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目的基于中国人数据探讨肥胖因素对血清前列腺特异性抗原(PSA)水平的影响,以及PSA质量和PSA质量比在不同血容量和身体质量指数(BMI)水平中的稳定性。方法回顾性分析2004年6月至2013年11月在解放军总医院进行PSA检查者,所有研究对象进行经直肠超声、经腹部超声以及MRI中的至少1种检查,且均未发现可疑前列腺癌,选取年龄50~80岁、PSA值在4ng/mL以下者纳入研究,共7 584例。分别计算PSA质量和PSA质量比两个参数,分析身体质量指数(BMI)、血容量与PSA、PSA质量和PSA质量比等参数的关系。结果线性回归分析显示,BMI与血容量、前列腺体积均相关(r血容量=0.613,r前列腺体积=0.001,P<0.01)。PSA质量和PSA质量比,均与BMI呈负相关(P<0.05)。当将BMI分成正常组(BMI<23)、超重组(BMI:23~24.9)和肥胖组(BMI>25)时,血容量在各组之间差异明显(P<0.05);PSA、前列腺体积、PSA质量和PSA质量比在正常组和超重组之间无明显差异(P>0.05),在其他组间的差异有统计学意义(P<0.05)。结论 BMI的增加会导致血容量的增大、而对前列腺体积无明显影响,从而通过血液稀释作用影响血清PSA水平。PSA<4ng/mL时,PSA质量比和PSA质量无助于消除BMI对PSA的影响。
OBJECTIVE: To investigate the effect of obesity on the level of serum prostate-specific antigen (PSA) based on Chinese data and the stability of PSA mass and PSA mass ratio at different blood volume and body mass index (BMI) levels. Methods A retrospective analysis of the PLA General Hospital of PLA from June 2004 to November 2013 was performed. All subjects underwent transrectal ultrasound, transabdominal ultrasonography and at least one MRI examination, and found no suspicious prostate cancer, Select the age of 50 to 80 years old, PSA value of 4ng / mL were included in the study, a total of 7 584 cases. The two parameters, PSA mass and PSA mass ratio, were calculated, and the relationship between body mass index (BMI), blood volume and PSA, PSA mass and PSA mass ratio were calculated. Results Linear regression analysis showed that BMI correlated with blood volume and prostate volume (r = 0.613, r = 0.001, P <0.01). PSA mass and PSA mass ratio were negatively correlated with BMI (P <0.05). When BMI was divided into normal group (BMI <23), overweight group (BMI: 23 ~ 24.9) and obesity group (BMI> 25) There was no significant difference between the normal group and the overweight group (P> 0.05). The difference between the other groups was statistically significant (P <0.05). Conclusions The increase of BMI leads to the increase of blood volume, but has no significant effect on the volume of prostate, so the serum PSA level is affected by hemodilution. When PSA <4 ng / mL, PSA mass ratio and PSA mass did not help eliminate the effect of BMI on PSA.