Asociación entre Síndrome Metabólico y niveles de Antígeno Prostático Específico
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v81i2.578Keywords:
metabolic syndrome, specific prostate antigen, insulin resistanceAbstract
Objective: To determine if there is an association between the metabolic syndrome (MetS) and the levels of prostate specific antigen (PSA).
Material and Methods: An observational, analytical and cross-sectional study was carried out, in which 357 men between 50-70 years were included, who went to a prostate control at the Urology Service of the Belén de Trujillo Hospital during the period March - July of the year 2019, which met the selection criteria. According to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII), patients were dichotomized by the presence or absence of MetS and the means of PSA levels in each group were calculated. Subsequently, a linear regression analysis was performed to assess the effect of age, BMI, prostate volume, blood plasma volume and lower urinary tract symptoms score on PSA levels.
Results: In the group of men with MetS, the mean PSA levels were slightly lower in men without MetS (1.54 ± 2.39 vs. 1.85 ± 3.0); obtaining a difference of 0.31 ng / ml; however, this association was not statistically significant (p = 0.103). On the other hand, PSA levels are influenced by blood plasma volume (p = 0.007) and BMI (p = 0.017).
Conclusions: The results obtained in this population affected that the presence of MetS had a non-significant association on PSA levels; However, these findings may be influenced by an antagonistic effect between each of the components of MetS.
References
Kim Y-J, Cho Y-J, Oh J-E, Jeon Y-S, Lee S-C, Kim W-J. The association between metabolic syndrome and prostate-specific antigen levels. Int J Urol. 2008 Oct;15(10):905–9. doi: https://doi.org/10.1111/j.1442-2042.2008.02137.x
Prcic A, Begic E, Hiros M. Usefulness of Total PSA Value in Prostate Diseases Diagnosis. Acta Inform Med. 2016 Jun;24(3):156–61. doi: https://doi.org/10.5455/aim.2016.24.156-161
Greene KL, Albertsen PC, Babaian RJ, Carter HB, Gann PH, Han M, et al. Prostate specific antigen best practice statement: 2009 update. J Urol. 2013 Jan;189(1 Suppl):S2–11. doi: https://doi.org/10.1016/j.juro.2012.11.014
Brenes Bermúdez FJ. Uso del antígeno prostático específico en atención primaria. SEMERGEN - Med Fam. 2017;43(3):173-4.
Lizarzaburu Robles JC. Síndrome metabólico: concepto y aplicación práctica. An Fac Med. 2014;74(4):315.
Villalobos Sánchez A, Millán García G, Narankievickz D. Síndrome metabólico. Med - Programa Form Médica Contin Acreditado. 2017;12(42):2485-93.
Carvajal Carvajal Carlos. Síndrome Metabólico: Definiciones, epidemiología, etiología, componentes y tratamiento. Medicina Legal de Costa Rica. 2017:175-93.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486–97. doi: https://doi.org/10.1001/jama.285.19.2486
Fridrich AD, Bonneau GA, Pedrozo WR, Novau CA, Palacios AL. Relación entre obesidad e insulino resistencia con el antígeno prostático específico. Rev.Cienc. Tecnol. 2012;(44-49).
Osorio-García MA, Reyes-García IA, Palacios-Saucedo GC. Comparación de los valores de antígeno prostático específico en pacientes con y sin obesidad abdominal del servicio de urología de una unidad médica de tercer nivel de atención. Rev Mex Urol. 2015;75(2):64-71.
