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Laguna J, Wijngaard R, Hidalgo S, González-Escribano C, Ortiz V, Bedini JL, Filella X. Asociación entre la 25-hidroxivitamina D y el antígeno prostático específico: un estudio retrospectivo en hombres sin patologías prostáticas. ADVANCES IN LABORATORY MEDICINE 2023; 4:413-418. [PMID: 38106496 PMCID: PMC10724857 DOI: 10.1515/almed-2023-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/01/2023] [Indexed: 12/19/2023]
Abstract
Objetivos Aunque estudios recientes asocian la vitamina D con el cáncer de próstata, otros estudios descartan una asociación entre esta vitamina y el cáncer de próstata o el antígeno prostático específico (PSA). Dado que no se pueden extraer conclusiones de los datos existentes, realizamos un estudio para analizar la relación entre el PSA y la 25-hidroxivitamina D [25(OH)D]. Métodos Un total de 415 sujetos sin patologías prostáticas fueron seleccionados, y se clasificaron por edad y concentraciones de 25(OH)D. El análisis estadístico se realizó con la prueba de Shapiro-Wilk, la prueba t de Student, ANOVA, y el coeficiente de correlación de Pearson. Además, se calculó el tamaño mínimo de muestra requerido para obtener resultados estadísticamente significativos en función de la concentración de 25(OH)D. Así mismo, se realizó la prueba t de Student para muestras pareadas para analizar a los individuos con dos determinaciones de PSA espaciadas en el tiempo en los que las concentraciones de 25(OH)D aumentaron o disminuyeron más de un 25 %. Resultados Observamos una leve correlación entre la edad y el PSA (r=0,379, p<0,001). Sin embargo, al comparar la concentración de PSA entre grupos en función de 25(OH)D, no se hallaron diferencias significativas (p=0,891): 1,25±1,32 μg/L (grupo con 25(OH)D<50 nmol/L) y 1,17±0,90 (grupo con 25(OH)D≥50 nmol/L). El coeficiente de correlación de Pearson fue casi 0. El tamaño mínimo de la muestra necesario para obtener resultados estadísticamente significativos fue de 815.346 hombres. No observamos diferencias en las concentraciones de PSA en los individuos que se sometieron a dos determinaciones. Conclusiones Nuestros resultados muestran que no existe asociación entre los niveles de 25(OH)D y de PSA en hombres sin patologías prostáticas.
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Affiliation(s)
- Javier Laguna
- Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
| | - Robin Wijngaard
- Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
| | - Susana Hidalgo
- Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
| | | | - Victoria Ortiz
- Laboratorio CORE, CDB, Hospital Clínic de Barcelona, BarcelonaEspaña
| | - José Luis Bedini
- Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
- Laboratorio CORE, CDB, Hospital Clínic de Barcelona, BarcelonaEspaña
| | - Xavier Filella
- Servicio de Bioquímica y Genética Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, España
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Laguna J, Wijngaard R, Hidalgo S, González-Escribano C, Ortiz V, Bedini JL, Filella X. Association between serum 25-hydroxyvitamin D and prostate-specific antigen: a retrospective study in men without prostate pathology. ADVANCES IN LABORATORY MEDICINE 2023; 4:408-412. [PMID: 38106489 PMCID: PMC10724855 DOI: 10.1515/almed-2023-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/01/2023] [Indexed: 12/19/2023]
Abstract
Objectives Recently, vitamin D status has been associated with prostate cancer risk. However, some studies argue that there is no association of vitamin D with prostate cancer risk and serum prostate-specific antigen (PSA) concentrations. No clear conclusions can be drawn from the studies found in the literature. Our aim was to assess the relationship between PSA and 25-hydroxyvitamin D [25(OH)D]. Methods We selected 415 individuals without prostate pathologies and subgroups were generated according to age and 25(OH)D. Statistical analyses were performed using Shapiro-Wilk test, Student's t and ANOVA tests, and Pearson's correlation. Besides, the minimum sample size needed to obtain statistically significant results between groups according to 25(OH)D concentration was calculated and a Student's t-test for paired samples was performed to study individuals with two PSA measurements over time, where 25(OH)D concentration increased or decreased more than 25 %. Results We observed a slight correlation between age and PSA concentration (r=0.379, p<0.001). However, we found no significant differences when we compared PSA concentrations between groups according to 25(OH)D concentrations (p=0.891): 1.25 ± 1.32 μg/L (group with 25(OH)D<50 nmol/L) and 1.17 ± 0.90 (group with 25(OH)D≥50 nmol/L). Pearson's correlation coefficient was close to 0. The minimum samples size to obtain statistically significant results was 815,346 men, and we observed no differences in PSA concentrations in individuals with two measurements. Conclusions Our findings show no association in men without prostate pathologies, based on 25(OH)D levels.
