title: Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy.
abstract: OBJECTIVE
  Observational data suggest that androgen deprivation therapy increases the risk of diabetes and cardiovascular disease. Using data from the population based PCOS we evaluated whether age at diagnosis and comorbidity impact the association of androgen deprivation therapy with incident diabetes and cardiovascular disease.
  
  
  METHODS
  We identified men with nonmetastatic prostate cancer diagnosed from 1994 to 1995 who were followed through 2009 to 2010. We used multivariable logistic regression models to assess the relationship of androgen deprivation therapy exposure (2 or fewer years, greater than 2 years or none) with incident diabetes and cardiovascular disease, adjusting for age at diagnosis, race, stage and comorbidity.
  
  
  RESULTS
  Of 3,526 eligible study participants 2,985 without diabetes and 3,112 without cardiovascular disease comprised the cohorts at risk. Androgen deprivation therapy was not associated with an increased risk of diabetes or cardiovascular disease in men diagnosed with prostate cancer before age 70 years. Prolonged androgen deprivation therapy and increasing age at diagnosis in older men was associated with an increased risk of diabetes (at age 76 years OR 2.1, 95% CI 1.0-4.4) and cardiovascular disease (at age 74 years OR 1.9, 95% CI 1.0-3.5). Men with comorbidities were at greater risk for diabetes (OR 4.3, 95% CI 2.3-7.9) and cardiovascular disease (OR 8.1, 95% CI 4.3-15.5) than men without comorbidities.
  
  
  CONCLUSIONS
  Prolonged androgen deprivation therapy exposure increases the risk of cardiovascular disease and diabetes in men diagnosed with prostate cancer who are older than approximately 75 years, especially those with other comorbidities. Older men who receive prolonged androgen deprivation therapy should be closely monitored for diabetes and cardiovascular disease.
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee. Electronic address: alicia.morgans@vanderbilt.edu.
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Morgans
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
authors.forename: Kang-Hsien
authors.initials: KH
authors.lastname: Fan
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Koyama
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.affiliation: University of New Mexico, Albuquerque, New Mexico.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hoffman
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Stanford
authors.affiliation: University of Utah, Salt Lake City, Utah.
authors.forename: Antoinette M
authors.initials: AM
authors.lastname: Stroup
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Resnick
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Barocas
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee; Geriatric Research, Education and Clinical Center, Tennessee Valley Veterans Administration Healthcare System, Nashville, Tennessee.
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D048909:Diabetes Complications / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy*; D012306:Risk; D017741:Survivors
chemical_list: D000726:Androgen Antagonists
keywords: antiandrogens; cardiovascular diseases; diabetes mellitus; prostatic neoplasms; risk