The association of metabolic syndrome and its components with serum prostate-specific antigen levels in a Korean-screened population.

BACKGROUND Metabolic syndrome plays a potential role in the etiology of prostate cancer and is associated with the increase in prostatic growth rate in patients with benign prostatic hyperplasia. However, the influence of metabolic syndrome on prostate-specific antigen (PSA) level remains unclear. METHODS Data were obtained from 23,601 men ages 40 years or older without a history of prostate cancer who underwent general health screening tests between 2006 and 2007 at Asan Medical Center. The criteria for metabolic syndrome were consistent with those defined by the NCEP-ATPIII-AHA/NHLBI statement. Multivariate linear regression analysis was used to determine the independent effects of age, body mass index (BMI), metabolic syndrome, and each component of metabolic syndrome, on PSA level. RESULTS Geometric mean PSA level increased linearly and significantly with increasing age and decreasing BMI (P < 0.001). Although the geometric mean PSA levels were lower in men with metabolic syndrome than in those without the condition, metabolic syndrome no longer retained a statistically significant association with PSA after the adjustment for age and BMI (P = 0.850). Among five metabolic components, higher waist circumference and fasting plasma glucose level were significantly associated with lower PSA (P = 0.021 and P = 0.001), whereas hypertension was significantly associated with higher PSA (P < 0.001), after complete adjustment for age, BMI, and other metabolic components. CONCLUSIONS In our screened population, metabolic syndrome was not associated with PSA level. The lack of association between metabolic syndrome and PSA level may reflect the heterogeneous relationship between each metabolic risk factor and PSA level.