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Affiliation(s)
- Javier Laguna
- Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Robin Wijngaard
- Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Susana Hidalgo
- Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | - Victoria Ortiz
- CORE Laboratory, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
| | - José Luis Bedini
- Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
- CORE Laboratory, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Xavier Filella
- Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic of Barcelona, Barcelona, Spain
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Wang A, Lazo M, Lu J, Couper DJ, Prizment AE, Vitolins MZ, Denmeade SR, Joshu CE, Platz EA. Liver Fibrosis Scores and Prostate Cancer Risk and Mortality in the Atherosclerosis Risk in Communities Study. Cancer Prev Res (Phila) 2023; 16:523-530. [PMID: 37339266 PMCID: PMC10527661 DOI: 10.1158/1940-6207.capr-23-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023]
Abstract
Subclinical liver impairment due to fibrosis could influence the development and detectability of prostate cancer. To investigate the association between liver fibrosis and prostate cancer incidence and mortality, we included 5,284 men (mean age: 57.6 years, 20.1% Black) without cancer or liver disease at Visit 2 in the Atherosclerosis Risk in Communities study. Liver fibrosis was assessed using the aspartate aminotransferase to platelet ratio index, fibrosis 4 index (FIB-4), and nonalcoholic fatty liver disease fibrosis score (NFS). Over 25 years, 215 Black and 511 White men were diagnosed with prostate cancer, and 26 Black and 51 White men died from the disease. We estimated HRs for total and fatal prostate cancer using Cox regression. FIB-4 [quintile 5 vs. 1: HR = 0.47, 95% confidence interval (CI): 0.29-0.77, Ptrend = 0.004] and NFS (HR = 0.56, 95% CI: 0.33-0.97, Ptrend = 0.03) were inversely associated with prostate cancer risk in Black men. Compared with no abnormal score, men with ≥1 abnormal score had a lower prostate cancer risk if they were Black (HR = 0.46, 95% CI: 0.24-0.89), but not White (HR = 1.04, 95% CI: 0.69-1.58). Liver fibrosis scores did not appear to be associated with fatal prostate cancer in Black or White men. Among men without a clinical diagnosis of liver disease, higher liver fibrosis scores were associated with lower incidence of prostate cancer in Black men, but not in White men, and not with fatal prostate cancer in either race. Further research is needed to understand the influence of subclinical liver disease on prostate cancer development versus detectability and the racial differences observed. PREVENTION RELEVANCE Investigating the link between liver fibrosis and prostate cancer risk and mortality, our study reveals the potential influence of liver health on prostate cancer development and on detection using PSA test, urging further research to understand the differential findings by race and to optimize prevention and intervention strategies.
