Influence of 1 year of androgen deprivation therapy on lipid and glucose metabolism and fat accumulation in Japanese patients with prostate cancer.
BACKGROUND
We prospectively examined influence of androgen deprivation therapy (ADT) on lipid and glucose metabolisms in Japanese patients with prostate cancer.


METHODS
Patients with prostate cancer who were hormone-naive and scheduled to receive long-term ADT were recruited between 2011 and 2013. Body weight, abdominal circumference and blood testing associated with lipid and glucose metabolism were recorded every 3 months during 1 year of ADT. Computed tomography (CT) was performed to measure areas of subcutaneous and visceral fat before and after 1 year of ADT. ADT was limited to a luteinizing hormone-releasing hormone (LHRH) agonist with or without bicalutamide.


RESULTS
Of 218 patients registered, data were available from 177 patients who completed 1 year of ADT. Of these, CT was performed before and after 1 year of ADT in 88 patients. Median age was 75 years (range, 49-85 years). Median PSA before ADT was 16.7 ng ml(-1) (range, 0.3-3316). Clinical stage was B (54.2%), C (23.2%) and D (20.9%). Mean increases in body weight and abdominal circumference after 1 year of ADT were 2.9 and 3.0%, respectively. Mean increases in total, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides were 10.6, 14.3, 7.8 and 16.2%, respectively. Mean increases in fasting blood sugar and hemoglobin A1c (HbA1c) were 3.9 and 2.7%, respectively. Lipid alterations were noted in patients without comorbidities, whereas changes in HbA1c were noted in patients with diabetes mellitus at baseline. These lipid and glucose alterations were prominent in the early ADT period. Both visceral and subcutaneous fat, as measured by CT, increased by >20%. The increase in subcutaneous fat was significantly greater than that in visceral fat (P=0.028).


CONCLUSIONS
One year of ADT significantly changed lipid and glucose metabolism in Japanese patients with prostate cancer. Patient characteristics or comorbidities at baseline may be associated with ADT-induced metabolic changes.
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
K
K
Mitsuzuka
Department of Urology, Shirakawa Kosei General Hospital, Shirakawa, Japan.
A
A
Kyan
Department of Urology, Shirakawa Kosei General Hospital, Shirakawa, Japan.
T
T
Sato
Department of Urology, Kesen-numa City Hospital, Kesen-numa, Japan.
K
K
Orikasa
Department of Urology, Ryukyu University, Nishihara, Japan.
M
M
Miyazato
Department of Urology, Sendai City Hospital, Sendai, Japan.
H
H
Aoki
Department of Urology, Miyagi Cancer Center, Natori, Japan.
N
N
Kakoi
Department of Urology, Akita University School of Medicine, Akita, Japan.
S
S
Narita
Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.
T
T
Koie
Department of Urology, Tohoku Rosai Hospital, Sendai, Japan.
T
T
Namima
Department of Urology, Sendai Jin Hinyokika Clinic, Sendai, Japan.
S
S
Toyoda
Department of Urology, Sendai Yanagyu Clinic, Sendai, Japan.
Y
Y
Fukushi
Department of Urology, Akita University School of Medicine, Akita, Japan.
T
T
Habuchi
Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.
C
C
Ohyama
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Y
Y
Arai
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000378:metabolism; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000473:pathology; D005947:Glucose / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D007987:Gonadotropin-Releasing Hormone / Q000378:metabolism*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000187:drug effects; D007564:Japan; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology
D000726:Androgen Antagonists; D005947:Glucose; D006442:Glycated Hemoglobin; D007987:Gonadotropin-Releasing Hormone; C517652:hemoglobin A1c protein, human