Statins may lower PSA levels, but not by a clinically significant amount
MedWire News: Statin use is associated with lower prostate-specific antigen (PSA) levels, but the clinical impact of this may be limited, say researchers.
Men who take statins are significantly more likely to have a lower PSA level than men who do not take statins, report Bulent Akduman (Zonguldak Karaelmas University, Turkey) and colleagues, who investigated the effect of statins on PSA levels in a cohort of men being screened for prostate cancer.
However, levels may not be low enough to “determine a different PSA cutoff level [for prostate cancer] for patients on statin medication,” they write in the Journal of Urology.
Recent studies have shown beneficial effects of statin use in prostate cancer patients, and have also indicated that statin use may lower serum PSA levels. Since PSA is influenced by androgens and the precursor of androgen synthesis is cholesterol, it is biologically plausible for cholesterol-lowering statins to be linked to PSA, Akduman et al explain.
“An effect of statins on serum PSA levels could potentially complicate prostate cancer detection,” they say.
Thus, the current study compared the serum PSA, total cholesterol, and total testosterone levels of 1379 men who were taking statin medication, and 3524 men who were not, all of whom were screened for prostate cancer, which was indicated at a PSA level of 4.0 ng/ml or higher.
Normal levels of total cholesterol and testosterone were considered to be 200 mg/ml or less, and 400 ng/dl or higher, respectively.
While the researchers found that mean serum testosterone levels were lower among statin-users compared with non-users, at 329.35 versus 374.97 ng/dl, mean cholesterol levels were similar, at 188.54 and 190.06 mg/dl, respectively, and mean serum PSA levels were marginally higher, at 1.56 ng/ml versus 1.48 ng/ml.
Multivariate analysis, adjusting for potential confounding factors including age, body mass index, and race, revealed that statin use was statistically significantly associated with a lower mean PSA.
In view of the 4-ng/ml or above PSA cutoff for prostate biopsy, the researchers analyzed patients with levels greater than this (n=312). They observed no difference between statin users and non-users in terms of the rate of patients with serum PSA levels greater than 4 ng/ml.
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By Sarah Guy