Prostate-specific Antigen Density: A Better Index of Obesity-related PSA Decrease in Ostensibly Healthy Korean Men With a PSA <3.0 ng/mL

ObjectiveTo determine whether prostate-specific antigen density (PSAD) has a more significant correlation with obesity than prostate-specific antigen (PSA).MethodsFrom October 2007 to March 2012, a total of 2402 Korean men over 40 years old who visited our clinic for prostate examination were enrolled in this study. All men underwent anthropometric measurements, digital rectal examination, serum PSA determination, and transrectal ultrasound examination. Body mass index (BMI) was grouped according to the Asia-Pacific criteria of obesity into the following categories: underweight or normal: less than 23; overweight: 23 to 24.9; obese: 25 kg/m2 or greater. A partial correlation and linear trend model among PSA, PSAD, and BMI were conducted, after adjusting for age.ResultsFinally, data from 2294 men in total were collected. Mean age was 52.3 years and mean PSA was 1.07 ng/mL. Partial correlation revealed a significant negative correlation between BMI and both PSA and PSAD (P = .0017 and <.0001, respectively), and revealed positive correlation between BMI and prostate volume (P <.0001). After adjustment for age, the linear trend model demonstrated that BMI had both a significant trend with PSA and PSAD (P = .0162 and <.0001, respectively), however, PSAD showed a significant linear trend in all BMI groups, whereas PSA showed a significant linear trend only in the group with a BMI ≥25kg/m2.ConclusionPSAD demonstrated a more significant negative correlation with obesity than PSA.