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Affiliation(s)
- Anqi Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Public and Population Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mariana Lazo
- Department of Community Health and Prevention and the Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Jiayun Lu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David J. Couper
- Department of Biostatistics, University of North Carolina at Chapel Gillings Hill School of Global Public Health, Chapel Hill, North Carolina
| | - Anna E. Prizment
- Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota and the Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Mara Z. Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Samuel R. Denmeade
- Department of Oncology, Johns Hopkins University School of Medicine, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Corinne E. Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Wang A, Lazo M, Carter HB, Groopman JD, Nelson WG, Platz EA. Association between Liver Fibrosis and Serum PSA among U.S. Men: National Health and Nutrition Examination Survey (NHANES), 2001-2010. Cancer Epidemiol Biomarkers Prev 2019; 28:1331-1338. [PMID: 31160348 DOI: 10.1158/1055-9965.epi-19-0145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/09/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To evaluate the association of liver fibrosis scores with PSA level among U.S. adult men overall and by race/ethnicity. METHODS Data from the National Health and Nutrition Examination Survey (NHANES), 2001-2010, were used. Males ages ≥40 years without a prostate cancer diagnosis and who had serum PSA, liver enzymes, albumin, and platelet counts measured as part of NHANES protocol were included. Liver fibrosis was measured using three scores: aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 index (FIB-4), and NAFLD fibrosis score (NFS). We assessed overall and race/ethnicity-stratified geometric mean PSA by fibrosis score using predictive margins by linear regression, and the association of abnormal fibrosis scores (APRI > 1, FIB-4 > 2.67, NFS > 0.676) and elevated PSA (>4 ng/mL) by logistic regression. RESULTS A total of 6,705 men were included. Abnormal liver fibrosis scores were present in 2.1% (APRI), 3.6% (FIB-4), and 5.6% (NFS). Men with higher fibrosis scores had lower geometric mean PSA (all P trend < 0.02). Men with abnormal APRI had a lower odds of PSA > 4 ng/mL [adjusted OR (aOR) = 0.33; 95% confidence interval (CI), 0.11-0.96]. Compared with men with 0 abnormal scores, those with 2 or 3 abnormal fibrosis scores had a lower odds of PSA > 4 ng/mL (aOR = 0.55; 95% CI, 0.33-0.91). The patterns were similar by race/ethnicity. CONCLUSIONS Men of all race/ethnicities with higher liver fibrosis scores had lower serum PSA, and men with advanced fibrosis scores had a lower odds of an elevated PSA. IMPACT These findings support further research to inform the likelihood of delay in prostate cancer detection in men with abnormal liver function.
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Affiliation(s)
- Anqi Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. .,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mariana Lazo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland
| | - H Ballentine Carter
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - John D Groopman
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - William G Nelson
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
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Tonyali S, Aksoy E, Sobaci E, Akdogan M, Ceylan C, Bostancı EB, Akoglu M. Is Serum Prostate-Specific Antigen a Reliable Prostate Cancer Marker in Liver Transplant Candidates. EXP CLIN TRANSPLANT 2018; 17:536-539. [PMID: 29619912 DOI: 10.6002/ect.2017.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES In this study, we aimed to determine whether the prostate-specific antigen level is a reliable marker of prostate cancer in patients with hepatic insufficiency, based on evaluation of alterations in serum prostate-specific antigen levels after liver transplant in patients with hepatic insufficiency. MATERIALS AND METHODS Medical records of all patients who underwent liver transplant at our hospital between January 2003 and June 2017 were retrospectively reviewed. Male patients who were > 40 years old with available pre- and posttransplant serum total prostate-specific antigen levels were included in the study. RESULTS Our study included 36 male patients with a mean age of 54.6 ± 5.3 years (range, 45-73 y) at the time of liver transplant. The mean pretransplant serum total prostate-specific antigen level was 0.75 ± 0.77 ng/mL, which was significantly lower than the mean posttransplant level of 1.29 ± 1.57 ng/mL (P < .05). The pretransplant serum total prostate-specific antigen level was measured a mean of 4.9 ± 5.4 months before liver transplant versus a mean 27.6 ± 16.3 months after transplant. Prostate-specific antigen velocity was 0.2 ng/mL/year. Biochemical tests of liver function, including the mean serum levels of bilirubin, international normalized ratio, and albumin, were normal after liver transplant at 1.37 ± 2.33 mg/dL, 1.22 ± 0.36, and 4.16 ± 0.69 g/dL, respectively. CONCLUSIONS Serum prostate-specific antigen levels may decrease in patients with hepatic insufficiency/cirrhosis; therefore, a low serum prostate-specific antigen level may not be a reliable marker for excluding prostate cancer in such patients. Transplant surgeons and clinicians must be aware of this so that all male transplant candidates > 40 years old are evaluated via digital rectal examination, regardless of the serum prostate-specific antigen level.
