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Circulating Prostate‐Specific Antigen and Telomere Length in a Nationally Representative Sample of Men Without History of Prostate Cancer
Author(s) -
Wulaningsih Wahyu,
Astuti Yuliana,
Matsuguchi Tetsuya,
Anggrandariyanny Putri,
Watkins Johnathan
Publication year - 2017
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23245
Subject(s) - medicine , prostate cancer , national health and nutrition examination survey , confidence interval , body mass index , prostate specific antigen , rectal examination , prostate , cancer , gynecology , oncology , urology , population , environmental health
BACKGROUND We investigated the association of prostate‐specific antigen (PSA) with leukocyte telomere length, which may be altered in preclinical prostate malignancies. METHODS This study was based on the 2001–2002 U.S. National Health and Nutrition Examination Survey (NHANES). A subsample of 1,127 men aged 40–85 years without prior history of prostate cancer who provided informed consent and blood samples were selected. Leukocyte telomere length (LTL) relative to standard DNA reference (T/S ratio) was quantified by polymerase chain reaction (PCR). Survey‐weighted multivariable linear regression was performed to examine T/S ratio across quintiles of total and free PSA and free‐to‐total PSA ratio (%fPSA). A sensitivity analysis was performed by excluding men dying from prostate cancer during follow‐up through to December 31, 2006. Stratification analyses were carried out to assess any effect modification by age group, race, body mass index (BMI), and levels of C‐reactive protein (CRP), a marker of inflammation. RESULTS Higher total PSA levels were associated to longer LTL, with approximately 8% increase in log‐transformed T/S ratio (95% confidence interval [CI]: 2–13%) among men in the highest quintile of total PSA compared to the lowest in the fully adjusted model (P trend = 0.01). No significant association was found for free PSA or %fPSA, although nonlinearity between all PSA measures and T/S ratio was indicated. Similar results were found after excluding men who died from prostate cancer during follow‐up. We also found the associations between total PSA and T/S ratio to be strongest among non‐Hispanic blacks, non‐obese men (BMI <30 kg/m 2 ), and those with low CRP. However, a significant interaction was only found between total PSA and race/ethnicity (P interaction = 0.01). CONCLUSION Total PSA levels were strongly associated to LTL, particularly among non‐Hispanic blacks. Our findings support a potential link between PSA and specific mechanisms contributing to prostate cancer development. Prostate 77:22–32, 2017 . © 2016 Wiley Periodicals, Inc.