Correlation of body mass index with serum total PSA, total testosterone and prostatic volume in a sample of men
More details
Hide details
Urology Department, Alexandria University, Alexandria, Egypt
Ahmed Fouad Kotb   

Faculty of Medicine, Azarita, Sultan Hussein Street, Alexandria, Egypt. Tel.: +20 34860029; mobile: +20 1203021316.
Submission date: 2015-05-09
Acceptance date: 2015-07-08
Online publication date: 2015-08-21
Publication date: 2020-03-23
Pol. Ann. Med. 2016;23(1):1–5
The prevalence of both obesity and prostate cancer are increasing worldwide.

The aim of this study was to correlate BMI with serum total PSA, serum total testosterone and prostatic volume.

Material and methods:
This study was conducted on 100 consecutive male patients aged ≥ 50 years old recruited from the Urogenital Surgery outpatient clinic. Exclusion criteria were history of previously diagnosed or treated cancer prostate, the use of 5-a-reductase inhibitors and patients with serum PSA ≥10 ng/mL.

Results and discussion:
The mean age of patients was 57.5 ± 5.4 years (range: 50–72). The mean BMI was 33.1 ± 6.5 kg/m2, (range: 23.7–51.3). The mean serum PSA was 4.1 ± 0.8 ng/mL (range: 0.9–5.4). The mean serum testosterone was 4.6 ± 2.2 nmol/L (range: 0.8–9.8). The mean prostate volume was 54 ± 14 cm3 (range: 19–90). Higher BMI was significantly associated with a lower serum PSA, testosterone and higher prostate volume (P < 0.05 for all factors).

Patients with higher body mass index are more liable to have lower serum total PSA, lower serum total testosterone and higher prostate volume. Obesity may be associated with hormonal independent growth of prostatic tissues.

