Adverse metabolic consequences of androgen deprivation therapy (ADT) on Asian patients with prostate cancer: Primary results from the real-life experience of ADT in Asia (READT) study.
Asian
androgen deprivation therapy
metabolic outcomes
Journal
The Prostate
ISSN: 1097-0045
Titre abrégé: Prostate
Pays: United States
ID NLM: 8101368
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
10
02
2023
received:
25
10
2022
accepted:
02
03
2023
medline:
24
4
2023
pubmed:
21
3
2023
entrez:
20
3
2023
Statut:
ppublish
Résumé
Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We investigated the relationship between ADT and adverse changes in metabolic parameters in an Asian population. This is an international prospective multicenter single-arm cohort yielded from the real-life experience of ADT in Asia (READT) registry. Consecutive ADT-naïve patients diagnosed of PCa and started on ADT were prospectively recruited from 2016 and analyzed. Baseline patient characteristics, PCa disease status, and metabolic parameters were documented. Patients were followed up at 6-month interval for up to 5 years. Metabolic parameters including body weight, lipid profiles, and glycemic profiles were recorded and analyzed. 589 patients were eligible for analysis. ADT was associated with adverse glycemic profiles, being notable at 6 months upon ADT initiation and persisted beyond 1 year. Comparing to baseline, fasting glucose level and hemoglobin A1c level increased by 4.8% (p < 0.001) and 2.7% (p < 0.001), respectively. Triglycerides level was also elevated by 16.1% at 6th month and by 20.6% at 12th month compared to baseline (p < 0.001). Mean body weight was 1.09 kg above baseline at 18th month (p < 0.001). ADT was associated with adverse metabolic parameters in terms of glycemic profiles, lipid profiles, and body weight in the Asian population. These changes developed early in the treatment and can persist beyond the first year. Regular monitoring of the biochemical profiles during treatment is paramount in safeguarding the patients' metabolic health.
Sections du résumé
BACKGROUND
Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We investigated the relationship between ADT and adverse changes in metabolic parameters in an Asian population.
METHODS
This is an international prospective multicenter single-arm cohort yielded from the real-life experience of ADT in Asia (READT) registry. Consecutive ADT-naïve patients diagnosed of PCa and started on ADT were prospectively recruited from 2016 and analyzed. Baseline patient characteristics, PCa disease status, and metabolic parameters were documented. Patients were followed up at 6-month interval for up to 5 years. Metabolic parameters including body weight, lipid profiles, and glycemic profiles were recorded and analyzed.
RESULTS
589 patients were eligible for analysis. ADT was associated with adverse glycemic profiles, being notable at 6 months upon ADT initiation and persisted beyond 1 year. Comparing to baseline, fasting glucose level and hemoglobin A1c level increased by 4.8% (p < 0.001) and 2.7% (p < 0.001), respectively. Triglycerides level was also elevated by 16.1% at 6th month and by 20.6% at 12th month compared to baseline (p < 0.001). Mean body weight was 1.09 kg above baseline at 18th month (p < 0.001).
CONCLUSION
ADT was associated with adverse metabolic parameters in terms of glycemic profiles, lipid profiles, and body weight in the Asian population. These changes developed early in the treatment and can persist beyond the first year. Regular monitoring of the biochemical profiles during treatment is paramount in safeguarding the patients' metabolic health.
Substances chimiques
Androgens
0
Androgen Antagonists
0
Lipids
0
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
801-808Informations de copyright
© 2023 The Authors. The Prostate published by Wiley Periodicals LLC.
Références
Huggins C, Hodges CV. Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin. 1972;22(4):232-240.
Bolla M, Van Tienhoven G, Warde P, et al. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol. 2010;11(11):1066-1073.
Faris JE, Smith MR. Metabolic sequelae associated with androgen deprivation therapy for prostate cancer. Curr Opin Endocrinol Diabetes Obes. 2010;17(3):240-246.
