title: Effects of a lifestyle intervention on endothelial function in men on long-term androgen deprivation therapy for prostate cancer.
abstract: BACKGROUND
  Treatment of prostate cancer with androgen deprivation therapy (ADT) is associated with metabolic changes that have been linked to an increase in cardiovascular risk.
  
  
  METHODS
  This randomised controlled trial investigated the effects of a 12-week lifestyle intervention that included supervised exercise training and dietary advice on markers of cardiovascular risk in 50 men on long-term ADT recruited to an on-going study investigating the effects of such a lifestyle intervention on quality of life. Participants were randomly allocated to receive the intervention or usual care. Cardiovascular outcomes included endothelial function (flow-mediated dilatation (FMD) of the brachial artery), blood pressure, body composition and serum lipids. Additional outcomes included treadmill walk time and exercise and dietary behaviours. Outcomes were assessed before randomisation (baseline), and 6, 12 and 24 weeks after randomisation.
  
  
  RESULTS
  At 12 weeks, the difference in mean relative FMD was 2.2% (95% confidence interval (CI) 0.1-4.3, P=0.04) with an effect size of 0.60 (95% CI <0.01-1.18) favouring the intervention group. Improvements in skeletal muscle mass, treadmill walk time and exercise behaviour also occurred in the intervention group over that duration (P<0.05). At 24 weeks, only the difference in treadmill walk time was maintained.
  
  
  CONCLUSIONS
  This study demonstrates that lifestyle changes can improve endothelial function in men on long-term ADT for prostate cancer. The implications for cardiovascular health need further investigation in larger studies over longer duration.
authors.affiliation: Faculty of Health and Life Sciences, York St John University, Lord Mayor's Walk, York YO31 7EX, UK.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilbert
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK.
authors.forename: Garry A
authors.initials: GA
authors.lastname: Tew
authors.affiliation: York Trials Unit, Department of Health Sciences, University of York, York YO10 5DD, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Fairhurst
authors.affiliation: Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent, Sheffield S10 2BP, UK.
authors.forename: Liam
authors.initials: L
authors.lastname: Bourke
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Saxton
authors.affiliation: Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent, Sheffield S10 2BP, UK.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Winter
authors.affiliation: Academic Urology Unit, Department of Oncology, Royal Hallamshire Hospital, University of Sheffield, Sheffield S11 7FE, UK.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rosario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000378:metabolism; D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal