Metabolik Sendrom ve Obezite Varlığında Prostat ile İlgili Belirteçlerin İncelenmesi: Tek Merkez Sonuçları

Öz

Amaç: Obezitenin ve metabolik sendromun prevalansı, dünya genelinde hızla yükselmektedir. Bu çalışmada obezite ve metabolik sendromu olan kişilerde prostat kanseri taramasında bir belirteç olarak kullanılan prostat spesifik antijen (PSA) ve türevlerinin nasıl değiştiğini incelemeyi amaçladık. Gereç ve Yöntemler: Araştırmaya Mayıs 2023 – Nisan 2024 tarihleri arasında Zonguldak Bülent Ecevit Hastanesi Endokrinoloji polikliniğinde obezite tanısı alan ve çalışma kriterlerini karşılayan 100 hasta ve 50 sağlıklı gönüllü dahil edildi. Hastalar metabolik sendromlu obezite ve metabolik sendromsuz obezite olmak üzere 2 gruba ayrıldı. Metabolik olarak sağlıklı olup olmadıklarını değerlendirmek amacıyla NCEP-ATP III metabolik sendrom tanı kriterleri kullanıldı. Bu kriterlere göre, beş kriterden herhangi üçünü karşılayan hastalar metabolik sendromlu obezite olarak kabul edilirken; bu kriterleri karşılamayan bireyler metabolik sendromsuz obezite kategorisinde değerlendirildi. Çalışma gruplarında PSA, freePSA ve proPSA düzeyleri bakılırken, %freePSA ve %proPSA düzeyleri hesaplandı. Bulgular: Obeziteli yaşayan hastaların total PSA, serbest PSA ve % free PSA düzeyleri kontrol grubundan farklı değildi (p>0.05). ProPSA düzeyleri obeziteli hastalarda, özellikle metabolik sendromsuz obezite hastalarında anlamlı derecede düşüktü (p=0.012), ancak %proPSA düzeylerinde herhangi bir fark gözlemlenmedi (p>0.05). ProPSA ile boy, vücut ağırlığı, VKİ, açlık kan şekeri, trigliserid ve HDL düzeyleri arasında bir korelasyon gözlenmedi. Sonuç: Daha düşük ProPSA konsantrasyonlarına rağmen %ProPSA'da değişiklik olmaması, ProPSA'daki azalmanın obeziteli hastalarda gözlenen toplam PSA'daki azalmaya orantılı bir yanıt olabileceğini düşündürmektedir. Ayrıca metabolik parametreler obezite ile ProPSA düzeyleri arasındaki ilişkiye katkıda bulunmamıştır. Bu özel popülasyonda ProPSA'nın tanısal faydasını ve klinik etkilerini değerlendirmek için daha fazla araştırmaya ihtiyaç vardır

Anahtar Kelimeler

• Obezite
• Metabolik sendrom
• Prostat spesifik antijen ve türevleri

Assessment of Prostate-Related Biomarkers in Individuals with Metabolic Syndrome and Obesity: A Single-Center Study

Öz

Aim: The prevalence of obesity and metabolic syndrome is rapidly increasing worldwide. This study aimed to investigate the changes prostate-specific antigen (PSA) and its derivatives, commonly used as biomarkers in prostate cancer screening in individuals with obesity and metabolic syndrome. Material and Methods: The study included 100 patients diagnosed with obesity at the Endocrinology Clinic of Zonguldak Bulent Ecevit Hospital between May 2023 and April 2024, along with 50 healthy volunteers. The patients were divided into 2 groups: metabolic syndrome obesity and metabolic syndrome-free obesity. NCEP-ATP III metabolic syndrome diagnostic criteria were used to assess whether they were metabolically healthy. According to these criteria, patients who meet any three of the five criteria are considered to have metabolic syndrome obesity; individuals who did not meet these criteria were evaluated in the metabolic syndrome-free obesity category. PSA, free PSA and proPSA levels were analyzed, %freePSA and %proPSA values were calculated. Group comparisons were performed using the Kruskal–Wallis test, and correlations were assessed using Spearman’s rank correlation analysis. Results: Total PSA, free PSA and %freePSA levels were not difference in patients with obesity compared to the control group (p>0.05). ProPSA levels were significantly lower in patients with obesity, especially metabolic syndrome-free obesity (p=0.012), but no difference was observed in %proPSA levels (p>0.05). No correlation was observed between ProPSA and height, weight, BMI, fasting blood glucose, triglyceride and HDL-cholesterole levels. Conclusion: The lack of change in %ProPSA despite lower ProPSA concentrations suggests that the decrease in ProPSA may be a proportional response to the reduction in total PSA observed in individuals with obesity. This study provides novel evidence on the effect of obesity and metabolic phenotype on ProPSA levels in prostate-healthy individuals, a population that has been underrepresented in previous PSA-related research.

Anahtar Kelimeler

• Obesity
• Metabolic syndrome
• Prostate specific antigen and its derivatives

Destekleyen Kurum

This study was supported by Zonguldak Bülent Ecevit University Scientific and Technological Research Projects Fund under project number 2023-66591019-01.

Etik Beyan

The research protocol received approval from the Ethics Committee on Clinical Research at Zonguldak Bülent Ecevit University Faculty of Medicine with approval granted on September 03, 2023 (approval number: 23-09).

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