Association between High-Density Lipoproteins (HDLs) and Prostate Specific Antigen (PSA): a cross-sectional study from NHANES database

Abstract

Abstract Background: According to growing evidence, high-density lipoproteins (HDLs ) may raise PSA levels in the prostate. The link between HDL-C and PSA, on the other hand, is debatable and challenging. Hence, this research examined the relationship between HDL-C and PSA in men using the National Health and Nutrition Examination Survey (NHANES) database. Methods: We extracted NHANES data for five cycles from 2001 to 2010. The data used for analysis included PSA concentrations, sociodemographic data, and laboratory data. After the screening, 6,669 of 52,195 participants were included in the study. Participants were divided into 4 groups based on HDL-C quartiles. We analyzed categorical and continuous variables using weighted chi-square tests and linear regression models to compare differences between groups. We constructed 3 weighted multivariate linear regression models and assessed the association between HDL-C and PSA using a smoothed curve fit. Results: In our study, unadjusted and adjusted multivariate linear regression models revealed a significant positive association between prostate-specific antigen (PSA) concentrations and serum high-density lipoprotein cholesterol (HDL-C) levels. Specifically, each unit increase in HDL-C ratio was associated with an increase in PSA concentration by 0.470 ng/mL (P < 0.001) in the unadjusted model. In minimally adjusted models, accounting for socioeconomic and demographic factors, this correlation remained significant, with an increase of 0.408 ng/mL per unit increase in serum HDL-C (P < 0.001). Furthermore, the stratified analysis revealed various impacts based on socioeconomic status and HDL-C levels, with a significant interaction between household income and HDL-C levels (P = 0.037). Exclusion of subjects with low HDL-C levels strengthened the association, showing a significant increase in PSA concentration with higher HDL-C levels (0.50 ng/mL per 1 mmol/L increase, P = 0.009). Our findings suggest a nuanced relationship between HDL-C levels, socioeconomic factors, and PSA concentrations, highlighting the potential importance of considering these factors in prostate cancer screening and risk assessment. Conclusion: This study found a positive association between serum HDL-C and PSA concentrations in adult men in the United States without a prostate cancer diagnosis. Moreover, People with low HDL-C are more likely to be diagnosed with prostate cancer in the late stage of the disease. Hence, people with high levels of HDL-C should be tested for PSA to help early detection of prostate cancer.