Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States

Abstract Objectives To examine the associations between prostate-specific antigen (PSA)-related biomarkers and diabetic kidney disease (DKD) in male patients with diabetes. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and...

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Main Authors: Limei Zhang, Chengxia Li, Deying Niu, Shihua Zhao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02897-6
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author Limei Zhang
Chengxia Li
Deying Niu
Shihua Zhao
author_facet Limei Zhang
Chengxia Li
Deying Niu
Shihua Zhao
author_sort Limei Zhang
collection DOAJ
description Abstract Objectives To examine the associations between prostate-specific antigen (PSA)-related biomarkers and diabetic kidney disease (DKD) in male patients with diabetes. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2010, including 1,681 male diabetic patients (409 of whom had DKD). Multivariable logistic regression models adjusted for age, race, body mass index (BMI), hypertension, and cardiovascular disease were employed to evaluate the relationships between total PSA (TPSA), free PSA (FPSA), and the FPSA/TPSA ratio with DKD. Dose–response curves and subgroup analyses were performed to further assess these associations. Results Elevated levels of TPSA, FPSA, and the FPSA/TPSA ratio were significantly associated with an increased risk of DKD. In fully adjusted models, the highest tertiles of TPSA (OR = 1.92, 95% CI 1.43–2.56) and FPSA (OR = 2.69, 95% CI 2.00–3.60) demonstrated the strongest associations. The FPSA/TPSA ratio exhibited a linear dose–response relationship with DKD (OR = 2.16, 95% CI 1.60–2.91), whereas TPSA and FPSA showed non-linear threshold effects. Subgroup analyses confirmed consistent findings across populations. Conclusions PSA-related biomarkers may serve as potential indicators for early diagnosis and risk stratification of DKD. Further validation studies and mechanistic investigations are necessary to optimize clinical interventions and improve renal outcomes in diabetic patients.
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spelling doaj-art-875b1630c87942eda2ae1af2d1ca91092025-08-20T03:42:35ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111210.1186/s40001-025-02897-6Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United StatesLimei Zhang0Chengxia Li1Deying Niu2Shihua Zhao3Department of Endocrinology, Zibo Central HospitalDepartment of Neurosurgery, Zibo Central HospitalDepartment of Neurosurgery, Zibo Central HospitalDepartment of Endocrinology, Zibo Central HospitalAbstract Objectives To examine the associations between prostate-specific antigen (PSA)-related biomarkers and diabetic kidney disease (DKD) in male patients with diabetes. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2010, including 1,681 male diabetic patients (409 of whom had DKD). Multivariable logistic regression models adjusted for age, race, body mass index (BMI), hypertension, and cardiovascular disease were employed to evaluate the relationships between total PSA (TPSA), free PSA (FPSA), and the FPSA/TPSA ratio with DKD. Dose–response curves and subgroup analyses were performed to further assess these associations. Results Elevated levels of TPSA, FPSA, and the FPSA/TPSA ratio were significantly associated with an increased risk of DKD. In fully adjusted models, the highest tertiles of TPSA (OR = 1.92, 95% CI 1.43–2.56) and FPSA (OR = 2.69, 95% CI 2.00–3.60) demonstrated the strongest associations. The FPSA/TPSA ratio exhibited a linear dose–response relationship with DKD (OR = 2.16, 95% CI 1.60–2.91), whereas TPSA and FPSA showed non-linear threshold effects. Subgroup analyses confirmed consistent findings across populations. Conclusions PSA-related biomarkers may serve as potential indicators for early diagnosis and risk stratification of DKD. Further validation studies and mechanistic investigations are necessary to optimize clinical interventions and improve renal outcomes in diabetic patients.https://doi.org/10.1186/s40001-025-02897-6Diabetic kidney diseaseProstate-specific antigenNHANESDiabetes mellitusSystemic inflammationOxidative stress
spellingShingle Limei Zhang
Chengxia Li
Deying Niu
Shihua Zhao
Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
European Journal of Medical Research
Diabetic kidney disease
Prostate-specific antigen
NHANES
Diabetes mellitus
Systemic inflammation
Oxidative stress
title Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
title_full Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
title_fullStr Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
title_full_unstemmed Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
title_short Free prostate-specific antigen, total prostate-specific antigen, and their ratio associated with diabetic kidney disease: new evidence from male patients with diabetes in the United States
title_sort free prostate specific antigen total prostate specific antigen and their ratio associated with diabetic kidney disease new evidence from male patients with diabetes in the united states
topic Diabetic kidney disease
Prostate-specific antigen
NHANES
Diabetes mellitus
Systemic inflammation
Oxidative stress
url https://doi.org/10.1186/s40001-025-02897-6
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