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Affiliation(s)
- Senol Tonyali
- From the Clinic of Urology, University of Health Sciences, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Bubnov RV, Drahulian MV, Buchek PV, Gulko TP. High regenerative capacity of the liver and irreversible injury of male reproductive system in carbon tetrachloride-induced liver fibrosis rat model. EPMA J 2018; 9:59-75. [PMID: 29515688 PMCID: PMC5833895 DOI: 10.1007/s13167-017-0115-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/17/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Liver fibrosis (LF) is a chronic disease, associated with many collateral diseases including reproductive dysfunction. Although the normal liver has a large regenerative capacity the complications of LF could be severe and irreversible. Hormone and sex-related issues of LF development and interactions with male reproductive have not been finally studied. The aim was to study the reproductive function of male rats in experimental CCl4-induced liver fibrosis rat model, and the capability for restoration of both the liver and male reproduction system. MATERIALS Studies were conducted on 20 3-month old Wistar male rats. The experimental animals were injected with freshly prepared 50% olive oil solution of carbohydrate tetrachloride (CCl4). On the 8th week after injection we noted the manifestations of liver fibrosis. The rats were left to self-healing of the liver for 8 weeks. All male rats underwent ultrasound and biopsy of the liver and testes on the 8th and 16th weeks. The male rats were mated with healthy females before CCl4 injection, after modeling LF on the 8th week, and after self-healing of the liver. Pregnancy was monitored on ultrasound. RESULTS On the 8th week of experiment we observed ultrasound manifestation of advanced liver fibrosis, including hepatosplenomegaly, portal hypertension. Ultrasound exam of the rat testes showed testicular degeneration, hydrocele, fibrosis, scarring, petrifications, size reduction, and restriction of testicular descent; testes size decreased from 1.24 ± 0.62 ml to 0.61 ± 0.13, p < 0.01. Liver histology showed granular dystrophy of hepatocytes, necrotic areas, lipid inclusions in parenchyma. Rats with liver fibrosis demonstrated severe injury of the reproductive system and altering of fertility: the offspring of male rats with advanced LF was 4.71 ± 0.53 born alive vs 9.55 ± 0.47 born from mating with healthy males, p < 0.001. Eight weeks after last CCl4 injection, we revealed signs of liver regeneration, significant recovery of its structure. The ALT and AST levels significantly decreased and reached background measurements. As a result of the second interbreeding after liver self-healing no significant difference was found vs previous mating. CONCLUSION Carbohydrate tetrachloride induces injury of liver parenchyma evoking fast and severe liver fibrosis, and is associated with irreversible structural and functional changes in testes, reducing fertility, decreasing potential pregnancy rate, and affecting its development. Liver showed high potential to regenerate, however the self-restoring after liver fibrosis was not accompanied with recovery of the reproductive system.
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Affiliation(s)
- Rostyslav V. Bubnov
- Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Zabolotny Str., 154, Kyiv, 03143 Ukraine
- Clinical Hospital ‘Pheophania’ of State Affairs Department, Zabolotny str., 21, Kyiv, 03143 Ukraine
| | - Maria V. Drahulian
- Institute of Molecular Biology and Genetics, National Academy of Sciences of Ukraine, Zabolotny str., 150, Kyiv, 03143 Ukraine
| | - Polina V. Buchek
- Institute of Molecular Biology and Genetics, National Academy of Sciences of Ukraine, Zabolotny str., 150, Kyiv, 03143 Ukraine
| | - Tamara P. Gulko
- Institute of Molecular Biology and Genetics, National Academy of Sciences of Ukraine, Zabolotny str., 150, Kyiv, 03143 Ukraine
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Yoon JH, Yang HJ, Kim JH, Doo SW, Yang WJ, Hwang J, Hong SS, Park S, Cho DY. The likelihood of having a serum PSA level of ≥2.5 ng/mL according to the degree of fatty liver disease in a screened population. Can Urol Assoc J 2016; 9:E868-72. [PMID: 26788237 DOI: 10.5489/cuaj.2395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to investigate the impact of fatty liver disease (FLD) on prostate cancer (PCa) screening by estimating the odds of having a prostate-specific antigen (PSA) value over the cutoff used to prompt for the recommendation of prostate biopsy. METHODS Between 2007 and 2013, 18 533 native Korean men eligible to receive a serum PSA test, liver profiles, and abdominal ultrasonography were recruited. Logistic regression was used to estimate the odds of an abnormal PSA (≥2.5 ng/mL) in these men (age 45-75 years, PSA≤10 ng/mL) in relation to FLD. The FLD status was categorized as normal, mild, moderate, and severe grade by abdominal sonography. RESULTS A total of 16 563 men (89.4%) were included in the study after applying the inclusion criteria. Liver profiles were negatively correlated with the serum PSA level. After controlling for age and obesity, there was a statistically significant trend towards a lower likelihood of having a serum PSA level of ≥2.5 ng/mL with severe FLD, having a 34.7% lower likelihood (odds ratio 0.653, 95% confidence interval 0.477-0.88; p<0.01) compared to men in the normal group. CONCLUSIONS Severe FLD is an independent predictor of a lower likelihood of having abnormal PSA level. Further studies are needed to better define these results in clinical biopsy practice.
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Affiliation(s)
- Jong Hyun Yoon
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchungyang University, College of Medicine, Seoul, Republic of Korea
| | - Dae Yeon Cho
- Department of Urology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Urologische Aspekte bei Patienten mit Leberzirrhose. Urologe A 2016; 55:63-7. [DOI: 10.1007/s00120-015-3978-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tillou X, Chiche L, Guleryuz K, Hervé S, Bensadoun H, Doerfler A. Prostate carcinoma in liver transplant recipients: Think about it! Urol Oncol 2015; 33:265.e9-13. [DOI: 10.1016/j.urolonc.2015.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 12/17/2022]
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Saad RA, Mahmoud YI. Ursodeoxycholic acid alleviates cholestasis-induced histophysiological alterations in the male reproductive system of bile duct-ligated rats. Reprod Toxicol 2014; 50:87-97. [PMID: 25461907 DOI: 10.1016/j.reprotox.2014.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/18/2014] [Accepted: 10/11/2014] [Indexed: 10/24/2022]
Abstract
Ursodeoxycholic acid is the most widely used drug for treating cholestatic liver diseases. However, its effect on the male reproductive system alterations associated with cholestasis has never been studied. Thus, this study aimed to investigate the effect of ursodeoxycholic acid on cholestasis-induced alterations in the male reproductive system. Cholestasis was induced by bile duct ligation. Bile duct-ligated rats had higher cholestasis biomarkers and lower levels of testosterone, LH and FSH than did the Sham rats. They also had lower reproductive organs weights, and lower sperm motility, density and normal morphology than those of Sham rats. Histologically, these animals suffered from testicular tubular atrophy, interstitial edema, thickening of basement membranes, vacuolation, and depletion of germ cells. After ursodeoxycholic acid administration, cholestasis-induced structural and functional alterations were significantly ameliorated. In conclusion, ursodeoxycholic acid can ameliorate the reproductive complications of chronic cholestasis in male patients, which represents an additional benefit to this drug.
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Affiliation(s)
- Ramadan A Saad
- Physiology Department, Faculty of Medicine, Ain Shams University, Abbassia 11566, Cairo, Egypt
| | - Yomna I Mahmoud
- Zoology Department, Faculty of Science, Ain Shams University, Abbassia 11566, Cairo, Egypt.
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11
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Mustafa M, Horuz R, Celik M, Kucukcan A. Is there an association between serum prostate-specific antigen values and serum testosterone levels in healthy men? Korean J Urol 2014; 55:465-8. [PMID: 25045445 PMCID: PMC4101116 DOI: 10.4111/kju.2014.55.7.465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 07/24/2013] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate the relationship between levels of total testosterone and total prostate-specific antigen (PSA) in healthy men with PSA<4 ng/mL. Materials and Methods The study comprised 179 men with a mean age of 59.19±12 years who visited Osmaniye State Hospital, Osmaniye, Turkey, between January 2006 and January 2007 for a routine checkup. The patients were divided into two subgroups: patients with PSA<2.5 mg/ml (group I, n=160 patients) and patients with PSA of 2.5 to 4 ng/mL (group II, n=19 patients). The relationship between PSA and testosterone levels was investigated in both groups and in patients aged <60 years. The mean testosterone level was calculated for patients aged <50 years and was compared with the mean value of patients aged ≥50 years. Results In all patients, the mean values for serum PSA and total testosterone were 1.27±0.88 ng/mL and 404.04±158.86 ng/mL, respectively. No correlation was detected between serum PSA and testosterone levels in either subgroup (group I, r=0.072, p=0.363; group II, r=0.031, p=0.900) or in patients aged <60 years (r=0.032, p=0.72). The mean values of testosterone in patients aged ≥50 years and in patients aged <50 years were 417.01±163.35 and 344.16±120.21 ng/dL, respectively (p=0.02). Conclusions No impact of testosterone was found on the PSA level in healthy men with PSA <4 ng/mL. Therefore, a high serum testosterone level may not mandate adjustment of PSA values. This serum sex hormone showed a significant increment after the age of 50 years. Further studies including a larger number of patients should be carried out to confirm these findings.
