Objectives: Prostate-specific antigen (PSA) levels are affected by many factors. Metabolic syndrome (MS) is a common metabolic disorder related to the increasing prevalence of obesity. The relationship between MS and PSA is currently unknown, however. The aim of this study was to examine whether PSA levels were affected by MS.
Methods: We evaluated the association between MS and PSA in a group of 2007 men (aged 30 to 79 years) without prostate cancer who received a general health checkup. Men with abnormal digital rectal examination findings or PSA values higher than 3.0 ng/mL were considered abnormal and excluded from the study. MS was defined according to the modified National Cholesterol Education Program Third Adult Treatment Panel guidelines. Eligible men were classified according to the number of each component and the presence or absence of MS.
Results: PSA levels, as a whole, were inversely correlated with MS (P = 0.043). An increased number of MS components was significantly associated with linear decreasing trends of PSA levels (P-trend < 0.001). When a multivariate analysis was performed with age and each MS, age (P < 0.001), abdominal obesity (P = 0.001), and an impaired fasting glucose level (P = 0.047) were strongly associated with PSA levels.
Conclusions: MS is associated with decreased PSA levels. When determining whether to perform prostate biopsy as part of early prostate cancer detection, MS should be considered as a factor associated with reduced PSA in men presenting with marginal PSA levels.