| Objectives:Remarkable increases in the incidence of prostate cancer were noted beginning in the early 1990s in many countries,largely due to the widespread measurement of prostate-specific antigen(PSA).The high tissue specificity of PSA makes it one of the most useful tumor markers in medicine,facilitating the diagnosis,staging,and monitoring of prostatic disease and treatment.With the introduction of PSA testing in PSA screening programs,the sensitivity of PSA has been questioned,because the serum prostate-specific antigen are not raise and within normal limits in almost 30% prostate cancer,at the same time,the sensitive rate of PSA in patients with benign prostitatic hyperplsaia reach 16%～86%.Still,PSA levels may be affected by many factors,such as age,prostate volume,and obesity.The aim of this study was to evaluate the association between serum prostate specific antigen(PSA) and clinical parameters such as body mass index(BMI),age,hepatic function and renal function in patients with benign prostatic hyperplasia(BPH).Methods:Free prostate specific antigen(FPSA) and total prostate specific antigen(TPSA) and F/TPSA were determined in 444 patients with BPH.Age,hepatic function,renal function and anthropometric measurements,including height,weight,and body mass index(BMI),were also determined。The BMI was calculated by dividing the weight in kilograms by the square of the height in meters.Aspartate aminotransferase (AST),alanine aminotransferase(ALT),alkaline phosphatase, gamma-glutamyltransferase,and total bilirubin were measured in the hepatic function tests.Urea nitrogen,creatinine,and creatinine clearance were used to determine renal function.Spearman correlation coefficients were determined to evaluate the association between serum PSA and clinical parameters.BMI was categorized as normal(BMI＜23.0 kg/m~2),overweight(BMI 23.0-27.4 kg/m~2),obese(BMI BMI＞27.4kg/m~2),according to the re-defined World Health Organization(WHO) criterion for the Asia Pacific Region.PSA levels were stratified by BMI category and we performed statistical analyses using rank sum tests for these data.Results:(1)444 patients with BPH,aged 52-90 years(median 73 years),visited the Qilu Hospital of shandong University.The course of there disease was 1-13 years.The tPSA result was 1.3-10.1 ng/ml.Of these patients,196 man(44.1%) whose tPSA＞4.0 ng/ml,and 48 man(10.8%) whose Tpsa＞10.0 ng/ml.(2) Although the relationships were weak,significant negative correlations were noted between serum tPSA and body weight(r= -0.102 P＜0.05),BMI(r=-0.357 P＜0.05),AST(r=-0.065,P＜0.05),ALT(r=-0.132,P＜0.05) and gamma-glutamyltransferase(r=-0.033,P=0.046).A positive correlation was found between serum(tPSA,fPSA) and age(r=0.459 and r=0.229,both p＜0.01),creatinine (r=0.070 and r=0.206,both P＜0.05).The serum f/tPSA levels did not correlate with all of the clinical parameters,except creatinine and creatinine clearance.(3) When the BMI classification for Asians recommended by the World Health Organization expert consultation was chosen,as the BMI increased,the serum tPSA levels decreased(P＜0.05 and P＜0.05,respectively).but the serum fPSA and f/tPSA levels of the three groups according to BMI had no significant differences(p＞0.05).Conclusions:The clnical parameters such as Patients' age,body weight,BMI,hepatic function and renal function could affect serum TPSA,FPSA level,but they are not correlate with F/TPSA.When determining whether to carry out prostate biopsy as part of early prostate cancer detection,obesity should be considered as a factor associated with reduced PSA in BPH man with marginal PSA levels...
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