Objective: Lower serum total prostate-specific antigen (PSA) levels (tPSA) have been reported in obese men. It has not been confirmed if this association truly exists in all ethnic groups. Thus, we evaluated the relationship between tPSA and obesity among Nigerian men. Methods: Men aged ≥40 years with tPSA <20 ng/ml and no known prostatic disease were involved. Obesity was defined using the body mass index (BMI) and waist to hip ratio (WHR). Multivariate linear regression was used to investigate the relationship between tPSA and either BMI or WHR. The odds of having abnormal tPSA were estimated using logistic regression. Results: A total of 3,191 men participated, and 3,049 (95.6%) were eligible for analysis. A BMI ≥25.0 and a WHR ≥0.9 were found in 47.7 and 64.6%, respectively. tPSA was significantly associated with age (p < 0.001) and digital rectal examination status (p < 0.001). Multivariate linear regression analysis showed no relationship between tPSA and obesity (BMI, p = 0.581; WHR, p = 0.160). Adjusting for age and digital rectal examination status, logistic regression showed no significantly observable trend of having a tPSA level greater than thresholds for men with a BMI ≥25 or a WHR ≥0.9 when compared with normal BMI or WHR, respectively. Conclusion: Although overweight and obesity were common among healthy Nigerian men, there was no associated tendency towards lower serum tPSA.

Keywords:
Prostate-specific antigen, Obesity, Body mass index, Waist to hip ratio
1.
Ogunbiyi JO, Shittu OB: Increased incidence of prostate cancer in Nigerians. J Natl Med Assoc 1999;91:159–164.
2.
Mohammed AZ, Edino ST, Ochicha O, Gwarzo AK, Samaila AA: Cancer in Nigeria: a 10-year analysis of the Kano cancer registry. Niger J Med 2008;17:280–284.
3.
Ajape AA, Babata A, Abiola OO: Knowledge of prostate cancer screening among native African urban population in Nigeria. Nig Q J Hosp Med 2010;20:94–96.
4.
Oesterling JE: Age-specific reference ranges for serum PSA. N Engl J Med 1996;335:345–346.
5.
Banez LL, Hamilton RJ, Partin AW, et al: Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer. JAMA 2007;298:2275–2280.
6.
Grubb RL 3rd, Black A, Izmirlian G, et al: Serum prostate-specific antigen hemodilution among obese men undergoing screening in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cancer Epidemiol Biomarkers Prev 2009;18:748–751.
7.
Price MM, Hamilton RJ, Robertson CN, Butts MC, Freedland SJ: Body mass index, prostate-specific antigen, and digital rectal examination findings among participants in a prostate cancer screening clinic. Urology 2008;71:787–791.
8.
Rundle A, Neugut AI: Obesity and screening PSA levels among men undergoing an annual physical exam. Prostate 2008;68:373–380.
9.
Werny DM, Thompson T, Saraiya M, et al: Obesity is negatively associated with prostate-specific antigen in US men, 2001–2004. Cancer Epidemiol Biomarkers Prev 2007;16:70–76.
10.
Hekal IA, Ibrahiem EI: Obesity-PSA relationship: a new formula. Prostate Cancer Prostatic Dis 2010;13:186–190.
11.
Kim JM, Song PH, Kim HT, Moon KH: Effect of obesity on prostate-specific antigen, prostate volume, and international prostate symptom score in patients with benign prostatic hyperplasia. Korean J Urol 2011;52:401–405.
12.
Quelly SB, Lieberman LS: Global prevalence of overweight and obesity in preschoolers. Anthropol Anz 2011;68:437–456.
13.
Shayo GA, Mugusi FM: Prevalence of obesity and associated risk factors among adults in Kinondoni municipal district, Dar es Salaam Tanzania. BMC Public Health 2011;11:365.
14.
Muller H, Raum E, Rothenbacher D, Stegmaier C, Brenner H: Association of diabetes and body mass index with levels of prostate-specific antigen: implications for correction of prostate-specific antigen cutoff values? Cancer Epidemiol Biomarkers Prev 2009;18:1350–1356.
15.
Hutterer G, Perrotte P, Gallina A, et al: Body mass index does not predict prostate-specific antigen or percent free prostate-specific antigen in men undergoing prostate cancer screening. Eur J Cancer 2007;43:1180–1187.
