title: Insulin sensitivity during combined androgen blockade for prostate cancer.
abstract: BACKGROUND
  GnRH agonists markedly increase fat mass in men with prostate cancer, but little is known about the effects of treatment on insulin sensitivity.
  
  
  OBJECTIVE
  The objective of the study was to assess the effects of short-term GnRH agonist treatment on insulin sensitivity.
  
  
  METHODS
  This was a prospective 12-wk study.
  
  
  METHODS
  The study was conducted at a general clinical research center.
  
  
  METHODS
  We studied 25 men with locally advanced or recurrent prostate cancer, no radiographic evidence of metastases, no history of diabetes mellitus, and no evidence of diabetes mellitus at baseline visit.
  
  
  METHODS
  Leuprolide depot and bicalutamide were used in the study.
  
  
  METHODS
  Oral glucose tolerance tests and body composition assessment by dual-energy x-ray absorptiometry were performed at baseline and wk 12. The primary study outcome was change in insulin sensitivity index.
  
  
  RESULTS
  Mean (+/- se) percentage fat body mass increased by 4.3 +/- 1.3% from baseline to wk 12 (P = 0.002). Insulin sensitivity index decreased by 12.9 +/- 7.6% (P = 0.02). Insulin sensitivity by homeostatic model assessment decreased by 12.8 +/- 5.9% (P = 0.02). Fasting plasma insulin levels increased by 25.9 +/- 9.3% (P = 0.04). Mean glycosylated hemoglobin also increased significantly (P < 0.001).
  
  
  CONCLUSIONS
  Short-term treatment with leuprolide and bicalutamide significantly increased fat mass and decreased insulin sensitivity in men with prostate cancer. These observations suggest that GnRH agonists may increase the risk of diabetes mellitus and cardiovascular disease in older men.
authors.affiliation: Massachusetts General Hospital, Cox 640, 100 Blossom Street, Boston, MA 02114, USA. smith.matthew@mgh.harvard.edu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Smith
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.forename: David M
authors.initials: DM
authors.lastname: Nathan
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use*; D000886:Anthropometry; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use*; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000187:drug effects; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007987:Gonadotropin-Releasing Hormone; D007328:Insulin; D008055:Lipids; D013739:Testosterone