The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study
Abstract Purpose The carcinogenic effects of nitrate reduction to nitrite are well established, and nitrate has been closely linked to various diseases. However, research on its effects on the urinary system remains limited, and its association with PSA remains unclear. This study aims to investigat...
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BMC
2025-08-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-025-01878-5 |
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| author | Zhiyi Chen Enpu Zhang Lu Gan Wenjuan Zhang Guixiao Huang |
| author_facet | Zhiyi Chen Enpu Zhang Lu Gan Wenjuan Zhang Guixiao Huang |
| author_sort | Zhiyi Chen |
| collection | DOAJ |
| description | Abstract Purpose The carcinogenic effects of nitrate reduction to nitrite are well established, and nitrate has been closely linked to various diseases. However, research on its effects on the urinary system remains limited, and its association with PSA remains unclear. This study aims to investigate the relationship between urinary nitrate and PSA. Methods We employed weighted generalized linear models, weighted univariate analysis, forest plots, weighted multivariable analysis, and generalized additive models (GAM) to investigate the relationship between urinary nitrate and PSA. Subgroup analyses were conducted to further validate the stability of this association across different groups. GAM was utilized to provide a more intuitive representation of the specific relationships between PSA and urinary nitrate. Results TPSA, FPSA, and the prostate specific antigen ratio (%, 4 ng/mL ≤ TPSA ≤ 10 ng/mL) showed negative correlations with urinary nitrate. After adjusting for confounders, only the prostate-specific antigen ratio maintained a significant negative association (β = -632.7; 95% CI: -1094.9, -170.6; P = 0.011), while correlations with TPSA and FPSA were not statistically significant. A nonlinear relationship was observed, where urinary nitrate initially remained stable or changed minimally before gradually declining. Conclusion This study identifies a negative correlation between urinary nitrate and the prostate-specific antigen ratio in individuals with gray-zone TPSA. These findings enhance our understanding of urinary nitrate’s impact and may help reduce overtreatment in this population. |
| format | Article |
| id | doaj-art-3b2f79a6ca1e4f5d871eafd31e2229bc |
| institution | Kabale University |
| issn | 1471-2490 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj-art-3b2f79a6ca1e4f5d871eafd31e2229bc2025-08-20T03:43:37ZengBMCBMC Urology1471-24902025-08-0125111110.1186/s12894-025-01878-5The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort studyZhiyi Chen0Enpu Zhang1Lu Gan2Wenjuan Zhang3Guixiao Huang4Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People’s HospitalDepartment of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People’s HospitalDepartment of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People’s HospitalDepartment of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People’s HospitalDepartment of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People’s HospitalAbstract Purpose The carcinogenic effects of nitrate reduction to nitrite are well established, and nitrate has been closely linked to various diseases. However, research on its effects on the urinary system remains limited, and its association with PSA remains unclear. This study aims to investigate the relationship between urinary nitrate and PSA. Methods We employed weighted generalized linear models, weighted univariate analysis, forest plots, weighted multivariable analysis, and generalized additive models (GAM) to investigate the relationship between urinary nitrate and PSA. Subgroup analyses were conducted to further validate the stability of this association across different groups. GAM was utilized to provide a more intuitive representation of the specific relationships between PSA and urinary nitrate. Results TPSA, FPSA, and the prostate specific antigen ratio (%, 4 ng/mL ≤ TPSA ≤ 10 ng/mL) showed negative correlations with urinary nitrate. After adjusting for confounders, only the prostate-specific antigen ratio maintained a significant negative association (β = -632.7; 95% CI: -1094.9, -170.6; P = 0.011), while correlations with TPSA and FPSA were not statistically significant. A nonlinear relationship was observed, where urinary nitrate initially remained stable or changed minimally before gradually declining. Conclusion This study identifies a negative correlation between urinary nitrate and the prostate-specific antigen ratio in individuals with gray-zone TPSA. These findings enhance our understanding of urinary nitrate’s impact and may help reduce overtreatment in this population.https://doi.org/10.1186/s12894-025-01878-5PSAUrinary nitratePCaNHANES |
| spellingShingle | Zhiyi Chen Enpu Zhang Lu Gan Wenjuan Zhang Guixiao Huang The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study BMC Urology PSA Urinary nitrate PCa NHANES |
| title | The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study |
| title_full | The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study |
| title_fullStr | The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study |
| title_full_unstemmed | The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study |
| title_short | The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study |
| title_sort | association between urinary nitrate and prostate specific antigen without prostatic disease a cohort study |
| topic | PSA Urinary nitrate PCa NHANES |
| url | https://doi.org/10.1186/s12894-025-01878-5 |
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