Relationship between body mass index and concentrations of prostate specific antigen: a cross-sectional study

Abstract

The possible relationship between body mass index (BMI) and prostate-specific antigen (PSA) concentrations is controversial. The objective of this study was to assess the relationship between BMI and PSA concentrations in Chinese men. A total of 81,122 men who had undergone annual medical examinations at the First Affiliated Hospital of Army Medical University between 1 January 2011 and 31 December 2018 were included. Univariate and multivariate linear regression models were used to assess the relationship between BMI and PSA concentrations. The nonlinear relationship was analyzed using a generalized additive model with a spline smoothing function. Subsequently, a stratified linear regression model was used for subgroup analysis. The mean age and BMI of the participants were 45.91 ± 12.21 years and 24.79 ± 3.11 kg/m², respectively. After adjustment for age, waist circumference–hip circumference ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase and aspartate aminotransferase, BMI was negatively related to PSA level (p < .001). A nonlinear relationship was detected, and different relationships between BMI and PSA concentrations were observed on each side of the inflection point (BMI = 23.11 kg/m²). Our study revealed an inverse, nonlinear relationship between BMI and PSA concentrations. Thus, this relationship may be a concern when establishing reference intervals or decision limits for PSA concentrations.

Keywords:

• Prostate-specific antigen
• body mass index
• prostate cancer
• cancer screening
• cross-sectional study

Ethical approval

The study protocol was approved by the Ethics Committee of the first Affiliated Hospital of Army Medical University.

Author contributions

Chen designed the study and revised the manuscript. Zhao performed the statistical analysis and drafted the first manuscript. Zhang, Xin Wang and Lin collected the clinical data. All authors attest to the integrity of the original data and the analysis reported in this manuscript. The final manuscript was approved by all authors, who all qualify for authorship.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Chongqing Technology Foresight and Institutional Innovation Project and Top talent training program of the first affiliated hospital of PLA Army Medical University.