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Lifestyle Determinants of 5-Reductase Metabolites in Older African-American, White, and Asian-American Men¹

Departments of Preventive Medicine [A. H. W.] and Obstetrics and Gynecology [F. Z. S.], University of Southern California, Los Angeles, California 90089-0251; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California 94305 [A. S. W.]; Cancer Research Center at Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii 96813 [L. N. K.]; Northern California Cancer Center, Union City, California 94587 [A. S. W., E. M. J., D. W. W.]; and Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6 Canada [R. P. G.]

Men with higher endogenous 5-reductase activity may have higher prostate cancer risk. This hypothesis raises two questions: (a) Could racial differences in 5-reductase activity explain the observed racial differences in prostate cancer risk? and (b) Could a man reduce his activity level by modifying his lifestyle? To address these questions, we measured two hormonal indices of 5-reductase activity [serum levels of androstane-3-17ß-diol glucuronide (3-diol G) and androsterone glucuronide (AG)] in healthy, older African-American, white, and Asian-American men, who are at high, intermediate, and low prostate cancer risk, respectively. We also examined associations between these metabolite levels and such lifestyle characteristics as body size and physical activity as well as select aspects of medical history and family history of prostate cancer. Men included in this cross-sectional analysis (n = 1054) had served as control subjects in a population-based case-control study of prostate cancer we conducted in California, Hawaii, and Vancouver, Canada and provided information on certain personal attributes and donated blood between March 1990 and March 1992. In this study, concentrations of 3-diol G declined significantly with age and increased significantly with body mass index. Mean levels of 3-diol G, adjusted for age and body mass index, were 6.1 ng/ml in African-Americans, 6.9 ng/ml in whites and 4.8 ng/ml in Asian-Americans. These differences were statistically significant (African-Americans versus whites: P < 0.01; whites versus Asian-Americans: P < 0.001). Concentrations of AG decreased significantly with age, but only in whites, and were unrelated to any of the reported personal attributes. Mean levels of AG, adjusted for age, were 44.1 ng/ml in African-Americans, 44.9 ng/ml in whites, and 37.5 ng/ml in Asian-Americans (Asian-Americans versus whites, P < 0.001). In conclusion, older African-American and white men have similar levels of these two indices of 5-reductase activity, and these levels are higher than those of older Asian-American men. This difference may be related to the lower prostate cancer risk in Asian-Americans.

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