Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer

被引:274
作者
Banez, Lionel L.
Hamilton, Robert J.
Partin, Alan W.
Vollmer, Robin T.
Sun, Leon
Rodriguez, Carmen
Wang, Yiting
Terris, Martha K.
Aronson, William J.
Presti, Joseph C., Jr.
Kane, Christopher J.
Amling, Christopher L.
Moul, Judd W.
Freedland, Stephen J.
机构
[1] Duke Univ, Med Ctr, Div Urol Surg, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Surg, Duke Prostate Ctr, Durham, NC 27710 USA
[3] Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA
[4] Vet Affairs Med Ctr, Urol Sect, Durham, NC USA
[5] Vet Affairs Med Ctr, Dept Pathol, Durham, NC USA
[6] Univ Toronto, Dept Surg, Div Urol, Toronto, ON, Canada
[7] Johns Hopkins Med Inst, James Buchanan Brady Urol Inst, Dept Urol, Baltimore, MD 21205 USA
[8] Amer Canc Soc, Dept Epidemiol & Surveillance Res, Atlanta, GA 30329 USA
[9] Vet Affairs Med Ctr, Urol Sect, Augusta, GA USA
[10] Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA
[11] Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Los Angeles, CA USA
[12] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA
[13] Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA
[14] Vet Affairs Med Ctr, Urol Sect, Palo Alto, CA 94304 USA
[15] Vet Affairs Med Ctr, Urol Sect, San Francisco, CA 94121 USA
[16] Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA
[17] Univ Alabama Birmingham, Dept Urol, Birmingham, AL USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2007年 / 298卷 / 19期
关键词
D O I
10.1001/jama.298.19.2275
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context Recent studies have suggested that obese men have lower serum prostate-specific antigen (PSA) concentrations than nonobese men. Because men with higher body mass index (BMI) have greater circulating plasma volumes, lower PSA concentrations among obese men may be due to hemodilution. Objective To determine the association between hemodilution and PSA concentration in obese men with prostate cancer. Design, Setting, and Participants Retrospective study of men who underwent radical prostatectomy for prostate adenocarcinoma from 1988 to 2006, using data from the databases of the Shared Equal Access Regional Cancer Hospital (n=1373), Duke Prostate Center (n=1974), and Johns Hopkins Hospital (n=10 287). Multivariate linear regression models adjusting for clinicopathological characteristics were used to analyze the main outcome measures. Main Outcome Measures Associations between BMI and mean adjusted PSA concentrations, mean plasma volume, and mean adjusted PSA mass ( total circulating PSA protein, calculated as PSA concentration multiplied by plasma volume), assessed by determining P values for trend. Results After controlling for clinicopathological characteristics, higher BMI was significantly associated with higher plasma volume ( P < .001 for trend) and lower PSA concentrations ( P <= .02 for trend) in all cohorts. In 2 of the 3 cohorts, PSA mass did not change significantly with increasing BMI. In the third cohort, higher BMI was associated with increased PSA mass ( P <. 001 for trend), but only between BMI category less than 25 and the other categories. Conclusions In men undergoing radical prostatectomy, higher BMI was associated with higher plasma volume hemodilution may therefore be responsible for the lower serum PSA concentrations among obese men with prostate cancer. Prospective studies are needed to evaluate this association in screened populations.
引用
收藏
页码:2275 / 2280
页数:6
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