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The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study
Zhiyi Chen1, Enpu Zhang1, Lu Gan1
1Department of Urology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, 518000, China.
BMC Urology
|August 9, 2025
Summary
Urinary nitrate levels are negatively associated with the prostate-specific antigen ratio in individuals with gray-zone TPSA. This finding may help reduce overtreatment for prostate cancer.
Area of Science:
- Urology
- Environmental Health
- Oncology
Background:
- Nitrate reduction to nitrite is carcinogenic and linked to various diseases.
- Limited research exists on nitrate's effects on the urinary system and its association with prostate-specific antigen (PSA).
Purpose of the Study:
- To investigate the relationship between urinary nitrate levels and PSA.
- To clarify the association between urinary nitrate and PSA in individuals with gray-zone TPSA.
Main Methods:
- Weighted generalized linear models, univariate analysis, forest plots, and multivariable analysis were employed.
- Generalized additive models (GAM) were used to visualize the relationship between PSA and urinary nitrate.
- Subgroup analyses were conducted to ensure the stability of the association.
Main Results:
- Urinary nitrate showed negative correlations with total PSA (TPSA), free PSA (FPSA), and the PSA ratio.
- Only the PSA ratio maintained a significant negative association after adjusting for confounders (β = -632.7; P = 0.011).
- A nonlinear relationship was observed, with urinary nitrate initially stable before declining.
Conclusions:
- A negative correlation exists between urinary nitrate and the PSA ratio in individuals with gray-zone TPSA.
- These findings improve understanding of urinary nitrate's impact on PSA.
- The results may aid in reducing overtreatment for prostate cancer in this population.
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