Association between Prostate-Specific Antigen and Cardiovascular Diseases in U.S. Adult Men: A Cross-Sectional Study from NHANES

Background: This study aims to examine the associations of total PSA (tPSA), free PSA (fPSA), and %fPSA with CVD risk in the adult male population of the United States. Methods: Using NHANES data (2001-2010), we analyzed cardiovascular conditions, PSA levels, and confounding factors in adult male participants. We employed multivariate logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI) for assessing correlations between total PSA (tPSA), free PSA (fPSA), and %fPSA with CVD risk. After identifying fPSA with most significant effect, we conducted quartile analysis to explore risk associations across different intervals. Results: Higher fPSA levels showed significant elevated CVD risk (Model1: OR:1.90; Model2: OR:1.71; all P<0.001). The highest versus lowest fPSA quartile showed an OR of 2.55 (95% CI: 1.98-3.29; P-trend <0.001). Weaker effect measured by OR were found for tPSA (Model2:OR: 1.08, P<0.001) and %fPSA (Model2:OR: 1.01, P=0.11). Conclusions: Our study suggests that fPSA, tPSA and %fPSA are associated with a higher prevalence of previous CVD. Elevated fPSA levels may be a more sensitive risk indicator of previous CVD. This analysis offers a novel perspective on the complex relationship between PSA and CVD. Future longitudinal studies are necessary to elucidate the potential mechanisms underlying this association.