The Correlation Between Serum Prostate-Specific Antigen and Calcium Levels in Patients With Benign Prostatic Hyperplasia: A Cross-Sectional Study

Background: Benign prostatic hyperplasia (BPH) is a common age-related condition with prostate enlargement and lower urinary tract symptoms. Prostate-specific antigen (PSA) is increasingly utilized as a biomarker of prostate health, while calcium (Ca) is involved in cellular regulation and prostate physiology. Thus, this study aimed to investigate the association between serum Ca and PSA levels in BPH patients. Methods: For this cross-sectional study, 125 clinically and sonographically confirmed BPH men were enrolled in the Hormoz Subspecialty Clinic, Bandar Abbas, Iran, during 2020–2021. Data related to smoking status, education level, marriage status, and residence were collected. Prostate volume was assessed using transrectal ultrasonography, and serum PSA and total Ca levels were determined by standard laboratory methods. Finally, Spearman’s rank test was used to compute correlations. Results: There was a significant negative correlation between serum Ca and PSA in general (ρ=–0.355, P<0.001). The results revealed stronger associations among patients<60 years (ρ=–0.422, P<0.001), smokers (ρ=–0.388, P=0.001), married patients (ρ=–0.399, P<0.001), patients with higher education (ρ=–0.420, P=0.007), those with prostate volume<40 cc (ρ=–0.378, P<0.001), and residents of Bandar Abbas (ρ=–0.429, P<0.001). None of these correlations was significant in patients≥60 years, patients with prostate volume≥40 cc, or patients in other cities. Conclusion: Serum Ca demonstrated an inverse relationship with PSA in BPH patients, particularly in younger, smoking, married, and better-educated subgroups with lower prostate volumes, suggesting that Ca metabolism may influence PSA expression.