The effect of androgen deprivation therapy on fasting serum lipid and glucose parameters.
OBJECTIVE
Although prostate cancer specific mortality is decreasing, there is little effect on overall mortality in this population, suggesting the possibility of an increased risk of death from nonprostate cancer related causes. Androgen deprivation therapy could adversely affect cardiovascular health. We investigated changes in lipid and glucose during androgen deprivation therapy.


METHODS
We performed an exploratory analysis of pooled data from 3 prospective clinical trials aimed at achieving medical castration by comparing the gonadotropin releasing hormone antagonist abarelix, the gonadotropin releasing hormone agonist leuprolide acetate and leuprolide acetate plus the antiandrogen bicalutamide. Most patients were treated in the neoadjuvant setting or because of biochemical recurrence. Fasting serum lipid, glucose and hemoglobin A1C were determined in 1,102 men at baseline, and on treatment days 85 and 169. In the current study men were categorized into 3 treatment groups according to the type of androgen deprivation therapy, that is leuprolide acetate, leuprolide acetate plus bicalutamide or abarelix, and statin therapy.


RESULTS
Significant increases in total cholesterol, triglyceride and high density lipoprotein-cholesterol were observed in patients on leuprolide acetate or abarelix but not in patients on leuprolide acetate plus bicalutamide. Consistent changes in low density lipoprotein-cholesterol were not detected. Increased total cholesterol was usually due to an increase in high density lipoprotein-cholesterol. Hemoglobin A1C increased from baseline to day 85 only and there were no significant changes in fasting glucose measurements. The type of androgen deprivation therapy did not affect these parameters.


CONCLUSIONS
Short-term androgen deprivation therapy affects serum lipid and hemoglobin A1C independent of statin therapy.
Yannucci
Jennifer
J
Beth Israel Deaconess Medical Center, Waltham, Massachusetts 02215, USA.
Manola
Judi
J
Garnick
Marc B
MB
Bhat
Gajanan
G
Bubley
Glenn J
GJ
D000726:Androgen Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000813:Anilides / Q000494:pharmacology* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis*; D002784:Cholesterol / Q000097:blood*; D005215:Fasting; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D016729:Leuprolide / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D009842:Oligopeptides / Q000494:pharmacology* / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D014105:Tosyl Compounds
D000726:Androgen Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D001786:Blood Glucose; D009570:Nitriles; D009842:Oligopeptides; D014105:Tosyl Compounds; D007987:Gonadotropin-Releasing Hormone; D002784:Cholesterol; C053541:bicalutamide; D016729:Leuprolide; C423508:abarelix