Metabolic syndrome as an independent determinant of prostate volume in elderly males over 60 years

Background: There is a high incidence of metabolic syndrome (MS) and prostate disease in elderly males over 60 years old. This study aimed to investigate the influence of MS on prostate-specific antigen (PSA) levels, prostate volume (PV) and PSA density (PSAD) in this population. Methods: We retrospectively analyzed 3918 males aged 60 and above who underwent physical examinations in our hospital from January 2022 to December 2024. The subjects were divided into MS group and non-MS group. PSA mass (PSA × plasma volume) was calculated to adjust plasma volume. PSA, PSA mass, PV and PSAD were compared between the 2 groups. To evaluate the impact of MS on the four parameters, linear regression analysis was used. Results: Compared with non-MS group, subjects of the MS group had significantly older age (p = 0.017), larger plasma volume (p < 0.001), larger PV (p < 0.001) and lower PSAD (p = 0.013). However, there was no statistical difference in PSA and PSA mass between the two groups (p = 0.339 and 0.919). In the multivariate linear regression, age, plasma volume and presence of MS were proved as independent factors for PV; age, Body Mass Index (BMI) and plasma volume were independent factors for PSAD. MS was proved as a significant factor for PSAD in univariate regression, but showed no statistical significance in multivariate regression analysis. Among the components of MS, central obesity was proved as independent influencing factor for both PV and PSAD. Conclusions: MS was independently associated with PV in elderly males over 60 years, but had no significant correlation with PSA. These results differed from previous research, as we selected an elder population in this study.

Metabolic syndrome; Prostate specific antigen; Prostate cancer; Prostate volume; Density

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