Does BMI Impact PSA Concentration By Variation In Plasma Volume?

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Blood / Hematology
Article Date: 26 Jun 2008 - 5:00 PDT

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ORLANDO, FL (UroToday.com) - Recent reports suggest that men with higher BMI have lower PSA concentrations due to dilution of a set PSA amount by a larger plasma volume.

The study published in JAMA in November of 2007, drew such conclusion from a cohort of men that had a known diagnosis of prostate cancer (and went on to prostatectomy). The current report by Grubb and colleagues substantiates the findings in a large cohort of men without prostate cancer.

Data from over 28 thousand men between 55 and 74 years of age who participated in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial were analyzed in this study. BMI and plasma volume were derived from self-reported data. Mean PSA in this group was 1.48 ng/ml, while the mean BMI was 27.0 kg/m2. Higher BMI correlated with higher plasma volumes. Partially adjusted mean PSA levels, on the other hand, decreased with increasing BMI. This relationship between BMI and PSA did not exist when investigators controlled for plasma volume. These data demonstrate that PSA concentrations in prostate-cancer-free men inversely correlate with BMI, due to a rise in plasma volume with increasing BMI.

More research is needed, but one can envision that in the clinical setting PSA may need to be adjusted to plasma volume for obese men.

Presented by Robert L Grubb, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD

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