Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy.
OBJECTIVE
Prostate cancer (PCa) is one of the most common cancers in men. Men with recurrent or metastatic PCa are treated with androgen-deprivation therapy (ADT), resulting in profound hypogonadism. Because male hypogonadism is a risk factor for metabolic syndrome and men with PCa have high cardiovascular mortality, we evaluated the prevalence of metabolic syndrome in men undergoing long-term ADT.


METHODS
This was a cross-sectional study. We evaluated 58 men, including 20 with PCa undergoing ADT for at least 12 months (ADT group), 18 age-matched men with nonmetastatic PCa who had received local treatment and were recently found to have an increasing prostate-specific antigen (non-ADT group), and 20 age-matched controls (control group). Men in the non-ADT and control groups were eugonadal. Metabolic syndrome was defined according to the Adult Treatment Panel III criteria.


RESULTS
Mean age was similar among the groups. Men on ADT had significantly higher body mass index and lower total and free testosterone levels. The prevalence of metabolic syndrome was higher in the ADT group compared with the non-ADT (P < .01) and control (P = .03) groups. Among the components of metabolic syndrome, men on ADT had a higher prevalence of abdominal obesity and hyperglycemia. Androgen-deprived men also had elevated triglycerides compared with controls (P = .02). The prevalence of hypertension and low high-density lipoprotein levels were similar.


CONCLUSIONS
These data suggest that metabolic syndrome was present in more than 50% of the men undergoing long-term ADT, predisposing them to higher cardiovascular risk. Abdominal obesity and hyperglycemia were responsible for this higher prevalence. We recommend prospective studies to further delineate this association.
Braga-Basaria
Milena
M
Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Bayview Medical Center, Baltimore, MD 21224, USA. sbasari1@jhmi.edu
Dobs
Adrian S
AS
Muller
Denis C
DC
Carducci
Michael A
MA
John
Majnu
M
Egan
Josephine
J
Basaria
Shehzad
S
D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006728:Hormones / Q000097:blood; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007006:Hypogonadism / Q000097:blood / Q000139:chemically induced / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D012307:Risk Factors
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D006728:Hormones; D017430:Prostate-Specific Antigen