Prostate-specific antigen age-specific reference ranges and the effect of metabolic syndrome factors in a Thai population Authors

Abstract

Objectives: An appropriate prostate specific antigen (PSA) cut-off value in Thailand has not been investigated, nor has an age-specific PSA reference range. This study aims to evaluate the correlation between metabolic syndrome, metabolic factors, and age specific PSA level. Materials and Methods: A cross-sectional study in men who underwent medical checkups from September 2019 to December 2019. The 95th percentile PSA value was applied to the normal age-specific reference range. Correlations between PSA levels and a variety of factors were determined using linear regression. Results: A total of 507 men met the criteria to be included in the analysis. Age-specific PSA reference ranges for men aged 40-49, 50-59, and 60-70 years were 0-2.3, 0-3.4, and 0-4.2 ng/ml, respectively. The multivariate adjusted geometric mean PSA model indicated that the factors related to PSA were age, higher body mass index (BMI) and serum fasting blood sugar (FBS) ≥ 100 mg/dl. The age group 50-59 and 60-70 have a 43% and 99% increase in mean PSA compared to the age group 40-49, respectively (p < 0.001). A higher BMI was associated with lower PSA (p < 0.001). And the serum FBS ≥ 100 mg/dl showed a 15% reduction in mean PSA compared to FBS < 100 mg/dl (p = 0.018). Conclusion: The age-specific PSA reference in Thai men was lower than reported in a previous study. Use of the lower PSA cut-off may increase the sensitivity of prostate cancer screening. This study demonstrates that age, BMI, and FBS may all influence the clinical interpretation of serum PSA levels. Screening for prostate cancer using PSA should be carried out with caution in those who have those risk factors.