Hu JR, Duncan MS, Morgans AK, et al. Cardiovascular effects of androgen deprivation therapy in prostate cancer: contemporary meta-analyses. Arterioscler Thromb Vasc Biol. 2020;40(3):e55-e64.
Wong C, Chu P, Teoh J, et al. Risks of metabolic diseases and androgen deprivation therapy for prostate cancer in a Chinese population: a prospective multi-centre cohort study. Int Urol Nephrol. 2022;54(5):993-1000.
Smith MR. Osteoporosis during androgen deprivation therapy for prostate cancer. Urology. 2002;60(3 suppl 1):79-85.
Derweesh IH, Diblasio CJ, Kincade MC, et al. Risk of new-onset diabetes mellitus and worsening glycaemic variables for established diabetes in men undergoing androgen-deprivation therapy for prostate cancer. BJU Int. 2007 Nov;100(5):1060-1065.
Teoh JYC, Ng CF. Cardiovascular risk after androgen deprivation therapy for prostate cancer: an Asian perspective. Int Urol Nephrol. 2016;48(9):1429-1435.
Teoh JYC, Chan SYS, Chiu PKF, et al. Risk of acute myocardial infarction after androgen-deprivation therapy for prostate cancer in a Chinese population. BJU Int. 2015;116(3):382-387.
Teoh JYC, Chiu PKF, Chan SYS, et al. Risk of new-onset diabetes after androgen deprivation therapy for prostate cancer in the Asian population. J Diabetes. 2015;7(5):672-680.
Teoh JYC, Tian XY, Wong CYP, et al. Endothelial dysfunction after androgen deprivation therapy and the possible underlying mechanisms. Prostate. 2022;82(1):13-25.
Teoh JYC, Chiu PKF, Chan SYS, et al. Androgen deprivation therapy, diabetes and poor physical performance status increase fracture risk in Chinese men treated for prostate cancer. The Aging Male. 2015;18(3):180-185.
Poon DMC, Chan K, Chan T, et al. Ethnic pharmacogenomic differences in the management of Asian patients with metastatic prostate cancer. Cancers. 2022;14(2):407.
Seong JM, Shin D, Sung JW, et al. Gonadotropin-releasing hormone agonists, anti-androgens and the risk of cardio-cerebrovascular disease in prostate cancer patients: an asian population-based observational study. J Cancer. 2020;11(14):4015-22.
Wang LH, Liu CK, Chen CH, Kao LT, Lin HC, Huang CY. No increased risk of coronary heart disease for patients receiving androgen deprivation therapy for prostate cancer in Chinese/Taiwanese men. Andrology. 2016;4(1):128-132.
Mitsuzuka K, Kyan A, Sato T, et al. Influence of 1 year of androgen deprivation therapy on lipid and glucose metabolism and fat accumulation in Japanese patients with prostate cancer. Prostate Cancer Prostatic Dis. 2016;19(1):57-62.
Torimoto K, Samma S, Kagebayashi Y, et al. The effects of androgen deprivation therapy on lipid metabolism and body composition in Japanese patients with prostate cancer. Jpn J Clin Oncol. 2011;41(4):577-581.
Nishiyama T, Ishizaki F, Anraku T, Shimura H, Takahashi K. The influence of androgen deprivation therapy on metabolism in patients with prostate cancer. J Clin Endocrinol Metab. 2005;90(2):657-660.
Cheung AS, Hoermann R, Dupuis P, Joon DL, Zajac JD, Grossmann M. Relationships between insulin resistance and frailty with body composition and testosterone in men undergoing androgen deprivation therapy for prostate cancer. Eur J Endocrinol. 2016;175:229-237.
Salvador C, Planas J, Agreda F, et al. Analysis of the lipid profile and atherogenic risk during androgen deprivation therapy in prostate cancer patients. Urol Int. 2013;90(1):41-44.