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Affiliation(s)
- Mahmoud Mustafa
- Urology Department, School of Medicine and Health Science, An-Najah University, Nablus, West-Bank, Palestine
| | - Rahim Horuz
- Department of Urology, Kartal Teaching Hospital, Istanbul, Turkey
| | - Metin Celik
- Department of Biochemistry, Osmaniye state Hospital, Osmaniye, Turkey
| | - Akif Kucukcan
- Department of Biochemistry, Osmaniye state Hospital, Osmaniye, Turkey
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Margreiter M, Heinisch BB, Schwarzer R, Klatte T, Shariat SF, Ferlitsch A. Lower urinary tract symptoms in patients with liver cirrhosis. World J Urol 2014; 33:315-21. [PMID: 24798455 DOI: 10.1007/s00345-014-1313-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 04/26/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the prevalence of lower urinary tract symptoms (LUTS) in men with liver cirrhosis. METHODS In total, 128 men with known liver cirrhosis were prospectively evaluated using the validated German version of the International Prostate Symptom Score (IPSS) questionnaire. In parallel, all men underwent a detailed examination including medical history; physical examination; Child-Pugh liver function score (CPS) assessment; and measurement of blood levels of prostate-specific antigen (PSA), total and free testosterone, sexual hormone-binding globulin (SHBG), prolactin, luteotropic hormone (LH), and follicle-stimulating hormone (FSH). RESULTS Mean patient age and mean IPSS was 56 ± 9 years and 8 ± 6, respectively. Mild (IPSS: 1-7), moderate (IPSS: 8-19), and severe (IPSS: 20-35) LUTS were present in 60.2 % (77/128), 31.3 % (40/128), and 7.0 % (9/128) of the patients, respectively. Storage symptoms increased with the CPS (p = 0.04). Voiding symptoms and overall IPSS did not differ between the CPS groups (p = 0.93 and p = 0.67). No correlation was found between ascites volume and IPSS, storage symptoms, voiding symptoms, or quality of life (QoL) (p = 0.46, p = 0.26, p = 0.81, p = 0.87). From CPS groups A to C, mean PSA levels (p = 0.04), total and free testosterone levels (p < 0.001 and p < 0.001), and SHBG levels decreased (p = 0.03); however, prolactin levels increased (p = 0.03). LH and FSH levels did not differ between the CPS groups (p = 0.15 and p = 0.35). CONCLUSIONS Men with liver cirrhosis commonly have LUTS, with a predominance of storage symptoms. Liver cirrhosis may also affect PSA-based prostate cancer risk assessment. Accurate diagnosis and therapy strategies are warranted to improve the QoL of these patients.
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Affiliation(s)
- Markus Margreiter
- Department of Urology, General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,
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The investigation of total PSA, free PSA, and free/total PSA ratio in patients with liver cirrhosis patients according to Child-Pugh score. Urology 2013; 81:617-22. [PMID: 23332995 DOI: 10.1016/j.urology.2012.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/08/2012] [Accepted: 11/13/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency. METHODS Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters. RESULTS The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score. CONCLUSION The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA.
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Li CC, Yang CR, Yu CC, Chen CS, Cheng CL, Ou YC, Ho HC, Hung SW, Li JR. Hepatic failure-induced hypogonadism in a prostate cancer patient. J Chin Med Assoc 2010; 73:389-92. [PMID: 20688306 DOI: 10.1016/s1726-4901(10)70083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 04/22/2010] [Indexed: 11/27/2022] Open
Abstract
Hypogonadism owing to systemic diseases in prostate cancer is rare. Here, we present a patient with metastatic prostate cancer to the pericardium who had low serum testosterone level due to hepatic failure. The patient had cardiac tamponade, and pericardiocentesis revealed sanguineous exudate. Cytology revealed adenocarcinoma. High serum prostate-specific antigen level of 244 ng/mL was detected. The patient experienced complications of stress gastric and duodenal ulcer perforation and underwent subtotal gastrectomy. Perioperative intra-abdominal inflammatory process caused subsequent cholestasis and hepatic dysfunction. Transrectal ultrasound-guided prostate biopsy confirmed prostate cancer. Hypogonadism and a gradual decline in prostate-specific antigen were detected without any hormone therapy. The patient died due to hepatic failure in the 12(th) postoperative week.
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Affiliation(s)
- Chien-Chang Li
- National Chung-Hsing University, Taichung, Taiwan, R.O.C
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