High serum PSA helps fight off diabetes in men
18 Feb 2021
High serum levels of prostate-specific antigen (PSA) lower the risk of developing type 2 diabetes mellitus (T2DM) in men, reports a recent China study.
The researchers conducted a cohort study with 16,811 nondiabetic men (mean age, 44.9±12.8 years) who had undergone health check-ups between 2009 and 2016. PSA was measured through a chemiluminescent assay. The main outcome of interest was the development of T2DM as defined by a physician diagnosis, self-report, medication use, or lab measurements.
Over a median follow-up of 3.8 years, 1,260 participants developed T2DM. Dividing participants according to PSA quartiles yielded the following stratified incidence rates: 8.2 percent in the lowest quartile, 7.1 percent in the second, 6.4 percent in the third, and 8.3 percent in the topmost.
Despite no apparent difference in T2DM incidence rates, Cox regression analysis adjusted for age revealed that men in the highest vs lowest PSA quartile were almost 30-percent less likely to develop T2DM (hazard ratio [HR], 0.72, 95 percent confidence interval [CI], 0.62–0.84; ptrend<0.001).
Further adjustments for confounders like smoking and drinking, family history of diabetes, cholesterol levels, and marital status weakened the impact of PSA, but could not attenuate significance (p=0.002).
Moreover, the researchers found that the interaction between T2DM risk and PSA was significantly nonlinear (p<0.001). When PSA was within normal levels (<4.0 ng/mL), it exerted a protective effect against incident T2DM.
“Serum PSA concentrations are a common biochemical index recorded during health check-ups, and thus may be used as a biomarker for clinical risk prediction of incident T2DM, and to guide T2DM screening procedures for individualized medicine. This will improve prevention of T2DM and reduce its burden on the population,” the researchers said.
“Additional prospective studies comprising larger sample sizes are needed to validate this association in other populations, and further experimental investigation is needed to determine the exact mechanisms that are involved,” they added.