[A clinical study of decreased bone density in the patients treated with long-term luteinizing hormone releasing hormone analogue (LHRH-a)--the risk of iatrogenic osteoporosis due to treatment of carcinoma of prostate].
BACKGROUND
It is well known that androgens play an important role in bone metabolism and male hypogonadism induce osteoporosis. Luteinizing hormone-releasing hormone analogue (LHRH-a) which is essential for conservative therapy of prostatic carcinoma (CaP) ultimately reduces circulating testosterone to castration levels. The purpose of this study was to determine the risk of decrease of bone mineral density in men receiving LHRH-a for CaP.


METHODS
Fifty-three man with CaP aged 63 to 95 years (mean 75.5 years) were included in this study. Seven patients received LHRH-a with estrogen drug, forty-six patients received LHRH-a with or without anti androgen drug. To estimate patient's bone density we use the second metacarpal bone density using a microdensitometry method.


RESULTS
Blood level of sex hormone of the forty-six patients who were received LHRH-a without estrogen, was the same as that of castration. Patients who were treated more than twelve months had less bone density than patients who were treated less than eleven months. As the duration of medical castration period was prolonged, patients bone density were reduced. Whereas seven patients who received estrogen drug did not find a decrease of bone density regardless of duration of treatment period.


CONCLUSIONS
Hypogonadism induced LHRH-a also reduce bone density, so there is a risk of iatrogenic osteoporosis caused by therapy for CaP with LHRH-a. Patients with osteoporosis easily suffer from a much complicated and pernicious bone fracture, so we should measure bone density of male patients same as female treated with LHRH-a for a long-term.
Suzuki
Y
Y
Department of Urology, Hoshi General Hospital.
Aikawa
K
K
Oishi
Y
Y
Yamazaki
H
H
Onishi
T
T
Suzuki
M
M
Kobari
T
T
Endo
K
K
Yanada
S
S
Kato
N
N
Yoshino
Y
Y
Wada
T
T
Ueda
M
M
Takasaka
S
S
Akazawa
K
K
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D004967:Estrogens / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012306:Risk