Presentation on theme: "RELATIONSHIP BETWEEN SERUM PROSTATE SPECIFIC ANTIGEN LEVEL AND ANTHROPOMETRIC MEASUREMENTS IN A PREVIOUSLY UNSCREENED NIGERIAN POPULATION Akinremi T.O,"— Presentation transcript:
RELATIONSHIP BETWEEN SERUM PROSTATE SPECIFIC ANTIGEN LEVEL AND ANTHROPOMETRIC MEASUREMENTS IN A PREVIOUSLY UNSCREENED NIGERIAN POPULATION Akinremi T.O, Afolabi D.O, Olatunde A.O, Oyerinde A, Ogo C.N Federal Medical Centre Abeokuta Ogun State, Nigeria.
INTRODUCTION The PSA test is widely used in screening and detection of prostate cancer as well as in monitoring response to treatment. 1 It has been hypothesized that body size and composition may influence prostate cancer risk. 2 Reports on the relationship between serum PSA level and anthropometric measurements have been inconsistent. Studies among various racial populations are needed to better define the association between this biomarker and body size/composition.
OBJECTIVE To assess the relationship between Prostate Specific Antigen and some anthropometric variables such as weight, height, BMI, waist circumference, and waist hip ratio (WHR) among a population of previously unscreened men in Abeokuta South Local Government of Ogun State, Nigeria.
METHOD A population-based cross-sectional study was conducted as part of a free health education and screening program in Abeokuta, South-West Nigeria Ninety-seven men aged 40 years and above were studied Each participant’s age and anthropometric data such as weight, height, waist circumference and hip circumference were recorded while 5mls of venous blood was collected for serum PSA analysis via ELISA technique Data was analysed using SPSS version 17.0 program
RESULTS The serum PSA levels of participants ranged from 0.1 to 49.0 ng/mL with a median of 0.7 ng/mL. Eighty-four (86.6%) participants had serum PSA ≤4.0 ng/mL, while 13 (13.4%) had serum PSA ≥4.0 ng/mL. Participants’ ages ranged from 40-80 years and the mean age was 55.6 ± 10.2 years.
VARIABLE% (n) Age group 40-49 years 50-59 years 60-69 years ≥ 70 years 32.0% (31) 33.0% (32) 19.6% (19) 15.5 % (15) Serum PSA < 4ng/ml ≥ 4ng/ml 86.6% (84) 13.4% (13) BMI Underweight Normal weight Overweight Obese 10.4% (10) 59.4% (57) 19.8% (19) 10.4% (10) WC No Abdominal Obesity Abdominal Obesity 83.3% (80) 16.7% (16)
Relationship between serum PSA and demographic/anthropometric variables Normal PSA % High PSA % P value Age Group 40-49 years 50-59 years 60-69 years 70 and above 93.5% 90.6% 84.2% 66.7% 6.5% 9.4% 15.8% 33.3% 0.073 BMI Group Underweight Normal weight Overweight Obesity 100% 82.5% 89.5% 90.0% 0.0% 17.5% 10.5% 10% 0.457 Waist Circumference No Abdominal Obesity Abdominal Obesity 87.5% 81.3% 12.5% 18.8% 0.505
RESULTS There was positive correlation between serum PSA and age. (Spearman’s r = 0.304, p = 0.002) There was also a significant difference in the mean PSA levels across the age groups. The median serum PSA levels increased with each successive 10-year age group showing a gradual rise between the 4 th and 5 th decades of life followed by a sharp rise between the 5 th and 6 th decades.
RESULTS Participants’ height (r=-0.027, p=0.793), weight (r=-0.133, p=0.198), BMI (r=-0.099, p=0.335), WC (r=0.067, p=0.517), HC (r=-0.58, p=0.574), and WHR (r=0.157, p=0.127) showed no significant correlation with serum PSA level. Further analysis however showed a trend of gradual increase in mean PSA levels across the BMI categories.