None declared.
Skolarus TA, Wolin KY, Grubb RL. The effect of body mass index on PSA, prostate cancer development and treatment. Nat Clin Pract Urol. 2007;4:605–614.
Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348:1625–1638.
Mosteller RD. Simplified calculation of body surface area. N Engl J Med. 1987;317:1098.
Laffin RJ, Chan DW, Tanasijevic MJ, et al. Hybritech total and free prostate-specific antigen assays developed fo the Beckman Coulter access automated chemiluminescent immunoassay system: a multicenter evaluation of analytical performance. Clin Chem. 2001;47:129–132.
Van Uytfanghe K, Stockl D, Kaufman JM, et al. Validation of 5 routine assays for serum free testosterone with a candidate reference measurement procedure based on ultrafiltration and isotope dilution–gas chromatography–mas spectrometry. Clin Biochem. 2005;38:253–261.
Hanash KA, Al-Othmaimen A, Kattan S, et al. Prostatic carcinoma. A nutritional disease? Conflicting data from the Kingdom of Saudi Arabia. J Urol. 1999;161:71.
Kehinde EO, Mojiminiyi OA, Sheikh M, et al. Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men. Br J Urol. 2005;96:308–312.
Hekal IA, Ibrahiem El.. Obesity–PSA relationship: a new formula. Prostate Cancer Prostatic Dis. 2010;13:186–190.
Kim GW, Doo SW, Yang WJ, et al. Effects of obesity on prostate volume and lower urinary tract symptoms in Korean men. Korean J Urol. 2010;51:344–347.
Price MM, Hamilton RJ, Robertson CN, et al. Body mass index, prostate-specific antigen, and digital rectal examination findings among participants in a prostate cancer screening clinic. Urology. 2008;71:787–791.
Baillargeon J, Pollock BH, Kristal AR, et al. The association of body mass index and prostate-specific antigen in a population-based study. Cancer. 2005;103:1092–1095.
Hutterer G, Perrotte P, Gallina A, et al. Body mass index does not predict prostate-specific antigen or percent free prostate-specific antigen in men undergoing prostate cancer screening. Eur J Cancer. 2007;43:1180–1187.
Freedland SJ, Platz EA, Presti Jr JC et al. Obesity, serum prostate specific antigen and prostate size: implications for prostate cancer detection. J Urol. 2006;175:500–504.
Loeb S, Yu X, Nadler RB, et al. Does body mass index affect preoperative prostate specific antigen velocity or pathological outcomes after radical prostatectomy? J Urol. 2007;177:102–106.
Parsons JK, Sarma AV, McVary K, et al. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. J Urol. 2009;182:S27–S31.
MacDonald AA, Herbison GP, Showell M, et al. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update. 2010;16:293–311.
Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol Diabetes Obes. 2007;14:482–487.
Schneider G, Kirschner MA, Berkowitz R, et al. Increased estrogen production in obese men. J Clin Endocrinol Metab. 1979;48:633–638.
Akingbemi BT. Estrogen regulation of testicular function. Reprod Biol Endocrinol. 2005;3:51.
de Boer H, Verschoor L, Ruinemans-Koerts J, et al. Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism. Diabetes Obes Metab. 2005;7:211–215.
Dhindsa S, Furlanetto R, Vora M, et al. Low estradiol concentrations in men with subnormal testosterone concentrations and type 2 diabetes. Diabetes Care. 2011;34:1854–1859.
Hammoud A, Carrell DT, Meikle AW. An aromatase polymorphism modulates the relationship between weight and estradiol levels in obese men. Fertil Steril. 2010;94:1734–1738.
Hammoud AO, Griffin J, Meikle AW, et al. Association of aromatase (TTTAn) repeat polymorphism length and relationship between obesity and decreased sperm concentration. Hum Reprod. 2010;25:3146–3151.
Vermeulen A, Kaufman JM, Deslypere JP, et al. Attenuated leuteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men. J Clin Endocrinol Metab. 1993;76:1140–1146.
Blank DM, Clark RV, Heymsfield SB, et al. Endogenous opioids and hypogonadism in human obesity. Brain Res Bull. 1994;34:571–574.
Dandona P, Dhindsa S. Update: hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab. 2011;96:2643–2651.
Luboshitzky R, Lavie L, Shen-Orr Z, et al. Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea. Obes Res. 2005;13:780–786.
Luboshitzky R, Zabari Z, Shen-Orr Z, et al. Disruption of the nocturnal testosterone rhythm by sleep fragmentation in normal men. J Clin Endocrinol Metab. 2001;86:1134–1139.
Hammoud AO, Walker JM, Gibson M. Sleep Apnea, reproductive hormones and quality of sexual life in severely obese men. Obesity. 2011;19:1118–1123.
Axelsson J, Ingre M, Akerstedt T, et al. Effects of acutely displaced sleep on testosterone. J Clin Endocrinol Metab. 2005;90:4530–4535.
Boyar RM, Rosenfeld RS, Kapen S. Human puberty: simultaneous secretion of luteinizing hormone and testosterone during sleep. J Clin Invest. 1974;54:609–618.
Schiavi RC, White D, Madeli J. Pituitary-gonadal function during sleep in healthy aging men. Psychoneuroendocrinology. 1992;17:599–609.
Stellato RK, Feldman HA, Hamdy O, et al. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23:490–494.
Tsai EC, Matsumoto AM, Fujimoto WY, et al. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes Care. 2004;27:861–868.
Goyal HO, Robateau A, Braden TD, et al. Neonatal estrogen exposure of male rats alters reproductive functions at adulthood. Biol Reprod. 2003;68:2081–2091.
Oliva A, Spira A, Multigner L. Contribution of environmental factors to the risk of male infertility. Hum Reprod. 2001;16:1768–1776.
Jimenez Torres M, Campoy Folgoso C, Canabate Rache F. Organochlorine pesticides in serum and adipose tissue of pregnant women in Southern Spain giving birth by Cesarean section. Sci Total Environ. 2006;372:32–38.
Momen MN, Fahmy I, Amer M, et al. Semen parameters in men with spinal cord injury: changes and aetiology. Asian J Androl. 2007;9:684–689.
Blomberg Jensen M, Bjerrum PJ, Jessen TE. Vitamin D is positively associated with sperm motility and increases intracellular calcium in human spermatozoa. Hum Reprod. 2011;26:1307–1317.