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Wei B, Tan W, Wang S, Guo Z, Gan S. Interaction between smoking status and dietary selenium intake affects PSA: A cross-sectional study. Urol Oncol 2023; 41:483.e1-483.e9. [PMID: 37940471 DOI: 10.1016/j.urolonc.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/30/2023] [Accepted: 07/28/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Conflicting results regarding the impact of selenium on reducing prostate cancer have been reported. The current analysis aimed to understand whether there are potential factors affecting the relationship between selenium and prostate cancer. OBJECTIVE To clarify the relationship between dietary selenium intake and prostate cancer, we evaluated the correlation between dietary selenium intake and prostate-specific antigen (PSA) based on the National Health and Nutrition Examination Survey (NHANES) database. METHODS After screening the NHANES survey data from 2005 to 2010, data for 3,614 of 31,034 participants were considered suitable to include in our study. Dietary selenium intake was the independent variable of our study, while PSA was the dependent variable. We stratified participants into current, former, and never smokers and performed an interaction test on the relationship between selenium intake and PSA using multivariable logistic regression for each smoking-status subgroup. RESULTS For our subgroup analysis, we grouped participants based on smoking status and investigated the association between dietary selenium intake and PSA levels. Among the 242 participants with a PSA level of 4 or higher, the mean age was 58.5 years (±12.1). After adjusting for covariates, we did not find a significant association between dietary selenium and the odds of having a high PSA level. However, we observed a significant interaction between smoking status and dietary selenium in relation to PSA levels (P = .007). Specifically, smokers had lower odds of having high PSA levels, while nonsmokers had higher odds. This suggests that smoking status may modify the effect of dietary selenium on PSA levels. CONCLUSION Our findings suggest that smoking status affects the relationship between dietary selenium intake and PSA and that smokers are at lower odds of having a high PSA level.
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Affiliation(s)
- Baian Wei
- The Second School of Clinical Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenyue Tan
- The Second School of Clinical Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shusheng Wang
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhenlang Guo
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shu Gan
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Hsieh TF, Chen HL, Hsia YF, Lin CC, Chiang HY, Wu MY, Chen SH, Hsieh PF, Wu HC, Chang H, Kuo CC. Age-specific percentile-based prostate-specific antigen cutoff values predict the risk of prostate cancer: A single hospital observation. Biomedicine (Taipei) 2023; 13:9-24. [PMID: 37937061 PMCID: PMC10627214 DOI: 10.37796/2211-8039.1415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/18/2023] [Accepted: 06/28/2023] [Indexed: 11/09/2023] Open
Abstract
Background Testing for prostate-specific antigen (PSA) is often recommended for men with a potential risk of prostate cancer (PCa) before requiring advanced examination. However, the best PSA cutoff value remains controversial. Object We compared the predictive performance of age-specific percentile-based PSA thresholds with a conventional cutoff of >4 ng/mL for the risk of PCa. Methods We included men who received PSA measurements between 2003 and 2017 in a medical center in Taiwan. Logistic regression modeling was used to assess the association between age-specific percentile-based PSA thresholds and PCa risk in age subgroups. We further applied C-statistic and decision curve analysis to compare the predictive performance of age-specific percentile-based PSA with that of a conventional cutoff PSA. Results We identified 626 patients with PCa and 40 836 patients without PCa. The slope of PSA in patients >60-year-old was almost 3 times that of those <60-year-old (0.713 vs 0.259). The risk effect sizes of the 75th percentile PSA cutoff (<60-year-old: 2.19; 60-70-year-old: 4.36; >70-year-old: 5.84 ng/mL) were comparable to those observed based on the conventional cutoff in all age groups. However, the discrimination performance of the 75th percentile PSA cutoff was better than that of the conventional cutoff among patients aged <60-year-old (C-statistic, 0.783 vs. 0.729, p < 0.05). The 75th percentile cutoffs also correctly identified an additional 2 patients with PCa for every 100 patients with PSA screening at the threshold probability of 20%. Conclusions Our data support the use of the 75th percentile PSA cutoff to facilitate individualized risk assessment, particularly for patients aged <60-year-old.
