title: Actual lowering effect of metabolic syndrome on serum prostate-specific antigen levels is partly concealed by enlarged prostate: results from a large-scale population-based study.
abstract: To clarify the lowering effect of metabolic syndrome (MetS) on serum prostate-specific antigen (PSA) levels in a Chinese screened population.
  
  
  
  A total of 45 540 ostensibly healthy men aged 55-69 years who underwent routine health check-ups at Beijing Shijitan Hospital between 2008 and 2015 were included in the study. All the men underwent detailed clinical evaluations. PSA mass density was calculated (serum PSA level × plasma volume ÷ prostate volume) for simultaneously adjusting plasma volume and prostate volume. According to the modified National Cholesterol Education Programme-Adult Treatment Panel (NCEP-ATP) III criteria, patients were dichotomized by the presence of MetS, and differences in PSA density and PSA mass density were compared between groups. Linear regression analysis was used to evaluate the effect of MetS on serum PSA levels.
  
  
  
  When larger prostate volume in men with MetS was adjusted for, both PSA density and PSA mass density in men with MetS were significantly lower than in men without MetS, and the estimated difference in mean serum PSA level between men with and without MetS was greater than that before adjusting for prostate volume. In the multivariate regression model, the presence of MetS was independently associated with an 11.3% decline in serum PSA levels compared with the absence of MetS. In addition, increasing number of positive MetS components was significantly and linearly associated with decline in serum PSA levels.
  
  
  
  The actual lowering effect of MetS on serum PSA levels was partly concealed by the enlarged prostate in men with MetS, and the presence of MetS was independently associated with lower serum PSA levels. Urologists need to be aware of the effect of MetS on serum PSA levels and should discuss this subject with their patients.
authors.affiliation: Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Sicong
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xia
authors.affiliation: Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jianchun
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yan
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China; D002784:Cholesterol / Q000097:blood; D016208:Databases, Factual; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D002784:Cholesterol; D017430:Prostate-Specific Antigen
keywords: metabolic syndrome; prostate cancer; prostate volume; prostate-specific antigen; screening