Effects of androgen suppression by gonadotropin-releasing hormone agonist and flutamide on lipid metabolism in men with prostate cancer: focus on lipoprotein(a)

Abstract

No clear relation between lipoprotein(a) [Lp(a)] and endogenous gonadal hormones has been demonstrated. In this study, we compared the effects on Lp(a) of pharmacological castration in 50 patients with prostate cancer who were undergoing therapy with a gonadotropin-releasing hormone agonist (goserelin), with effects on 58 age-matched controls. We also studied 16 untreated patients under baseline conditions and after 3 months of therapy with goserelin alone or combined with an antiandrogen (flutamide). Neither cross-sectional nor prospective studies showed any significant effects of therapy on Lp(a). However, cluster analysis identified a subgroup of patients showing slight but significant increases in Lp(a) concentrations, as well as greater declines of testosterone and estradiol, suggesting that androgen, like estrogen, can exert some slight, though not easily detectable, influence on Lp(a).

Aging‐Related Decline of Gonadal Function in Healthy Men: Correlation with Body Composition and Lipoproteins

“…These findings are in contrast with well documented findings of HDL‐C decrease after exogenous androgen administration in both sexes 31–37 . Accordingly, androgen deprivation induced by surgical or chemical castration is associated with increased HDL‐C and apoprotein AI concentrations 38–41 . Androgen supplementation in older people, however, did not show any effects on HDL; rather, a decline of LDL‐C has been reported 9, 11–13 …”

Effects of Androgen Deprivation Therapy on Extraocular Muscles, Retrobulbar Orbital Fat, and the Optic Nerve in Patients with Prostate Cancer

“…A previous meta-analysis evaluated the effects of ADT on body composition and indicated that 6 out of 8 studies that evaluated BMI changes reported a significant increase of approximately 2.15% in BMI [11]. In the remaining two studies, no significant BMI increase was observed in one study, and a mean decrease of 0.39% was observed in the other study [36,37]. In our Ophthalmic Res 2023;66:272-280 DOI: 10.1159/000527387 study, although an increase of 0.88% was noted in the mean BMI value, this increase was statistically insignificant.…”

Hormonal influences on lipoprotein(a) metabolism

“…Neither cross-sectional nor prospective studies showed any significant effects of such therapy on Lp(a). However, cluster analysis suggests that the Lp(a) responses to androgen suppression are related to baseline concentrations of Lp(a) [51]. In another study, suppression of endogenous testosterone by the administration of Cetrorelix, an antagonist of GnRH, significantly increased Lp(a) levels by 40±60% in men [52].…”