MP47-12 SERUM PSA AS A PREDICTOR OF SYMPTOMATIC HYPOGONADISM

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation1 Apr 2016MP47-12 SERUM PSA AS A PREDICTOR OF SYMPTOMATIC HYPOGONADISM Kazuhito Matsushita, Osamu Takahashi, Masaki Shimbo, Fumiyasu Endo, Osamu Muraishi, and Kazunori Hattori Kazuhito MatsushitaKazuhito Matsushita More articles by this author , Osamu TakahashiOsamu Takahashi More articles by this author , Masaki ShimboMasaki Shimbo More articles by this author , Fumiyasu EndoFumiyasu Endo More articles by this author , Osamu MuraishiOsamu Muraishi More articles by this author , and Kazunori HattoriKazunori Hattori More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.331AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We often see low levels of PSA in men with symptomatic hypogonadism. The relationship between serum PSA and testosterone levels is still controversial. According to the saturation hypothesis, a significant relationship is apparent only in the low testosterone range. We hypothesize that PSA might represent a surrogate marker for symptomatic hypogonadism. METHODS Patients presenting to our academic mens health clinic reported hypogonadal symptoms using the Aging Males Symptoms (AMS) scale which grades each hypogonadal symptom on a 5-point Likert scale. Several hormonal and biochemical parameters were measured the same day the survey was completed. In order to prevent possible bias in the analysis, we selected only subjects without a history of prostate disease and with a PSA level <4 ng/mL. RESULTS 149 men were included for analysis with an average age of 55y±10. At baseline, mean AMS scale 47±12, mean total testosterone (TT) 4.65±1.91 ng/mL, mean free testosterone(FT) 7.45±2.70 pg/mL, mean PSA 1.15±0.78ng/mL. We tested the efficacy of PSA, TT, and FT in detecting severe hypogonadism, defined as AMS scale≥50 in symptomatic subjects. Receiver operating characteristic (ROC) curve analysis for PSA showed an accuracy (area under the ROC curve) of 0.667±0.046 (p<0.01), in predicting severe hypogonadism. In particular, when a threshold of 0.8 ng/mL was chosen, sensitivity and specificity for severe hypogonadism were 72.8% and 59.0%. ROC curve analysis for TT and FT showed an accuracy of 0.51 (p=0.811) and 0.480 (p=0.693), respectively. We also tested the efficacy of PSA in detecting severe hypogonadism, defined as FT<8.5 pg/mL. ROC curve showed an accuracy of 0.512 (p=0.816). After adjusting for age, low PSA (<0.8ng/mL) was not associated with hypogonadism related features, such as metabolic syndrome. CONCLUSIONS Our data demonstrated that PSA levels were more accurate for the prediction of severe hypogonadism compared to testosterone levels and suggest that low PSA levels may represent a new tool in confirming severe hypogonadism. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e631 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kazuhito Matsushita More articles by this author Osamu Takahashi More articles by this author Masaki Shimbo More articles by this author Fumiyasu Endo More articles by this author Osamu Muraishi More articles by this author Kazunori Hattori More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...