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

Abstract

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 ADTnaïve 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.

Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

“…A total of 18 consensus statements (Table 1) were accepted and the rationale for each is described below. A number of studies of patients with PCa in Asia including Hong Kong have revealed that ADT users have higher risks of heart failure, hypertension, new-onset diabetes mellitus, dyslipidemia, and being overweight, compared with non-ADT users (11)(12)(13)(14)(15)(16)(17)(18). The association between ADT and an increased risk of developing cardiometabolic complications involves multiple factors, which include a decrease in the testosterone level, an elevation in follicle-stimulating hormone (FSH), changes in body composition, increased insulin resistance, and endothelial dysfunction (77).…”

Review of Cardiovascular Risk of Androgen Deprivation Therapy and the Influence of Race in Men with Prostate Cancer

“…Diagnostic criteria for the syndrome include 3/5 of the following criteria: fasting plasma glucose level > 110 mg/dL, serum triglyceride level ≥ 150 mg/dL, serum HDL < 40 mg/dL, waist circumference > 102 cm, and blood pressure ≥ 130/85 mmHg [ 11 ]. A study of Asian men with prostate cancer who received ADT showed significant changes in metabolic parameters during the treatment course [ 12 ]. A 4.8% increase in fasting blood glucose and 2.7% increase in HbA1c were both noted at 6 months as well as increased triglycerides and mean body weight during follow-up.…”