{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:52:52Z","timestamp":1787802772939,"version":"build-2784847793"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The relationship between serum prostate-specific antigen (PSA) and testosterone (T) levels is still controversial. According to the \u201csaturation hypothesis,\u201d a significant relationship is apparent only in the low T range.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To verify whether, in a large sample of male subjects seeking medical care for sexual dysfunction (SD), PSA might represent a reliable marker of T levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A consecutive series of 3,156 patients attending our unit for SD was studied. Among them, only subjects without history of prostate disease and with PSA levels &amp;lt;4 ng\/mL (N = 2,967) were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Several hormonal and biochemical parameters were studied, along with structured interview on erectile dysfunction (SIEDY), ANDROTEST, and PsychoANDROTEST.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Receiver operating characteristic curve analysis for predicting severe hypogonadism (T &amp;lt; 8 nmol\/L) showed an accuracy of PSA = 0.612 \u00b1 0.022 (P &amp;lt; 0.0001), with the best sensitivity and specificity at PSA &amp;lt; 0.65 ng\/mL (65.2% and 55.5%, respectively). In the entire cohort, 254 subjects (8.6%) showed T &amp;lt; 8 nmol\/L and, among them, more than half (N = 141, 4.8%) had PSA &amp;lt; 0.65 ng\/mL. After adjusting for age, low PSA was associated with hypogonadism-related features (i.e., delayed puberty, lower testis volume) and associated conditions, such as metabolic syndrome (hazard ratio [HR] = 1.506 [1.241\u20131.827]; P &amp;lt; 0.0001), type 2 diabetes (HR = 2.044 [1.675\u20132.494]; P &amp;lt; 0.0001), and cardiovascular diseases (HR = 1.275 [1.006\u20131.617]; P = 0.045). Furthermore, low PSA was associated with impaired sex- and sleep-related erections. The association between low PSA and hypogonadal symptoms and signs as well as with metabolic syndrome was retained even after adjusting for T levels. Sensitivity and positive predictive values of low PSA increased, whereas specificity and negative predictive value decreased as a function of age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PSA is a marker of T concentrations and it may represent a new tool in confirming hypogonadism. The determination of PSA levels might give insights not only on the circulating levels of total T but also on its active fractions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/jsm.12266","type":"journal-article","created":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T15:14:54Z","timestamp":1373987694000},"page":"2518-2528","source":"Crossref","is-referenced-by-count":86,"title":["Serum PSA as a Predictor of Testosterone Deficiency"],"prefix":"10.1093","volume":"10","author":[{"given":"Giulia","family":"Rastrelli","sequence":"first","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Corona","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"},{"name":"Endocrinology Unit, Maggiore-Bellaria Hospital , Bologna, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Vignozzi","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Maseroli","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Silverii","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Monami","sequence":"additional","affiliation":[{"name":"Diabetes Section, Geriatric Unit, Department of Critical Care, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Mannucci","sequence":"additional","affiliation":[{"name":"Diabetes Section, Geriatric Unit, Department of Critical Care, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Forti","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Maggi","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Biomedical, Experimental, and Clinical Sciences, University of Florence , Florence, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"2024032602350016200_bib1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1007\/BF03349232","article-title":"Which patients with sexual dysfunction are suitable for testosterone replacement therapy?","volume":"30","author":"Morelli","year":"2007","journal-title":"J Endocrinol Invest"},{"key":"2024032602350016200_bib2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.eururo.2008.08.033","article-title":"Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations","volume":"55","author":"Wang","year":"2009","journal-title":"Eur Urol"},{"key":"2024032602350016200_bib3","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1210\/jc.2009-2354","article-title":"Testosterone therapy in men with androgen deficiency syndromes: An Endocrine Society clinical practice guideline","volume":"95","author":"Bhasin","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2024032602350016200_bib4","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/j.1743-6109.2012.02783.x","article-title":"Testosterone deficiency in men: Systematic review and standard operating procedures for diagnosis and treatment","volume":"10","author":"Buvat","year":"2013","journal-title":"J Sex Med"},{"key":"2024032602350016200_bib5","first-page":"681","article-title":"Endocrine aspects of male sexual dysfunctions","volume-title":"Sexual medicine, sexual dysfunctions in men and women. 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