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Obesity Is Negatively Associated with Prostate-Specific Antigen in U.S. Men, 2001-2004

¹ Division of Cancer Prevention and Control, ² Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ³ Office of HIV AIDS, U.S. Agency for International Development, Washington, District of Columbia; and ⁴ University of Washington-Seattle, School of Medicine, Seattle, Washington

Requests for reprints: Mona Saraiya, Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Mailstop K-55, Atlanta, GA 30341. Phone: 770-488-4293; Fax: 770-488-4639. E-mail: msaraiya{at}cdc.gov

Background: Recent studies have shown a negative association between body mass index (BMI) and prostate-specific antigen (PSA), a commonly used serum marker for the detection and diagnosis of prostate cancer. We have examined the association between several anthropometric measures and PSA in a nationally representative sample of men.

Methods: We analyzed data from the 2001-2004 National Health and Nutrition Examination Survey. Participants in this study were men ages 40 years without previously diagnosed prostate cancer who had PSA measured. Height, weight, waist circumference, BMI, triceps skinfold, subscapular skinfold, and calculated total body water were examined categorically by quintiles using multiple linear regression models. All tests of significance were two sided.

Results: Among white men, we report a trend for decreasing PSA with increasing weight, BMI, waist circumference, triceps skinfold thickness, and calculated total body water. Among Mexican American men, we found a trend for decreasing PSA with increasing BMI, and among black men we found a trend for decreasing PSA with increasing triceps thickness. None of the interaction terms between race/ethnicity and any of the anthropometric measures were statistically significant. Controlling for age and race/ethnicity in the multiple linear regression model, we found moderate declines in PSA with a 1 SD increase in BMI [5.9% decrease (95% confidence interval, –9.0% to –2.8%) in geometric mean PSA per 5.2-unit increase], weight [5.9% decline (–8.8% to –2.8%) per 17.7-kg increase], waist circumference [6.6% decline (–9.4% to –3.6%) per 13.4-cm increase], triceps skinfold [5.4% decline (–8.9% to –1.8%) per 6.4-mm increase], and calculated total body water [5.7% decline (–8.9% to –2.4%) per 6.5-liter increase].

Conclusion: Our population-based, nationally representative results expand the validity of previous studies on obesity and PSA. Higher weight, BMI, waist circumference, triceps skinfold, and total body water are associated with moderately lower PSA values. A prospective study is needed to verify whether this association affects the accuracy of the PSA test in obese men. (Cancer Epidemiol Biomarkers Prev 2007;16(1):70–6)

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