Growth and development during early manhood as determinants of prostate size in later life.
BACKGROUND
Age and androgens are key determinants of benign prostate hyperplasia, but the mechanisms remain unclear. We examine the relationship between androgens and total, central, and peripheral prostate volume with a focus on early life factors.


METHODS
We conducted a cross-sectional observational study of 406 community-dwelling Australian men aged 20-82 yr old without known prostate disease. Prostate zonal (total, central, and peripheral) volumes were measured by planimetric transrectal ultrasound. Participants completed questionnaires, underwent physical examination, and provided blood samples to measure total, free, and bioavailable testosterone, dihydrotestosterone, estradiol, SHBG, LH, FSH, and prostate-specific antigen.


RESULTS
Prostate zonal volumes were positively associated with age, prostate-specific antigen, early onset of puberty, current height, body surface area, lean body mass, hip and waist circumference as well as recalled height and weight during puberty and adolescence but not current weight, fat mass, or body mass index. Stepwise multivariate regression modeling indicated that age and height were the only independent predictors of prostate zonal volumes. When adjusted for age and sampling time of day, the negative correlations of age-adjusted prostate zonal volumes with current blood total, free, and bioavailable testosterone and the positive correlation with blood SHBG were no longer significant.


CONCLUSIONS
This study suggests that early and long-term androgen exposure may have long-acting effects on mature prostate zonal volumes, whereas relationships with current blood androgens and related hormones levels were mostly a result of confounding by age. Additional studies on the mechanism of androgen effects on late-life prostate diseases should consider lasting effects of early-life androgen exposure.
Zhuang
Tian N
TN
Department of Andrology and Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney NSW 2139, Australia.
Ly
Lam P
LP
Cumming
Robert G
RG
Handelsman
David J
DJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D001830:Body Surface Area; D003430:Cross-Sectional Studies; D013196:Dihydrotestosterone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000033:anatomy & histology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011627:Puberty; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood
D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D013739:Testosterone; D017430:Prostate-Specific Antigen