title: Association between obesity, prostate-specific antigen level and prostate-specific antigen density in men with a negative prostate biopsy.
abstract: OBJECTIVE
  To determine the association between body mass index (BMI), serum prostate-specific antigen (PSA) level and PSA density (PSAD) in patients with an elevated serum PSA level but a negative prostate biopsy.
  
  
  METHODS
  This retrospective study enrolled men with a negative prostate biopsy but a serum PSA level of 3.0-10 ng/ml. All men underwent anthropometric measurements, serum PSA determination and transrectal ultrasound examination. BMI was grouped according to the Asia-Pacific obesity criteria: nonobese (<25 kg/m(2)) versus obese (≥ 25 kg/m(2)). Partial correlation and linear regression models between PSA, PSAD and BMI were conducted after adjusting for age.
  
  
  RESULTS
  A total of 907 men were enrolled in this study. On multivariate analyses, PSA showed no significant correlation with age or BMI, whereas PSAD had a negative correlation with age and BMI. Similar results were obtained when patients were categorized as having low (3.0 < PSA  ≤ 6.5 ng/ml) or high PSA (6.5 < PSA ≤ 10.0 ng/ml) levels.
  
  
  CONCLUSIONS
  PSAD, but not PSA, demonstrated a significant negative correlation with BMI. This indicates that a new strategy including PSAD rather than simple PSA levels should be adopted in the study of obesity-adjusted PSA cut-offs.
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea wonjya@schmc.ac.kr.
authors.forename: Hee Jo
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Seung Whan
authors.initials: SW
authors.lastname: Doo
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Doo Sang
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yang
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Kwang Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Jun Mo
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Changho
authors.initials: C
authors.lastname: Lee
authors.affiliation: Medical Research Collaborating Centre, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Soon-Sun
authors.initials: SS
authors.lastname: Kwon
mesh_terms: D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D011467:Prostate / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
keywords: Prostate-specific antigen; body mass index; prostate-specific antigen density