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Affiliation(s)
- Teng-Fu Hsieh
- Division of Urology, Department of Surgery, Taichung Tzu Chi Hospital, Taichung,
Taiwan
| | - Hung-Lin Chen
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Ying-Fang Hsia
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Che-Chen Lin
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Hsiu-Yin Chiang
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Min-Yen Wu
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Sheng-Hsuan Chen
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
| | - Po-Fan Hsieh
- Department of Urology, China Medical University Hospital, Taichung,
Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung,
Taiwan
- Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin,
Taiwan
| | - Hsi-Chin Wu
- Department of Urology, China Medical University Hospital, Taichung,
Taiwan
- Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin,
Taiwan
| | - Han Chang
- Department of Pathology, China Medical University Hospital, Taichung,
Taiwan
| | - Chin-Chi Kuo
- Big Data Center, China Medical University Hospital, Taichung,
Taiwan
- College of Medicine, China Medical University, Taichung,
Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung,
Taiwan
- Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung,
Taiwan
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Zhang W, Zhang K. Quantifying the Contributions of Environmental Factors to Prostate Cancer and Detecting Risk-Related Diet Metrics and Racial Disparities. Cancer Inform 2023; 22:11769351231168006. [PMID: 37139178 PMCID: PMC10150431 DOI: 10.1177/11769351231168006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
The relevance of nongenetic factors to prostate cancer (PCa) has been elusive. We aimed to quantify the contributions of environmental factors to PCa and identify risk-related diet metrics and relevant racial disparities. We performed a unique analysis of the Diet History Questionnaire data of 41 830 European Americans (EAs) and 1282 African Americans (AAs) in the PLCO project. The independent variables in the regression models consisted of age at trial entry, race, family history of prostate cancer (PCa-fh), diabetes history, body mass index (BMI), lifestyle (smoking and coffee consumption), marital status, and a specific nutrient/food factor (X). P < .05 and a 95% confidence interval excluding zero were adopted as the criteria for determining a significant difference (effect). We established a priority ranking among PCa risk-related genetic and environmental factors according to the deviances explained by them in the multivariate Cox-PH regression analysis: age > PCa-fh > diabetes ⩾ race > lifestyle ⩾marital-status ⩾BMI > X. We confirmed previous studies showing that (1) high protein and saturated fat levels in diet were related to increased PCa risk, (2) high-level supplementary selenium intake was harmful rather than beneficial for preventing PCa, and (3) supplementary vitamin B6 was beneficial for preventing benign PCa. We obtained the following novel findings: high-level organ meat intake was an independent predictor for increased aggressive PCa risk; supplementary iron, copper and magnesium increased benign PCa risk; and the AA diet was "healthy" in terms of the relatively lower protein and fat levels and was "unhealthy" in that it more commonly contained organ meat. In conclusion, we established a priority ranking among the contributing factors for PCa and identified several risk-related diet metrics and the racial disparities. Our findings suggested some new approaches to prevent PCa such as restriction of organ meat intake and supplementary microminerals.
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Affiliation(s)
- Wensheng Zhang
- Bioinformatics Core of Xavier NIH RCMI
Center of Cancer Research, Xavier University of Louisiana, New Orleans, LA,
USA
| | - Kun Zhang
- Bioinformatics Core of Xavier NIH RCMI
Center of Cancer Research, Xavier University of Louisiana, New Orleans, LA,
USA
- Department of Computer Science, Xavier
University of Louisiana, New Orleans, LA, USA
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Xu K, Yan Y, Cheng C, Li S, Liao Y, Zeng J, Chen Z, Zhou J. The relationship between serum albumin and prostate-specific antigen: A analysis of the National Health and Nutrition Examination Survey, 2003-2010. Front Public Health 2023; 11:1078280. [PMID: 36950094 PMCID: PMC10025559 DOI: 10.3389/fpubh.2023.1078280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
Background Previous studies have shown that serum albumin is associated with prostate cancer (PCa), but not with prostate-specific antigen (PSA) levels in populations without PCa history. Therefore, we analyzed secondary data provided by the National Health and Nutrition Examination Survey (NHANES) (2003-2010). Methods In total, 5,469 participants were selected from the NHANES database (2003-2010). Serum albumin and PSA levels were serially considered independent and dependent variables, serially. A number of covariates were included in this study, including demographic, dietary, physical examination, and comorbidity data. Using weighted linear regression model and smooth curve fitting, the linear and non-linear relationship between serum albumin and PSA was investigated. Results After modulating underlying interference factors, the weighted multivariate linear regression analysis revealed that serum albumin did not independently predict PSA levels (β = -0.009 95%CI: -0.020, 0.002). Nevertheless, a non-linear relationship was found between serum albumin and PSA, with a point of 41 g/L. Left of the inflection point, the effect size, 95%CI, and P-value were 0.019 (log2 transformation) (-0.006, 0.043) and 0.1335, respectively. We found a negative association between serum albumin and PSA on the right side of the inflection point, with effect size, 95%CI, and a P-value of -0.022 (log2 transformation) (-0.037, -0.007), 0.0036. Conclusion In summary, serum albumin and PSA levels are not linearly related. When serum albumin levels exceed 41 g, serum albumin levels are negatively associated with PSA levels.