16.
Ku JH, Kim ME, Lee NK, Park YH, Ahn JO: Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men. Urology 2003;61:132–136.
17.
Capitanio U, Perrotte P, Hutterer GC, et al: Effect of body mass index on prostate-specific antigen and percentage free prostate-specific antigen: results from a prostate cancer screening cohort of 1,490 men. Int J Urol 2009;16:91–95.
18.
Kubota Y, Seike K, Maeda S, Shinohara Y, Iwata M, Sugimoto N: Relationship between prostate-specific antigen and obesity in prostate cancer screening: analysis of a large cohort in Japan. Int J Urol 2011;18:72–75.
19.
Culp S, Porter M: The effect of obesity and lower serum prostate-specific antigen levels on prostate-cancer screening results in American men. BJU Int 2009;104:1457–1461.
20.
Carroll P, Coley C, McLeod D, et al: Prostate-specific antigen best practice policy – part II: prostate cancer staging and post-treatment follow-up. Urology 2001;57:225–229.
21.
Smith RA, Cokkinides V, Eyre HJ: American Cancer Society guidelines for the early detection of cancer, 2004. CA Cancer J Clin 2004;54:41–52.
22.
Ajape AA, Mustapha K, Lawal IO, Mbibu HN: Survey of urologists on clients’ demand for screening for prostate cancer in Nigeria. Niger J Clin Pract 2011;14:151–153.
23.
Osegbe DN: Prostate cancer in Nigerians: facts and nonfacts. J Urol 1997;157:1340–1343.
24.
Badmus TA, Adesunkanmi AR, Yusuf BM, et al: Burden of prostate cancer in southwestern Nigeria. Urology 2010;76:412–416.
25.
Flegal KM, Carroll MD, Ogden CL, Curtin LR: Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010;303:235–241.
26.
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 2003;348:1625–1638.
27.
Rapp K, Schroeder J, Klenk J, et al: Obesity and incidence of cancer: a large cohort study of over 145,000 adults in Austria. Br J Cancer 2005;93:1062–1067.
28.
De Nunzio C, Albisinni S, Freedland SJ, et al: Abdominal obesity as risk factor for prostate cancer diagnosis and high grade disease: a prospective multicenter Italian cohort study. Urol Oncol 2011, E-pub ahead of print.
29.
Rohrmann S, Roberts WW, Walsh PC, Platz EA: Family history of prostate cancer and obesity in relation to high-grade disease and extraprostatic extension in young men with prostate cancer. Prostate 2003;55:140–146.
30.
Gong Z, Neuhouser ML, Goodman PJ, et al: Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 2006;15:1977–1983.
31.
De Nunzio C, Freedland SJ, Miano L, Finazzi Agro E, Banez L, Tubaro A: The uncertain relationship between obesity and prostate cancer: an Italian biopsy cohort analysis. Eur J Surg Oncol 2011;37:1025–1029.
32.
Amling CL, Riffenburgh RH, Sun L, et al: Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy. J Clin Oncol 2004;22:439–445.
33.
Freedland SJ, Aronson WJ, Kane CJ, et al: Impact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group. J Clin Oncol 2004;22:446–453.
34.
Dimitropoulou P, Martin RM, Turner EL, et al: Association of obesity with prostate cancer: a case-control study within the population-based PSA testing phase of the ProtecT study. Br J Cancer 2011;104:875–881.
35.
Pater LE, Hart KW, Blonigen BJ, Lindsell CJ, Barrett WL: Relationship between prostate-specific antigen, age, and body mass index in a prostate cancer screening population. Am J Clin Oncol 2011, E-pub ahead of print.
36.
Wright JL, Lin DW, Stanford JL: The effect of demographic and clinical factors on the relationship between BMI and PSA levels. Prostate 2011;71:1631–1637.
37.
Eastham JA, Sartor O, Richey W, Moparty B, Sullivan J: Racial variation in prostate specific antigen in a large cohort of men without prostate cancer. J La State Med Soc 2001;153:184–189.
38.
Aoki Y, Arai Y, Maeda H, Okubo K, Shinohara K: Racial differences in cellular composition of benign prostatic hyperplasia. Prostate 2001;49:243–250.
© 2012 S. Karger AG, Basel
2012
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