Advertisement
Mayo Clinic Proceedings Home

Effect of Physical Activity and Sedentary Behavior on Serum Prostate-Specific Antigen Concentrations: Results From the National Health and Nutrition Examination Survey (NHANES), 2003-2006

  • Paul D. Loprinzi
    Correspondence
    Correspondence: Address to Paul D. Loprinzi, PhD, Department of Exercise Science, Donna and Allan Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY 40205.
    Affiliations
    Department of Exercise Science, Donna and Allan Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY
    Search for articles by this author
  • Manish Kohli
    Affiliations
    Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
    Search for articles by this author

      Abstract

      Objective

      To examine the association between accelerometer-derived sedentary and physical activity and prostate-specific antigen (PSA) in a nationally representative sample of men in the United States.

      Participants and Methods

      Data from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey cycles were used in the present study, with data from 1672 adult male participants used in the analyses. The manuscript was prepared between July 7, 2012, and September 26, 2012. Sedentary and physical activity was objectively measured using an accelerometer. Covariates included various demographic, dietary, biological, and immunologic variables including age, height, weight, body mass index, race/ethnicity, marital status, education, and poverty-income ratio; dietary fiber, fat, protein, and carbohydrate intake and total energy intake; vitamin C and vitamin E; alcohol intake; medication use; concentrations of cotinine, total cholesterol, and high-density lipoprotein cholesterol; blood pressure (elevated or not elevated); diabetes; C-reactive protein; and white blood cell count and number of basophils and eosinophils.

      Results

      Only after controlling for all covariates, for every 1-hour increase in sedentary behavior, participants were 16% more likely to have an elevated PSA concentration (odds ratio, 1.16 [95% CI, 1.06-1.27]; P=.001). For every 1-hour increase in light physical activity, participants were 18% less likely to have an elevated PSA concentration (odds ratio, 0.82 [95% CI, 0.68-1.00]; P=.05).

      Conclusion

      Individuals who engage in more sedentary behavior and lower levels of light physical activity have higher PSA concentrations. Future studies are needed to better identify the potential underlying mechanisms delineating the association between sedentary and physical activity and PSA concentration.

      Abbreviations and Acronyms:

      BMI (body mass index), CRP (C-reactive protein), HDL (high-density lipoprotein), NHANES (National Health and Nutrition Examination Survey), PSA (prostate-specific antigen)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Loprinzi P.D.
        • Cardinal B.J.
        • Smit E.
        • Winters-Stone K.
        Physical activity and breast cancer risk.
        J Exerc Sci Fitness. 2012; 10: 1-7
      1. Physical activity decreases cancer risk: exercise may help prevent the development of certain cancers, notably colon and breast, numerous studies show.
        Duke Med Health News. 2008; 14: 9-10
        • Friedenreich C.M.
        • Cust A.E.
        Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects.
        Br J Sports Med. 2008; 42: 636-647
        • Wolin K.Y.
        • Yan Y.
        • Colditz G.A.
        • Lee I.M.
        Physical activity and colon cancer prevention: a meta-analysis.
        Br J Cancer. 2009; 100: 611-616
        • Loprinzi P.D.
        • Cardinal B.J.
        • Winters-Stone K.
        • Smit E.
        • Loprinzi C.L.
        Physical activity and the risk of breast cancer recurrence: a literature review.
        Oncol Nurs Forum. 2012; 39: 269-274
        • Siegel R.
        • Naishadham D.
        • Jemal A.
        Cancer statistics, 2012.
        CA: Cancer J Clin. 2012; 62: 10-29
        • Friedenreich C.M.
        • Thune I.
        A review of physical activity and prostate cancer risk.
        Cancer Causes Control. 2001; 12: 461-475
        • Drudge-Coates L.
        • Turner B.
        Prostate cancer overview. Part 1: non-metastatic disease.
        Br J Nurs. 2012; 21: S23-S28
        • Parekh N.
        • Lin Y.
        • Marcella S.
        • Kant A.K.
        • Lu-Yao G.
        Associations of lifestyle and physiologic factors with prostate-specific antigen concentrations: evidence from the National Health and Nutrition Examination Survey (2001-2004).
        Cancer Epidemiol Biomarkers Prev. 2008; 17: 2467-2472
        • Andriole G.L.
        • Crawford E.D.
        • Grubb III, R.L.
        • et al.
        PLCO Project Team. Mortality results from a randomized prostate-cancer screening trial.
        N Engl J Med. 2009; 360 ([published correction appears in N Engl J Med. 2009;360:1797]): 1310-1319
        • Schröder F.H.
        • Hugosson J.
        • Roobol M.J.
        • et al.
        • ERSPC Investigators
        Screening and prostate-cancer mortality in a randomized European study.
        N Engl J Med. 2009; 360: 1320-1328
        • Kristal A.R.
        • Chi C.
        • Tangen C.M.
        • Goodman P.J.
        • Etzioni R.
        • Thompson I.M.
        Associations of demographic and lifestyle characteristics with prostate-specific antigen (PSA) concentration and rate of PSA increase.
        Cancer. 2006; 106: 320-328
        • Shephard R.J.
        Limits to the measurement of habitual physical activity by questionnaires.
        Br J Sports Med. 2003; 37 (discussion 206): 197-206
        • Owen N.
        • Sparling P.B.
        • Healy G.N.
        • Dunstan D.W.
        • Matthews C.E.
        Sedentary behavior: emerging evidence for a new health risk.
        Mayo Clin Proc. 2010; 85: 1138-1141
        • Owen N.
        • Healy G.N.
        • Matthews C.E.
        • Dunstan D.W.
        Too much sitting: the population health science of sedentary behavior.
        Exerc Sport Sci Rev. 2010; 38: 105-113
        • Chen K.Y.
        • Bassett Jr., D.R.
        The technology of accelerometry-based activity monitors: current and future.
        Med Sci Sports Exerc. 2005; 37: S490-S500
        • Matthews C.E.
        • Chen K.Y.
        • Freedson P.S.
        • et al.
        Amount of time spent in sedentary behaviors in the United States, 2003-2004.
        Am J Epidemiol. 2008; 167: 875-881
        • Troiano R.P.
        • Berrigan D.
        • Dodd K.W.
        • Mâsse L.C.
        • Tilert T.
        • McDowell M.
        Physical activity in the United States measured by accelerometer.
        Med Sci Sports Exerc. 2008; 40: 181-188
        • Tucker J.M.
        • Welk G.J.
        • Beyler N.K.
        Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans.
        Am J Prev Med. 2011; 40: 454-461
        • Luboldt H.J.
        • Schindler J.F.
        • Rubben H.
        Age-specific reference ranges for prostate-specific antigen as a marker for prostate cancer.
        EAU-EBU Update Series. 2007; 5: 38-48
        • Moshfegh A.J.
        • Baer D.
        • Cleveland L.
        • et al.
        Validation of reported energy intakes in 24-hour dietary recalls using USDA automated multiple-pass method.
        FASEB J. 2003; 17 ([abstract]): A281
        • Rhodes D.G.
        • Moshfegh A.
        • Cleveland L.
        • et al.
        Accuracy of 24 hour dietary recalls: preliminary results from USDA AMPM Validation Study.
        FASEB J. 2004; 18 ([abstract]): A111
        • Chang S.L.
        • Harshman L.C.
        • Presti Jr., J.C.
        Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey.
        J Clin Oncol. 2010; 28: 3951-3957
      2. Summary of revisions for the 2010 Clinical Practice Recommendations.
        Diabetes Care. 2010; 33: S3
      3. Diagnosis and classification of diabetes mellitus.
        Diabetes Care. 2010; 33: S62-S69
      4. National Health and Nutrition Examination Survey: Laboratory Procedures Manual. Complete Blood Count. http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/l25_c_met_complete_blood_count.pdf. Accessed November 28, 2012.

        • Lau C.-C.
        • Kuk F.
        Enough is enough: a primer on power analysis in study designs.
        Hearing Journal. 2011; 64: 30-39
        • Wood N.
        The Health Project Book: a Handbook for New Researchers in the Field of Health.
        Routledge, London, UK2001
        • Carroll K.K.
        Obesity as a risk factor for certain types of cancer.
        Lipids. 1998; 33: 1055-1059
        • Shaw K.
        • Gennat H.
        • O'Rourke P.
        • Del Mar C.
        Exercise for overweight or obesity.
        Cochrane Database Syst Rev. 2006; : CD003817
        • Wallner L.P.
        • Morgenstern H.
        • McGree M.E.
        • et al.
        The effects of body mass index on changes in prostate-specific antigen levels and prostate volume over 15 years of follow-up: implications for prostate cancer detection.
        Cancer Epidemiol Biomarkers Prev. 2011; 20: 501-508
        • Tulloch-Reid M.K.
        • Aiken W.D.
        • Morrison B.F.
        • et al.
        Body mass index and prostate specific antigen levels in Jamaican men.
        West Indian Med J. 2011; 60: 316-321
        • Lissbrant I.F.
        • Stattin P.
        • Wikstrom P.
        • Damber J.E.
        • Egevad L.
        • Bergh A.
        Tumor associated macrophages in human prostate cancer: relation to clinicopathological variables and survival.
        Int J Oncol. 2000; 17: 445-451
        • Nieman D.C.
        Exercise immunology: practical applications.
        Int J Sports Med. 1997; 18: S91-S100
        • Vendramini-Costa D.B.
        • Carvalho J.E.
        Molecular link mechanisms between inflammation and cancer.
        Curr Pharm Design. 2012; 18: 3831-3852
      5. Loprinzi P, Cardinal B, Crespo C, et al. Objectively measured physical activity and C-reactive protein: National Health and Nutrition Examination Survey 2003-2004. Scand J Med Sci Sports. In press.

        • Ji L.L.
        Exercise and oxidative stress: role of the cellular antioxidant systems.
        Exerc Sport Sci Rev. 1995; 23: 135-166
        • Feig D.I.
        • Reid T.M.
        • Loeb L.A.
        Reactive oxygen species in tumorigenesis.
        Cancer Res. 1994; 54: 1890s-1894s
        • Tremblay M.S.
        • Colley R.C.
        • Saunders T.J.
        • Healy G.N.
        • Owen N.
        Physiological and health implications of a sedentary lifestyle.
        Appl Physiol Nutr Metab. 2010; 35: 725-740
        • Marshall S.J.
        • Ramirez E.
        Reducing sedentary behavior: a new paradigm in physical activity promotion.
        Am J Lifestyle Med. 2011; 5: 518-530
        • Mondul A.M.
        • Weinstein S.J.
        • Virtamo J.
        • Albanes D.
        Serum total and HDL cholesterol and risk of prostate cancer.
        Cancer Causes Control. 2011; 22: 1545-1552
        • Ahmed F.S.
        • Borrell L.N.
        • Spencer B.A.
        Health risk behaviors and prostate specific antigen awareness among men in California.
        J Urol. 2008; 180 (discussion 662): 658-662
        • Loprinzi P.D.
        • Lee H.
        • Cardinal B.J.
        • Crespo C.
        • Andersen R.
        • Smit E.
        The relationship of Actigraph accelerometer cut-points for estimating physical activity with selected health outcomes: results from NHANES 2003-06.
        Res Q Exerc Sport. 2012; 83: 422-430
        • Chou R.
        • Croswell J.M.
        • Dana T.
        • et al.
        Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force.
        Ann Intern Med. 2011; 155: 762-771
        • Hugosson J.
        • Carlsson S.
        • Aus G.
        • et al.
        Mortality results from the Göteborg randomised population-based prostate-cancer screening trial.
        Lancet Oncol. 2010; 11: 725-732
        • Allegra C.J.
        • Jessup J.M.
        • Somerfield M.R.
        • et al.
        American Society of Clinical Oncology provisional clinical opinion: testing for KRAS gene mutations in patients with metastatic colorectal carcinoma to predict response to anti-epidermal growth factor receptor monoclonal antibody therapy.
        J Clin Oncol. 2009; 27: 2091-2096
        • Thompson I.M.
        • Pauler D.K.
        • Goodman P.J.
        • et al.
        Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter.
        N Engl J Med. 2004; 350 ([published correction appears in N Engl J Med. 2004;351:1470]): 2239-2246
        • Basch E.
        • Oliver T.K.
        • Vickers A.
        • et al.
        Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology Provisional Clinical Opinion.
        J Clin Oncol. 2012; 30: 3020-3025
      6. American Urological Association. Prostate Specific Antigen Best Practice Statement, 2009. http://www.auanet.org/content/clinical-practice-guidelines/clinical-guidelines.cfm#2. Accessed September 26, 2012.