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Wei C, Chen Y, Yang Y, Ni D, Huang Y, Wang M, Yang X, Chen Z. Assessing volatile organic compounds exposure and prostate-specific antigen: National Health and Nutrition Examination Survey, 2001–2010. Front Public Health 2022; 10:957069. [PMID: 35968491 PMCID: PMC9372286 DOI: 10.3389/fpubh.2022.957069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundVolatile organic compounds (VOCs) are a large group of chemicals widely used in people's daily routines. Increasing evidence revealed the VOCs' accumulating toxicity. However, the VOCs toxicity in male prostate has not been reported previously. Thus, we comprehensively evaluated the association between VOCs and prostate-specific antigen (PSA).MethodsA total of 2016 subjects were included in our study from the National Health and Nutrition Examination Survey with VOCs, PSA, and other variables among U.S. average population. We constructed XGBoost Algorithm Model, Regression Model, and Generalized linear Model (GAM) to analyze the potential association. Stratified analysis was used to identify high-risk populations.ResultsXGBoost Algorithm model identified blood chloroform as the most critical variable in the PSA concentration. Regression analysis suggested that blood chloroform was a positive association with PSA, which showed that environmental chloroform exposure is an independent risk factor that may cause prostate gland changes [β, (95% CI), P = 0.007, (0.003, 0.011), 0.00019]. GAM observed the linear relationship between blood chloroform and PSA concentration. Meanwhile, blood chloroform linear correlated with water chloroform in the lower dose range, indicating that the absorption of water may be the primary origin of chloroform. Stratified associations analysis identified the high-risk group on the chloroform exposures.ConclusionThis study revealed that blood chloroform was positively and independently associated with total PSA level, suggesting that long-term environmental chloroform exposure may cause changes in the prostate gland.
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Affiliation(s)
- Chengcheng Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yumao Chen
- Department of Urology, Ezhou Central Hospital, Ezhou, China
| | - Yu Yang
- Department of Pathologist and Laboratory Medicine, Staff Pathologist, Deaconess Hospital, Evansville, IN, United States
| | - Dong Ni
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Huang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiong Yang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xiong Yang
| | - Zhaohui Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Zhaohui Chen
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Alzahrani MA, Shakil Ahmad M, Alkhamees M, Aljuhayman A, Binsaleh S, Tiwari R, Almannie R. Dietary protein intake and prostate cancer risk in adults: A systematic review and dose-response meta-analysis of prospective cohort studies. Complement Ther Med 2022; 70:102851. [PMID: 35820576 DOI: 10.1016/j.ctim.2022.102851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to conduct a comprehensive systematic review and dose-response meta-analysis to summarize available findings on the associations between dietary protein intake and prostate cancer risk as well as the dose-response associations of total, animal, plant, and dairy protein intake with prostate cancer risk. METHODS This study followed the 2020 PRISMA guideline. We conducted a systematic search in the online databases of PubMed, Scopus, ISI Web of Science, and Google Scholar to detect eligible prospective studies published to October 2021 that assessed total, animal, plant, and dairy protein intake in relation to prostate cancer risk. RESULTS Overall, 12 articles containing prospective studies with a total sample size of 388,062 individuals and 30,165 cases of prostate cancer were included. The overall relative risks (RRs) of prostate cancer, comparing the highest and lowest intakes of total, animal, plant, and dairy protein intake, were 0.99 (95% CI: 92-1.07, I2 =12.8%), 0.99 (95% CI: 95-1.04, I2 =0), 1.01 (95% CI: 96-1.06, I2 =0), and 1.08 (95% CI: 1.00-1.16, I2 =38.1%), respectively, indicating a significant positive association for dairy protein intake (P = 0.04) and non-significant associations for other protein types. However, this positive association was seen among men who consumed ≥ 30 gr/day of dairy protein, such that a 20 g/d increase in dairy protein intake (equal to 2.5 cups milk or yogurt) was associated with a 10% higher risk of prostate cancer (Pooled RR: 1.10, 95% CI: 1.02-1.20, I2 = 42.5%). Such dose-response association was not seen for total, animal, and plant protein intake. CONCLUSION Overall, dairy protein intake may increase the risk of prostate cancer in men who consumed > 30 gr/day of dairy protein. Larger, well-designed studies are still required to further evaluation of this association.
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Affiliation(s)
- Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.
