Smith MR and Braga-Basaria M (26, 27) also showed that endocrine therapy in prostate cancer patients significantly increases the incidence of MetS and subgroups, which may ultimately lead to a reduction in PSA remission rates.Since PSA levels can be influenced by many factors, Tarantino G et al,studied the effects of obesity, smoking habits, alcohol abuse and chronic obstructive pulmonary disease on PSA levels in men with pathologically histologically confirmed prostate cancer, showed that only smoking was associated with PSA levels (28), but this finding has not been verified in our study. Here, KLK3 is linked to obesity due to melanocortin 4 receptor deficiency.