mask biologically consequential
prostate carcinoma," the authors write. "Future investigations should assess whether
consideration of BMI in PSA interpretation results in earlier detection and, ultimately, in better
prostate carcinoma prognosis for obese men."
The Early Detection Research Network of the National Cancer Institute supported this study.
Cancer. Published online Jan. 24, 2005.
Reviewed by Gary D. Vogin, MD