Seible DM, Gu X, Hyatt AS, et al. Weight gain on androgen deprivation therapy: which patients are at highest risk? Urology. 2014;83(6):1316-1321.
Smith MR, Lee H, Nathan DM. Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab. 2006;91(4):1305-1308.
Timilshina N, Breunis H, Alibhai SMH. Impact of androgen deprivation therapy on weight gain differs by age in men with nonmetastatic prostate cancer. J Urol. 2012;188(6):2183-2189.
Hamilton EJ, Gianatti E, Strauss BJ, et al. Increase in visceral and subcutaneous abdominal fat in men with prostate cancer treated with androgen deprivation therapy. Clin Endocrinol. 2011;74(3):377-383.
Ng C, Chiu PKF, Yee C, Lau BSY, Leung SCH, Teoh JYC. Effect of androgen deprivation therapy on cardiovascular function in Chinese patients with advanced prostate cancer: a prospective cohort study. Sci Rep. 2020;10(1):18060.
Matsushita Y, Nakagawa T, Yamamoto S, et al. Associations of visceral and subcutaneous fat areas with the prevalence of metabolic risk factor clustering in 6,292 Japanese individuals. Diabetes Care. 2010;33(9):2117-2119.
Kuk JL, Church TS, Blair SN, Ross R. Does measurement site for visceral and abdominal subcutaneous adipose tissue alter associations with the metabolic syndrome? Diabetes Care. 2006;29(3):679-684.
Smith MR, Goode M, Zietman AL, McGovern FJ, Lee H, Finkelstein JS. Bicalutamide monotherapy versus leuprolide monotherapy for prostate cancer: effects on bone mineral density and body composition. J Clin Oncol. 2004;22(13):2546-2553.
Lee H, McGovern K, Finkelstein JS, Smith MR. Changes in bone mineral density and body composition during initial and long-term gonadotropin-releasing hormone agonist treatment for prostate carcinoma. Cancer. 2005;104(8):1633-1637.
Braga-Basaria M, Muller DC, Carducci MA, Dobs AS, Basaria S. Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy. Int J Impotence Res. 2006;18(5):494-498.
Smith JC, Bennett S, Evans LM, et al. The effects of induced hypogonadism on arterial stiffness, body composition, and metabolic parameters in males with prostate cancer. J Clin Endocrinol Metab. 2001;86(9):4261-4267.
Wolny-Rokicka E, Tukiendorf A, Wydmański J, Ostrowska M, Zembroń-Łacny A. Lipid status during combined treatment in prostate cancer patients. Am J Mens Health. 2019;13(5):155798831987648.
Dockery F, Bulpitt CJ, Agarwal S, Donaldson M, Rajkumar C. Testosterone suppression in men with prostate cancer leads to an increase in arterial stiffness and hyperinsulinaemia. Clin Sci. 2003;104(2):195-201.
Bo JJ, Zhang C, Zhang LH, et al. Androgen deprivation therapy through bilateral orchiectomy: increased metabolic risks. Asian J Androl. 2011;13(6):833-837.
Gagliano-Jucá T, Burak MF, Pencina KM, et al. Metabolic changes in androgen-deprived nondiabetic men with prostate cancer are not mediated by cytokines or aP2. J Clin Endocrinol Metab. 2018;103(10):3900-3908.
Smith MR, Finkelstein JS, McGovern FJ, et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002;87(2):599-603.
Yannucci J, Manola J, Garnick MB, Bhat G, Bubley GJ. The effect of androgen deprivation therapy on fasting serum lipid and glucose parameters. J Urol. 2006;176(2):520-525.
Chen KC, Peng CC, Hsieh HM, et al. Antiandrogenic therapy can cause coronary arterial disease. Int J Urol. 2005;12(10):886-891.
Saglam HS, Kose O, Kumsar S, Budak S, Adsan O. Fasting blood glucose and lipid profile alterations following twelve-month androgen deprivation therapy in men with prostate cancer. ScientificWorldJournal. 2012;2012:696329.