Abstract
BACKGROUND: The association between depression and serum total prostate-specific antigen (PSA) concentrations remains unclear. To explore whether there is a relationship between depression and PSA in American males without prostate cancer (PCa), according to the National Health and Nutrition Examination Survey (NHANES) database. METHODS: Three biennial cycles of survey data from 2005 to 2010 were used in our study. Multivariate adjusted regression analysis, stratified analysis, trend testing, smooth curve fitting and multiple imputation (MI) were our main research methods. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). RESULTS: The study included a total of 4185 participants. After adjusting all covariates, whether depression was used as a continuous [β = -0.038; 95% confidence interval (CI): -0.059, -0.017; P < 0.001] or categorical variable (P for trend = 0.001), especially in the mild [β = -0.239; 95% CI: -0.473, -0.006; P = 0.044)] and moderate [β = -0.499; 95% CI: -0.907, -0.092; P = 0.016)] depression groups, it was associated with a decrease in serum PSA concentrations. Smoothing curve fitting found the presence of a linear relationship, with PSA reduced by 0.038 ng/ml or 0.026 ng/ml (log-2 transformed total PSA) for each additional unit of depression score. Similar results were obtained for complete data after MI or data categorized by depressive symptoms. CONCLUSIONS: Depression score is inversely correlated with serum total PSA concentrations among American men, and there is an interaction between depression and myocardial infarction. CLINICAL TRIAL NUMBER: Not applicable.