Relationship between mean PSA level and BMI category
DISCUSSION The prevalence of elevated serum PSA in this study (13.4%) is comparable to that reported in 2003 (10.0%) and 2007 (11.0%) among rural Nigerian men. 3,4 The finding of positive correlation between Serum PSA and age is in keeping with previous reports from this region 3,5,6 and beyond 7 This may be attributed to prostatic enlargement which occurs after age 50 with concomitant increase in PSA production.
DISCUSSION (Contd) In contrast to many prior studies 4,8-14 our study showed no correlation between serum PSA level and anthropometric measurements. Ikuerowo et al 5 also found no relationship between total PSA and obesity in Lagos.
CONCLUSION Serum PSA levels were positively associated with age. Anthropometric parameters were not associated with serum PSA levels. There is a need to look beyond anthropometry for possible modifiable risk factors to prostate cancer.
REFERENCES (1) 1. Oesterling JE (1991). Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol, 145, 907-23. 2. Maclnnis RG, English DR. Body size and composition and prostate cancer risk factors: systemic review and meta-regression analysis. Cancer Causes Control 2006; 17; 989-1003 3. Ukoli F, Osime U, Akereyeni F, Okunzuwa O, Kittles R, Adams- Campbell L. Prevalence of elevated serum prostate-specific antigen in rural Nigeria. Int J Urol 2003 Jun;10(6):315-22 4. Ukoli FA, Egbagbe E, Zhao BB, Lyamu E, Young D, Oside P, Osime U, Adams-Campbell LL> Anthropometric predictors of elevated prostate specific antigen among rural and urban Nigerians: a population-based study. West Afr J Med. 2007 Jan-Mar;26(1):7-13.
REFERENCES (2) 5. Ikuerowo SO, Omisanjo OA, Biobaku MJ, Ajala MO, Esho JO. Effect of obesity on serum prostate-specific antigen in Nigerian men. Urol Int 2012;89(1):52-6 6. Abbiyesuku FM, Shittu OB, Oduwole OO, Osotimehin BO. Prostate specific antigen in the Nigerian African. Afr J Med Med Sci. 2000 Jun;29(2):97-100. 7. Lee SE, Kwak C, Park MS, et al (2000). Ethnic differences in the age-related distribution of serum prostate-specific antigen values: a study in a healthy Korean male population. Urology 2000;56:1007-10. 8. Culp S, Porter M. The effect of obesity and lower serum prostate-specific antigen on prostate cancer screening results in American men. BJU Int 2009 Nov;104(10):1457-61 9. Beebe-Dimmer J, Faerber G, Morgenstern H, Werny D, Wojno K, Halstead- Nussloch B et al. Body composition and serum Prostate Specific Antigen: A Review and Findings from the Flint Men’s Health Study. Urology 2008;71(4):554-560
REFERENCES (3) 10. Ando R, Nagaya T, Hshimoto Y, Suzuki S, Itoh Y, Umemoto Y et al. Inverse relationship between obesity and serum prostate specific antigen level in healthy Japanese men: a hospital-based cross-sectional survey, 2004- 2006. Urology 2008 Sep;72(3):561-5 11. Fowke JH, Signorello LB, Chang SS, Matthews CE, Buchowski MS, Cookson MS et al. Effects of obesity and height on prostate-specific antigen (PSA) and percentage of free PSA levels among African-Americans and Caucasian men. Cancer 2006 Nov ;107(10):2361-7 12. Fowke JH, Motley SS, Cookson MS, Concepcion R, Chang SS, Wills ML et al. The association between body size, prostate volume and prostate-specific antigen. Prostate Cancer Prostate Dis 2007;10(2):137-42 13. Park SG, Choi HO, Cho B, Kwon YM, Kwon TH, Park JH, Effect of Cenctral Obesity on Prostate Specific Antigen Measured by Computer Tomography: Related Markers and Prostate Volume. J Urol. 2012: Vol 187, 1589-1593 14. Werny DM, Thompson T, Saraiya M et al: Obesity is negatively associated with prostate-specific antigen in U. S. men, 2001-2004. Cancer Epidemiol Biomarkers Prev2007;16:70