Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

Abstract

PurposeCardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population.Patients and MethodsThe design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT.ResultsMean total cholesterol (P = .010), LDL cholesterol (P = .021), BMI (P = .001), and waist circumference (P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone.ConclusionThis study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

Impact of Androgen Deprivation on Oxidative Stress and Antioxidant Status in Nigerian Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy

“…ADT has been shown in other studies to increase measures of central obesity independent of the type of ADT, and central obesity is one of the first metabolic changes to occur. 46 , 47 This may be a result of the fact that testosterone deficiency caused by ADT results in decreased visceral adipose tissue lipolysis and accumulation of abdominal fat stores. 48 Previous studies have shown a correlation between overproduction of ROS and fat accumulation, which may lead to lipid metabolic pathway dysfunction through direct lipid peroxidation, thereby maintaining a vicious cycle that, if not checked, may encourage CaP recurrence.…”

Androgen Deprivation Therapy–Induced Cardiovascular Disease

“…Essien et al 1 reported an interesting study, “Cardiovascular disease risk factors: How relevant in African men with prostate cancer receiving androgen-deprivation therapy?” We have a few questions regarding the study.…”

Reply to M. Dhanushkodi

“…We thank Dhanushkodi 1 sincerely for his questions regarding our study, “Cardiovascular Disease Risk Factors: How Relevant in African Men with Prostate Cancer Receiving Androgen-Deprivation Therapy?” 2 In our facility, the gonadotropin-releasing hormone agonist used is goserelin. The dose administered is 3.6 mg every 28 days subcutaneously until the prostate-specific antigen (PSA) level is 0 ng/mL.…”

“…Blood pressure was assessed in this study, and there was no significant difference ( P < .05) in the blood pressures of those receiving ADT and those not receiving ADT. 2 Our study was cross-sectional, so we did not follow up with those patients receiving ADT to see if they had any cardiovascular events. That is also why we do not have baseline values of glucose, lipid profile, and indices of obesity.…”

“…It was actually the treatment-naïve group who had statistically higher mean PSA values compared with patients who underwent orchiectomy alone or hormone manipulation. 2 …”