Changes in bone mineral density, lean body mass and fat content as measured by dual energy x-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy.
OBJECTIVE
We characterize the consequences of androgen deprivation therapy on body composition in elderly men.


METHODS
Using a dual energy x-ray absorptiometry instrument, we determined the changes in bone mineral density, bone mineral content, fat body mass and lean body mass in 35 patients with prostate cancer without bone metastases who received luteinizing hormone releasing hormone analogue for 12 months.


RESULTS
At baseline conditions 46% of cases were classified as osteopenic and 14% as osteoporotic at the lumbar spine and 40% were osteopenic and 4% osteoporotic at the hip. Androgen deprivation significantly decreased bone mineral density either at the lumbar spine (mean gm./cm.2 [SD] 1.00 [0.194], 0.986 [0.172] and 0.977 [0.182] at baseline, and 6 and 12 months, respectively, p <0.002) or the hip (0.929 [0.136], 0.926 [0.144] and 0.923 [0.138], p <0.03). A more than 2% decrease in bone mineral density was found at the lumbar spine in 19 men (54.3%) and at the hip in 15 (42.9%). Bone mineral content paralleled the bone mineral density pattern. Lean body mass decreased (mean gm. [SD] 50,287 [6,656], 49,296 [6,554] and 49,327 [6,345], p <0.003), whereas fat body mass consistently increased (18,115 [6,209], 20,724 [6,029] and 21,604 [5,923] p <0.001).


CONCLUSIONS
Serial bone densitometry evaluation during androgen deprivation therapy may allow the detection of patients with prostate cancer at risk for osteoporotic fractures, that is those with osteopenia or osteoporosis at baseline and fast bone loss. The change in body composition may predispose patients to accidental falls, thus increasing the risk of bone fracture.
Berruti
Alfredo
A
Department of Clinical and Biological Sciences, University of Torino at San Luigi Hospital, Orbassano, Italy.
Dogliotti
Luigi
L
Terrone
Carlo
C
Cerutti
Stefania
S
Isaia
Giancarlo
G
Tarabuzzi
Roberto
R
Reimondo
Giuseppe
G
Mari
Mauro
M
Ardissone
Paola
P
De Luca
Stefano
S
Fasolis
Giuseppe
G
Fontana
Dario
D
Rossetti
Salvatore Rocca
SR
Angeli
Alberto
A
D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000000981:diagnostic imaging; D005485:Flutamide / Q000627:therapeutic use*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D013851:Thinness
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D005485:Flutamide; D016729:Leuprolide