Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy.
OBJECTIVE
Preexisting osteopenia and osteoporosis in men with prostate cancer are of concern due to accelerated bone loss during androgen deprivation therapy (ADT). We sought to identify risk factors for osteoporosis in men with prostate cancer who have not received ADT to help determine which patients may need bone mineral density (BMD) testing prior to ADT.


METHODS
Lumbar spine and hip BMD testing were performed using dual-energy x-ray absorptiometry in 34 men with nonmetastatic prostate cancer who were not receiving ADT. The demographic, health status, lifestyle, and disease variables (Gleason score, clinical stage, and prostate-specific antigen level) were obtained and analyzed using univariate and multivariate methods for their role in spine and hip BMD levels.


RESULTS
Of the 34 men, 73.5% had osteopenia (55.9%) or osteoporosis (17.6%) of the spine and/or hip. On univariate analysis, aging, lower body mass index, and elevated prostate-specific antigen level correlated significantly with bone loss in the spine and hip. Regression models showed age independently predicted bone loss in the spine (R2 = 0.14). Prostate-specific antigen was an independent predictor of low BMD in the trochanter (R2 = 0.18), and body mass index independently predicted low BMD in the femoral neck (R2 = 0.19). Compared with men younger than 70 years old, men 70 years old or older had less BMD in the spine (P = 0.017), femoral neck (P = 0.047), and trochanter (P = 0.030).


CONCLUSIONS
A high prevalence of osteopenia or osteoporosis was found in men with prostate cancer not receiving ADT. Consideration should be given to performing BMD studies in men older than 70 years and with slender stature before initiating ADT.
Department of Nursing, University of California, Los Angeles, School of Nursing, Los Angeles, California, USA.
Francisco A
FA
Conde
Linda
L
Sarna
Roberta K
RK
Oka
Donna L
DL
Vredevoe
Matthew B
MB
Rettig
William J
WJ
Aronson
D015502:Absorptiometry, Photon; D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D005272:Femur Neck / Q000473:pathology; D006801:Humans; D008019:Life Style; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D009765:Obesity / Q000453:epidemiology*; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D017430:Prostate-Specific Antigen