Zhao S, Xia M, Tang J, Yan Y. Actual lowering effect of metabolic syndrome on serum prostate-specific antigen levels is partly concealed by enlarged prostate: results from a large-scale population-based study. BJU Int. 2017 Oct;120(4):482–9. doi: https://doi.org/10.1111/bju.13621
Jeong IG, Hwang SS, Kim HK, Ahn H, Kim C-S. The association of metabolic syndrome and its components with serum prostate-specific antigen levels in a Korean-screened population. Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):371–80. doi: https://doi.org/10.1158/1055-9965.epi-09-0760
Salih BA, Abdulla AA, Ali RH, Al-Shaam”a QA-S, Saeed SD, Hussein YF. Effects of metabolic syndrome on prostate specific antigen level, prostate volume and international prostate symptom scores in patients with benign prostatic hyperplasia. 1. 2016;20(2):1385 _ 1389-1385 _ 1389. doi: https://doi.org/10.15218/zjms.2016.0035
Cyrus A, Kabir A, Goodarzi D, Talaei A, Moradi A, Rafiee M, et al. Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia. Korean J Urol. 2014 Dec;55(12):814–20. doi: https://doi.org/10.4111/kju.2014.55.12.814
Gidron Y, Fabre B, Grosman H, Nolazco C, Mesch V, Mazza O, et al. Life events, cortisol and levels of prostate specific antigen: a story of synergism. Psychoneuroendocrinology. 2011 Jul;36(6):874–80. doi: https://doi.org/10.1016/j.psyneuen.2010.11.011
Gallina A, Nini A, Montorsi F, Briganti A. Metabolic syndrome as a marker for prostate cancer: still a work in progress. Eur Urol. 2015 Jan;67(1):71–2. doi: https://doi.org/10.1016/j.eururo.2014.03.018
Bhindi B, Fleshner NE. Reply from Authors re: Andrea Gallina, Alessandro Nini, Francesco Montorsi, Alberto Briganti. Metabolic Syndrome as a Marker for Prostate Cancer: Still a Work in Progress. Eur Urol 2015;67:71-2. Eur Urol. 2015 Jan;67(1):72–3. doi: https://doi.org/10.1016/j.eururo.2014.04.001
Najar F, Faisal M, Khesal A, Ansari T. Metabolic syndrome and its association with benign prostatic hyperplasia with special reference to unani system of medicine: A review. J Biol Sci Opin. 2017;5. doi: http://dx.doi.org/10.7897/2321-6328.05359
Choi WS, Heo NJ, Paick J-S, Son H. Prostate-specific antigen lowering effect of metabolic syndrome is influenced by prostate volume. Int J Urol. 2016 Apr;23(4):299–304. doi: https://doi.org/10.1111/iju.13042
Kim T-Y, Choi D-H, Lee T-Y, Moon H-C, An Y-I, Park S-J, et al. Association of Metabolic Factors with Prostate Volume and Prostate-Specific Antigen. Korean Journal of Family Practice. 2018 Feb 20;8(1):39–46. doi: https://doi.org/10.21215/kjfp.2018.8.1.39
Wang J-Y, Fu Y-Y, Kang D-Y. The Association Between Metabolic Syndrome and Characteristics of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis. Medicine (Baltimore). 2016 May;95(19):e3243. doi: https://doi.org/10.1097/md.0000000000003243
He Q, Wang Z, Liu G, Daneshgari F, MacLennan GT, Gupta S. Metabolic syndrome, inflammation and lower urinary tract symptoms: possible translational links. Prostate Cancer Prostatic Dis. 2016 Mar;19(1):7–13. doi: https://doi.org/10.1038/pcan.2015.43
Yin Z, Yang J-R, Rao J-M, Song W, Zhou K-Q. Association between benign prostatic hyperplasia, body mass index, and metabolic syndrome in Chinese men. Asian J Androl. 2015 Oct;17(5):826–30. doi: https://doi.org/10.4103/1008-682x.148081
Sáenz Medina J, Carballido Rodríguez J. Aspectos fisiopatológicos implicados en la patología urologica asociada al síndrome metabólico. Revisión bibliográfica. Actas Urol Esp. 2016 Jun 1;40(5):279–87. doi: https://doi.org/10.1016/j.acuro.2015.10.001
Carreño GL, Arciniegas AJ, Ramos Ulloa JG, Mayans GG, Cano CA. Asociación entre obesidad y diagnóstico de cáncer de próstata en adultos mayores: análisis secundario de la encuesta SABE. Rev Urol Colomb Colomb Urol J. 2019;28(03):240-5.
Muazu S, Ahmad B, Bako H. Obesity Indices and Serum Total Prostate Specific Antigen among Hausa Ethnic Group of Northern Nigeria; A Community Survey. American Journal of Medicine and Medical Sciences. 2018;8(4):61–5. doi: doi:10.5923/j.ajmms.20180804.02
McGrowder DA, Jackson LA, Crawford TV. Prostate cancer and metabolic syndrome: is there a link? Asian Pac J Cancer Prev. 2012;13(1):1–13. doi: https://doi.org/10.7314/apjcp.2012.13.1.001
Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Parretta E, et al. Effect of metabolic syndrome and its components on prostate cancer risk: meta-analysis. J Endocrinol Invest. 2013 Feb;36(2):132–9. doi: https://doi.org/10.1007/bf03346748
Van Hemelrijck M, Garmo H, Holmberg L, Walldius G, Jungner I, Hammar N, et al. Prostate cancer risk in the Swedish AMORIS study: the interplay among triglycerides, total cholesterol, and glucose. Cancer. 2011 May 15;117(10):2086–95. doi: https://doi.org/10.1002/cncr.25758
Xiang Y, Xiong H, Cui Z, Jiang S, Xia Q, Zhao Y, et al. The association between metabolic syndrome and the risk of prostate cancer, high-grade prostate cancer, advanced prostate cancer, prostate cancer-specific mortality and biochemical recurrence. J Exp Clin Cancer Res. 2013 Feb 13;32:9. doi: https://doi.org/10.1186/1756-9966-32-9
