The Association between prostate specific antigen (PSA) assay and serum nutrients, metabolites and metallic elements profile in adult males (NHANES 2001–2006)

Abstract

Abstract Objectives: Seeing as PSA is a specific indicator to assist in the diagnosis of prostate cancer, the prevention of prostate cancer can be explored from the etiological mechanism of PSA elevation. Therefore, the purpose of this study is to find out the serological risk markers that lead to PSA elevation or prostate cancer. Methods: Our data came from National Health and Nutrition Examination Survey (NHANES, 2001–2006), and we performed multivariate regressions to examine the association between prostate specific antigen (PSA) assay and serum nutrients, metabolites and metallic elements profile in adult males. Results: A total of 4,022 participants were included in this study, and we confirmed suspected prostate cancer significantly positively correlated with lead and homocysteine. Specifically, blood lead (OR = 1.084; 95%CI: 1.043–1.126) and homocysteine (OR = 1.037; 95%CI: 1.017–1.058) are the significant independent risk factors for the increase of serum PSA. The results of random forest model of suspected prostate cancer group and normal prostate group showed that the predictive potentials of serum lead assay and serum homocysteine assay were 79.2% (75.2–83.2%) and 78.0% (74.0–82.1%), respectively. Conclusions: Elevated blood lead and homocysteine levels may be the key risk factors for serum PSA elevation, that is, they may cause prostate cancer. Therefore, reducing blood lead exposure and concentration of metabolite homocysteine may be effective methods to prevent prostate cancer.