| | - Mohammad Shakil Ahmad
- Department of Community Medicine and Public Health, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mohammad Alkhamees
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Ahmed Aljuhayman
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Saleh Binsaleh
- Section of Urology, Department of Surgery, King Saud University, College of Medicine, King Saud University Medical City, Saudi Arabia
| | - Rahul Tiwari
- Consultant Urologist in Kailash Hospital, Noida, India
| | - Raed Almannie
- Section of Urology, Department of Surgery, King Saud University, College of Medicine, King Saud University Medical City, Saudi Arabia
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Mouzannar A, Kuchakulla M, Blachman-Braun R, Nackeeran S, Becerra M, Nahar B, Punnen S, Ritch C, Parekh DJ, Gonzalgo ML. Impact of Plant-Based Diet on PSA Level: Data From the National Health and Nutrition Examination Survey. Urology 2021; 156:205-210. [PMID: 34303759 DOI: 10.1016/j.urology.2021.05.086] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine the potential association between plant-based dietary content and PSA levels among men enrolled in the National Health and Nutrition Examination Survey (NHANES). METHODS Data on demographics, diet, and PSA levels was acquired from the NHANES database. Plant-based diet index (PDI) and healthful plant-based diet index (hPDI) were calculated using food frequency questionnaires. A higher score on PDI and hPDI indicates higher consumption of plant foods or healthy plant foods, respectively. Multivariable-adjusted logistic regression analysis was performed to determine the association between elevated PSA, clinical variables, demographics, and plant-based diet indices. RESULTS A total of 1399 men were included in the final cohort. Median age of participants was 54 [46-63] years. Median PSA level was 0.9 [0.6-1.5] ng/dL, and 69 (4.9%) men had a PSA level ≥4 ng/dL. Although there was no association between elevated PSA and PDI, on multivariable analysis patients with higher consumption of healthy plant-based diet (high hPDI scores) had a decreased probability of having an elevated PSA (OR = 0.47, 95% CI: 0.24-0.95; P = .034). CONCLUSION There is a significant association between increased consumption of a healthy plant-based diet and lower PSA levels. This finding may be incorporated into the shared-decision making process with patients to promote healthier lifestyle choices to reduce the likelihood of prostate biopsy and potential treatment-related morbidity.
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Affiliation(s)
- Ali Mouzannar
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL.
| | - Manish Kuchakulla
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Ruben Blachman-Braun
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Sirpi Nackeeran
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Maria Becerra
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Bruno Nahar
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Sanoj Punnen
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Chad Ritch
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Dipen J Parekh
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Mark L Gonzalgo
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
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Liu Z, Chen C, Yu F, Yuan D, Wang W, Jiao K, Yang S, Zhang Y, Wang Y, Liu L, Xu H, Zhang Y, Zhu G, Hu B, Zhu J. Association of Total Dietary Intake of Sugars with Prostate-Specific Antigen (PSA) Concentrations: Evidence from the National Health and Nutrition Examination Survey (NHANES), 2003-2010. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4140767. [PMID: 33506014 PMCID: PMC7811566 DOI: 10.1155/2021/4140767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 12/05/2020] [Accepted: 12/17/2020] [Indexed: 12/05/2022]
Abstract
BACKGROUND There is increasing evidence that dietary intake of sugars may be a risk factor for prostate cancer (PCa) and elevate the concentration of serum prostate-specific antigen (PSA). However, there is limited evidence of the correlation between total dietary intake of sugars and serum PSA concentrations for adult American males. Herein, we evaluated the association between total dietary intake of sugars and serum PSA concentrations in men without a malignant tumor diagnosis in the United States (US) National Health and Nutrition Examination Survey (NHANES) database. Material and Methods. In this secondary data analysis, a total of 6,403 men aged ≥40 years and without malignant tumor history were included from 2003 to 2010. The independent variable of this study was the total dietary intake of sugars, and the dependent variable was serum PSA concentrations. Covariates included dietary, comorbidity, physical examination, and demographic data. RESULTS The average age of participants included in this study was 58.1 years (±13.6). After adjusting for the dietary, comorbidity, physical examination, and demographic data, we observed that a dietary intake increase of one gram of total dietary intake of sugars was associated with an increase of serum PSA concentrations by 0.003 ng/mL (after log2 transformed, 95% CI: 0.001 to 0.005) with a P value for trend less than 0.05. Sensitivity analysis using the generalized additive model (GAM) supported the linear association between total dietary intake of sugars and serum PSA concentrations. CONCLUSION The total dietary intake of sugars is independently and positively associated with serum PSA concentrations in adult American males who are without a personal history of malignant tumors.
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Affiliation(s)
- Zhangcheng Liu
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
- Department of Urology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641000, China
| | - Chi Chen
- Department of Immunology and Microbiology, Guiyang College of Traditional Chinese Medicine, Guiyang, Guizhou Province 550001, China
| | - Fuxun Yu
- The National Health Commission's Key Laboratory of Immunological Pulmonary Disease, Guizhou Provincial People's Hospital, Guiyang, Guizhou Province 550002, China
| | - Dongbo Yuan
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Wei Wang
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Ke Jiao
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Shengbang Yang
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province 510180, China
| | - Yongqiang Zhang
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Yong Wang
- Department of Urology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641000, China
| | - Linhai Liu
- Department of Urology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641000, China
| | - Huali Xu
- Department of Urology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641000, China
| | - Yang Zhang
- Department of Urology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641000, China
| | - Guohua Zhu
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Bin Hu
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
| | - Jianguo Zhu
- Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550002, China
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province 510180, China
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