Is a Decreased Serum Testosterone Level a Risk Factor for Prostate Cancer? A Cohort Study of Korean Men
신보성, 황의창, 임창민, 김선옥, 정승일, 강택원, 권동득, 박광성, 류수방,
소속 상세정보
신보성 ( Shin Bo-Sung )
전남대학교 의과대학 비뇨기과학교실
황의창 ( Hwang Eu-Chang )
전남대학교 의과대학 비뇨기과학교실
임창민 ( Im Chang-Min )
전남대학교 의과대학 비뇨기과학교실
김선옥 ( Kim Sun-Ouck )
전남대학교 의과대학 비뇨기과학교실
정승일 ( Jung Seung-Il )
전남대학교 의과대학 비뇨기과학교실
강택원 ( Kang Taek-Won )
전남대학교 의과대학 비뇨기과학교실
권동득 ( Kwon Dong-Deuk )
전남대학교 의과대학 비뇨기과학교실
박광성 ( Park Kwang-Sung )
전남대학교 의과대학 비뇨기과학교실
류수방 ( Ryu Soo-Bang )
전남대학교 의과대학 비뇨기과학교실
KMID : 0358320100510120819
Abstract
Purpose: To investigate patients who had transrectal ultrasonography (TRUS)-guided prostate biopsy to define the role of the serum testosterone level in predicting prostate cancer risk and its association with a high Gleason score.
Materials and Methods: A total of 568 patients who underwent prostate biopsy were entered in this study. We divided the patients into two groups according to serum testosterone level (median level, 3.85 ng/ml): the high-testosterone group (n=285) and the low-testosterone group (n=283). Multivariate regression analysis was used to define the effect of age, prostate volume, serum prostate-specific antigen (PSA) level and PSA density, and serum testosterone level on the risk of prostate cancer and a high Gleason score.
Results: Baseline characteristics did not differ significantly between the two groups. Compared with the high-testosterone group, the low-testosterone group had a significantly higher prostate cancer incidence (38.9% vs. 29.5%, p=0.018). Factors associated with an increased risk of prostate cancer were increased age (odds ratio [OR]=1.08, 95% confidence interval [CI]=1.25-3.16, p=0.001), a high serum PSA level (OR=3.35, 95% CI=2.63-4.25, p=0.001), a low prostate volume (OR=0.183, 95% CI=0.11-0.30, p=0.001), and a low serum testosterone level (OR=1.99, 95% CI=1.25-3.16, p=0.001). Among these, only the serum PSA level was a strong predictor of high-grade prostate cancer (Gleason score ≥7) (OR=2.19, 95% CI=1.57-2.95, p=0.001).
Conclusions: Patients with lower levels of serum testosterone had a higher risk of prostate cancer than did patients with high serum testosterone. Even though a lower serum testosterone level was a predictor of prostate cancer risk, it was not associated with an increased risk of high-grade prostate cancer.
키워드
Prostatic neoplasms; Risk factors; Testosterone
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