title: Ethnicity is an independent determinant of age-specific PSA level: findings from a multiethnic Asian setting.
abstract: OBJECTIVE
  To study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting.
  
  
  METHODS
  We conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis.
  
  
  RESULTS
  There were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (≤4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (p<0.05).
  
  
  CONCLUSIONS
  These findings support the concept that the baseline PSA level varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity may also need to be taken into account when investigating serum PSA concentrations in the multiethnic Asian population.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Lim
authors.affiliation: Julius Center University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Bhoo-Pathy
authors.affiliation: Department of Urology, Tuanku Mizan Military Hospital, Kuala Lumpur, Malaysia.
authors.forename: Selvalingam
authors.initials: S
authors.lastname: Sothilingam
authors.affiliation: Department of Urology, Selayang Hospital, Selangor, Malaysia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Malek
authors.affiliation: Department of Urology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
authors.forename: Murali
authors.initials: M
authors.lastname: Sundram
authors.affiliation: Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
authors.forename: Badrul
authors.initials: B
authors.lastname: Hisham Bahadzor
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Teng Aik
authors.initials: TA
authors.lastname: Ong
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia.
authors.forename: Keng Lim
authors.initials: KL
authors.lastname: Ng
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sivaprakasam
authors.initials: S
authors.lastname: Sivalingam
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Azad Hassan Abdul
authors.initials: AH
authors.lastname: Razack
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D051517:Digital Rectal Examination; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D011467:Prostate / Q000502:physiology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis; D012016:Reference Values; D014554:Urination / Q000502:physiology
chemical_list: D017430:Prostate-Specific Antigen
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