Elsevier

Urology

Volume 71, Issue 4, April 2008, Pages 554-560
Urology

Review
Body Composition and Serum Prostate-Specific Antigen: Review and Findings from Flint Men’s Health Study

https://doi.org/10.1016/j.urology.2007.11.049Get rights and content

Recent studies have suggested that obesity is associated with lower serum prostate-specific antigen levels, perhaps influencing the recommendation for prostate biopsy and potentially explaining part of the observed poorer prognosis among obese men. African-American men have the greatest rates of prostate cancer and are more likely to die of the disease, making early detection a priority in this group. We present findings from the Flint Men’s Health Study, a study of African-American men, that are consistent with most studies suggesting that overweight men have prostate-specific antigen levels that are 0.15 to 0.30 ng/mL lower than those who are not overweight. We have coupled our results with a systematic review of publications in this area.

Section snippets

Data Collection

The FMHS is a cross-sectional, community-based study of prostatic disease in African-American men. The study design, sampling, and methods for data collection have previously been described in detail.16, 17 The University of Michigan institutional review board reviewed and approved the protocol. At baseline, 730 men, aged 40 to 79, were recruited from a probability sample of age-eligible residents in Flint, Michigan and neighboring communities. All subjects completed an

Results

The mean age of the 348 FMHS subjects at baseline was 57 years. The distribution of men by age and BMI is given in Table 1. Despite the initial sampling strategy to oversample men in older age groups, just more than 60% of participants were younger than 60 years at the baseline clinical examination. Approximately 32% of the men were considered obese, and nearly 70% were classified as overweight (or obese). The mean waist circumference of the FMHS subjects was 38 in., with 30% having a waist

Comment

The upward trend in the prevalence of obesity has become a major public health concern in the United States. Ogden et al.19 estimated that 34% of the U.S. adult population in 2004 was considered overweight and 32% were considered obese. If current trends are extrapolated into the future, by 2010, more than 40% of the total adult population will be classified as obese.20 The prevalence of overweight and obesity in the African-American community is particularly staggering, because 45% of the

Conclusions

Taken together, the findings of our study and those of others suggest a modest decrease in PSA concentrations with increasing body mass among men without prostate cancer. However, the importance of this relation and its contribution to delayed detection and the consequently poorer prognosis among obese men diagnosed with prostate cancer is still debatable. One must also consider the screening practices of the individual, competing risk factors, and normal physician practice for the

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    This work was supported by the National Institutes of Health Specialized Program of Research Excellence (SPORE) grant P50CA89568.

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