Association of Metabolic Syndrome Components and Systemic Inflammation with Prostate-Specific Antigen Levels in Adult Males: A Cross-Sectional Study

Author(s): KM Lokman Nayan, Asrafun Nahar, Jubaer Ahmed, Mst. Jannatul Ferdousi, Dewan Mohammad Nadim, Md Rashedul Islam Emon, Monira Akter Monisha, Faozia Zannat

Background: Prostate-specific antigen (PSA) is widely used for the evaluation of prostate-related disorders; however, its clinical interpretation is complicated by influences beyond prostate-specific pathology. Emerging evidence suggests that metabolic syndrome and systemic inflammation may contribute to PSA variability, particularly in populations with a high metabolic disease burden.

Objective: To investigate the association of metabolic syndrome components and systemic inflammation with serum PSA levels in adult males.

Methods: This cross-sectional analytical study was conducted at a private cancer hospital in Dhaka, Bangladesh, from January to December 2024. A total of 250 adult males (≥40 years) undergoing PSA testing were included. Demographic, clinical, metabolic, biochemical, and inflammatory parameters were recorded. PSA was analyzed as both a continuous and categorical variable (≤4.0, 4.1–10.0, >10.0 ng/mL). Statistical analyses included correlation analysis, univariate and multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis.

Results: The mean age and BMI were 64.72 ± 12.06 years and 25.77 ± 3.83 kg/m², respectively, while the mean PSA level was 5.37 ± 3.52 ng/mL. PSA levels increased significantly across age categories (p = 0.009) and showed positive correlations with age (r = 0.28, p = 0.001) and C-reactive protein (CRP) (r = 0.21, p = 0.004). In multivariable analysis, age (OR = 1.027), BMI (OR = 1.035), and CRP (OR = 1.063) were independently associated with elevated PSA (>4 ng/mL). Individual lipid and glycemic parameters were not independently associated after adjustment. The number of metabolic syndrome components demonstrated the strongest correlation with PSA (ρ = 0.27, p < 0.001).

Conclusion: PSA levels are influenced by advancing age, systemic inflammation, and cumulative metabolic syndrome burden rather than isolated metabolic abnormalities.