Risk factors for bone loss with prostate cancer in Korean men not receiving androgen deprivation therapy.
OBJECTIVE
Preexisting bone loss in men with prostate cancer is an important issue due to the accelerated bone loss during androgen deprivation therapy (ADT). In addition, a high prostate-specific antigen (PSA) level has been reported to be related to bone metabolism. This study assessed the factors associated with osteoporosis in Korean men with non-metastatic prostate cancer before undergoing ADT.


METHODS
The study enrolled patients admitted for a prostate biopsy because of a high PSA or palpable nodule on a digital rectal examination. We divided the patients (n = 172) according to the results of the biopsy: group I, non-metastatic prostate cancer (n = 42) and group II, benign prostatic hypertrophy (BPH; n = 130). The lumbar bone mineral density (BMD) was evaluated using quantitative computed tomography. The demographic, health status, lifestyle, body mass index (BMI), serum testosterone concentration, and disease variables in prostate cancer (Gleason score, clinical stage, and PSA) were analyzed prospectively to determine their effect on the BMD.


RESULTS
The estimated mean T-score was higher in group I than in group II (-1.96 +/- 3.35 vs. -2.66 +/- 3.20), but without statistic significance (p = 0.235). The significant factors correlated with BMD in group I were a high serum PSA (Beta = -0.346, p = 0.010) and low BMI (Beta = 0.345, p = 0.014) in the multiple linear regression model. Also old age (r = -0.481, p = 0.001), a high serum PSA (r = -0.571, p < 0.001), low BMI (r = 0.598, p < 0.001), and a high Gleason's score (r = -0.319, p = 0.040) were the factors related to BMD in the correlation. The significant factors correlated with BMD in group II were old age (Beta = -0.324, p = 0.001) and BMI (Beta = 0.143, p = 0.014) in the multiple linear regression model.


CONCLUSIONS
The risk factors for osteoporosis in men with prostate cancer include a low BMI, and elevated serum PSA. Monitoring BMD from the outset of ADT is a logical first step in the clinical strategy to avoid or minimize potential bone-related complications in these patients.
Kim
Sun-Ouck
SO
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Kang
Taek Won
TW
Kwon
Dongdeuk
D
Park
Kwangsung
K
Ryu
Soo Bang
SB
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D015992:Body Mass Index; D015519:Bone Density; D006801:Humans; D007723:Korea; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology; D012189:Retrospective Studies; D012307:Risk Factors; D013739:Testosterone / Q000172:deficiency
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D013739:Testosterone; D017430:Prostate-Specific Antigen