Online Program

Serum levels of folate and prostate-specific antigen among US men

Monday, November 4, 2013

Yueh-Ying Han, PhD, MS, School of Medicine, University of Pittsburgh, Pittsburgh, PA
Ji Young Song, PhD, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Evelyn O. Talbott, DrPH, MPH, Department of Epidemiology, Director University of Pittsburgh Academic Center for Excellence in Environmental PH Tracking, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Background Results from epidemiologic studies relating folate status to prostate cancer are controversial. This study investigates the association between levels of serum folate and prostate-specific antigen (PSA), a biomarker for prostate cancer detection. Methods Using data from the 2007-2010 National Health and Nutrition Examination Survey, 2,198 men aged 40 years and older with serum PSA and folate measures were studied. Total PSA (tPSA) and percent free/total PSA ratio (%fPSA) were outcomes of interest. The alternative cutpoints were used to categorize as higher risks of prostate cancer (tPSA: ≥10 and ≥4 ng/ml; %fPSA: ≤25%). Serum levels of folate was defined as quintiles and examined as risk/protective factors for PSA biomarkers. Multivariate logistic regression was applied to estimate odds ratios (OR) and 95% confidence interval (CI). Results Linear regression found that higher serum folate was associated with decreased log10-transformed tPSA (β=-0003, p=0.003) and increased %fPSA (β=0.082, p=0.011). Adjusting for age, race/ethnicity, socioeconomic status, body mass index, use of non-steroidal anti-inflammatory drugs and smoking, higher folate levels were associated with lower odds of having higher tPSA (≥10 ng/ml, OR associated with fifth to first quintile of folate = 0.36, 95% CI=0.16-0.84, p for trend=0.021) and lower %fPSA (≤25%, OR [fifth vs. first quintile of folate] = 0.54, 95% CI=0.35-0.82, p for trend=0.006). Conclusion The study suggests that higher folate status may protect against elevated total PSA levels among men without diagnosed prostate cancer. Further studies are necessary to confirm this finding and to investigate potential mechanisms that may explain this relationship.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Public health biology

Learning Objectives:
Assess serum levels of folate and prostate-specific antigen (PSA) in the US population Evaluate relationships between folate level and PSA biomarkers Identify potential role of folate status on prostate cancer risk for future research

Keyword(s): Nutrition, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research interests include environmental and dietary factors and cancer prevention. I conducted and analyzed the data for this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.