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Objectives: To evaluate the impact of obesity on the biopsy detection of prostate cancer., Methods: We retrospectively reviewed data of 1182 consecutive Korean patients (≥50 years) with serum prostate-specific antigen levels of 3-10 ng/mL who underwent initial extended 12-cores biopsy from September 2009 to March 2013. Patients who took medications that were likely to influence the prostate-specific antigen level were excluded. Receiver operating characteristic curves were plotted for prostate-specific antigen and prostate-specific antigen density predicting cancer status among non-obese and obese men., Results: A total of 1062 patients (mean age 67.1 years) were enrolled in the analysis. A total of 230 men (21.7%) had a positive biopsy. In the overall study sample, the area under the receiver operator characteristic curve of serum prostate-specific antigen for predicting prostate cancer on biopsy were 0.584 and 0.633 for non-obese and obese men, respectively (P = 0.234). However, the area under the curve for prostate-specific antigen density in predicting cancer status showed a significant difference (non-obese 0.696, obese 0.784; P = 0.017)., Conclusions: There seems to be a significant difference in the ability of prostate-specific antigen density to predict biopsy results between non-obese and obese men. Obesity positively influenced the overall ability of prostate-specific antigen density to predict prostate cancer., (© 2014 The Japanese Urological Association.)

Objective: To determine the association between body mass index (BMI), serum prostate-specific antigen (PSA) level and PSA density (PSAD) in patients with an elevated serum PSA level but a negative prostate biopsy., Methods: This retrospective study enrolled men with a negative prostate biopsy but a serum PSA level of 3.0-10 ng/ml. All men underwent anthropometric measurements, serum PSA determination and transrectal ultrasound examination. BMI was grouped according to the Asia-Pacific obesity criteria: nonobese (<25 kg/m(2)) versus obese (≥ 25 kg/m(2)). Partial correlation and linear regression models between PSA, PSAD and BMI were conducted after adjusting for age., Results: A total of 907 men were enrolled in this study. On multivariate analyses, PSA showed no significant correlation with age or BMI, whereas PSAD had a negative correlation with age and BMI. Similar results were obtained when patients were categorized as having low (3.0 < PSA  ≤ 6.5 ng/ml) or high PSA (6.5 < PSA ≤ 10.0 ng/ml) levels., Conclusion: PSAD, but not PSA, demonstrated a significant negative correlation with BMI. This indicates that a new strategy including PSAD rather than simple PSA levels should be adopted in the study of obesity-adjusted PSA cut-offs., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Objective: To determine whether prostate-specific antigen density (PSAD) has a more significant correlation with obesity than prostate-specific antigen (PSA)., Methods: From 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/m(2) or greater. A partial correlation and linear trend model among PSA, PSAD, and BMI were conducted, after adjusting for age., Results: Finally, 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 ≥ 25 kg/m(2)., Conclusion: PSAD demonstrated a more significant negative correlation with obesity than PSA., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To determine which measurement variable, waist circumference (WC), body mass index (BMI), or waist-to-hip ratio (WHR) is most closely related to the prostate volume (PV), prostate-specific antigen (PSA), and lower urinary tract symptoms (LUTS)., Methods: Between January 2010 and September 2011, 1632 consecutive ostensibly healthy Korean men aged 40-69 years who visited our clinic for a prostate checkup were enrolled into the study. Exclusion criteria included pyuria, history of lower urinary tract disorder influencing urination, and a high PSA level of >3.0 ng/mL. All men underwent a detailed clinical evaluation using the International Prostate Symptom Score (I-PSS) questionnaire. Anthropometric measurements were determined. Serum PSA, urinalysis, and transrectal ultrasound were also performed., Results: Data from 1601 men were analyzed. The mean age was 51.6 years, WC 83.7 cm, BMI 24.8 kg/m(2), PV 24.6 mL, and the mean PSA level was 1.07 ng/mL. Using multivariate analysis, PV most positively associated with WC (P < .001), while PSA level had negatively associated with BMI (P = .036) and no significant association with WC or WHR was noted. There was no significant relationship between various obesity indexes and I-PSS., Conclusion: Our data showed that PV positively associated with central obesity, as represented by WC. In contrast, serum PSA negatively associated with BMI, which represented overall obesity (ie, hemodilution). Our data also suggested that obesity is not associated with lower urinary tract symptoms in Korean men., (Copyright © 2012 Elsevier Inc. All rights reserved.)

It has been suggested that the larger vascular volume among obese men causes a dilution effect, decreasing the concentration of serum prostate-specific antigen (PSA). However, plasma volume is proportional to body surface area (BSA) rather than to body mass index (BMI). We determined whether serum PSA level is better correlated to BSA than BMI in a population of ostensibly healthy Korean men. Data from 2604 men who visited our health promotion center were evaluated. All men underwent anthropometric measurements, digital rectal examination, serum PSA determination, and transrectal ultrasound examination. The correlation between serum PSA and other parameters was statistically analyzed. The mean age was 49.9 years and the mean serum PSA level was 1.14 ng/mL. The multivariate analysis revealed that the serum PSA was positively correlated with age, prostate volume, and negatively correlated with BSA only and not with BMI. In addition, BSA, rather than BMI, was the significant factor in predicting the prostate volume. Our results suggest that men with larger BSA (rather than BMI), have larger prostate volumes, and lower serum PSA.