Effects of obesity and height on prostate-specific antigen (PSA) and percentage of free PSA levels among African-American and Caucasian men.
BACKGROUND
Prior studies suggest that obese men have lower prostate-specific antigen (PSA) levels than leaner men. Caucasian (CA) men also may have lower PSA levels than African-American (AA) men, but the relevance of body size to racial disparities in PSA levels is unclear. The association between body mass index (BMI) and height on PSA and percentage of free PSA (%fPSA) was investigated within AA and CA men without a prior prostate cancer diagnosis.


METHODS
AA (n = 150) and CA (n = 149) men of similar socioeconomic status completed an extensive in-person interview and donated blood. PSA and %fPSA levels were compared across race, BMI, and height categories after adjusting for age and other factors.


RESULTS
PSA levels decreased with increasing BMI (PSA = .72, .69, .67, .59 ng/mL for BMI 18.5 to <25, 25 to <30, 30 to <35, and > or =35, respectively; P(trend) = .18), and trends were significant among men less than age 60 years (PSA = .81, .76, .66, .59, respectively; P(trend) = .02). fPSA also significantly decreased with BMI among men <60 years (P(trend) = .04). In contrast, %fPSA was not associated with BMI. However, %fPSA increased 27% across height categories (P(trend) = .02). PSA levels were significantly lower among CA men (PSA(AA) = 0.87, PSA(CA) = 0.63 ng/mL; P < .01), whereas %fPSA levels did not differ by race. Also, associations between body size and PSA or %fPSA did not significantly differ by race, and adjustment for BMI and height had no effect on the racial disparity in PSA (PSA(AA) = 0.87, PSA(CA) = 0.63 ng/mL; P < .01).


CONCLUSIONS
The data suggest that race, BMI, and height are independently associated with PSA and %fPSA levels.
Fowke
Jay H
JH
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA. jay.fowke@vanderbilt.edu
Signorello
Lisa B
LB
Chang
Sam S
SS
Matthews
Charles E
CE
Buchowski
Maciej S
MS
Cookson
Michael S
MS
Ukoli
Flora M
FM
Blot
William J
WJ
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001827:Body Height / Q000502:physiology*; D015992:Body Mass Index; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000453:epidemiology; D015144:Southeastern United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D017430:Prostate-Specific Antigen