Serum PSA Hemodilution Among Obese Men Undergoing Screening In The Prostate, Lung, Colorectal, And Ovarian Cancer Screening Trial

Main Category: Urology / Nephrology
Also Included In: Prostate / Prostate Cancer;  Obesity / Weight Loss / Fitness;  Cancer / Oncology
Article Date: 30 Apr 2009 - 2:00 PDT

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UroToday.com - This study reported in Cancer, Epidemiology, Biomarkers and Prevention used the same Prostate, Lung, Colorectal and Ovarian (PLCO) database as that by Andriole and colleagues in the NEJM article recently covered in Urotoday¹. It is previously proposed that PSA levels in obese men could be due to hemodilution secondary to increased circulating blood volume. This study evaluated that phenomenon among 38,349 men randomized to the screened group of PLCO.

Body surface area, plasma volume and PSA mass were calculated for study participants. Mean age of me analyzed was 62.3 years. There was an inverse relationship between age and body mass index (BMI) that was statistically significant. The mean and median BMI were 27.6 and 27.0 kg/m2, respectively. Half of all men were classified as overweight and 23.5% as obese or morbidly obese. The mean PSA concentration decreased from 1.27ng/ml in normal weight men to 1.07ng/ml in morbidly obese men. Estimated mean plasma volume increased with increasing BMI from 3.19 liters in normal weight men to 3.94 in morbidly obese men. Estimated PSA mass (calculated as PSA concentration x plasma volume) did not demonstrate significant association with BMI.

While the PLCO confirms an inverse correlation between PSA and BMI, the change in PSA from normal to morbidly obese men is only 16%.

Grubb RL 3rd, Black A, Izmirlian G, Hickey TP, Pinsky PF, Mabie JE, Riley TL, Ragard LR, Prorok PC, Berg CD, Crawford ED, Church TR, Andriole GL Jr; PLCO Project Team

Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):748-51
10.1158/1055-9965.EPI-08-0938

Reference:
¹. Andriole GL, et.al., N Engl J Med. 2009 Mar 26;360(13):1310-9

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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