Metabolic syndrome in patients with prostate cancer undergoing intermittent androgen-deprivation therapy

Abstract

Introduction: The presence of metabolic syndrome in men with prostate cancer (PCa) undergoing androgen-deprivation therapy (ADT), especially intermittent type, has not been completely evaluated. The aim of this study is to evaluate metabolic syndrome in men with PCa undergoing intermittent ADT. Methods: In this longitudinal study, we studied the prevalence of metabolic syndrome and its components in 190 patients who were undergoing intermittent ADT. The metabolic syndrome was defined according to the Adult Treatment Panel III criteria. All metabolic parameters, including lipid profile, blood glucose, blood pressures, and waist circumferences of the patients were measured six and 12 months after treatment. Results: Mean age of the patients was 67.5 ± 6.74 years. The incidence of metabolic syndrome after six and 12 months was 6.8% and 14.7%, respectively. Analysis of various components of the metabolic syndrome revealed that patients had significantly higher overall prevalence of hyperglycemia, abdominal obesity, and hypertriglyceridemia in their six-and 12-month followups, but blood pressure has not been changed in the same period except for diastolic blood pressure after six months. Conclusions: Although there was an increased risk of metabolic syndrome in patients receiving intermittent ADT, it was lower than other studies that treated the same patients with continuous ADT. Also it seems that intermittent ADT has less metabolic complications than continuous ADT and could be used as a safe alternative in patients with advanced and metastatic PCa.

Association of Gonadotropin-Releasing Hormone Agonists for Prostate Cancer With Cardiovascular Disease Risk and Hypertension in Men With Diabetes

“…GnRH agonist use may be associated with elevated blood pressure because of its reduction in testosterone . However, several observational studies reported no change in blood pressure after 12 months of treatment with GnRH agonists . Testosterone has been shown to activate both vasodilator and vasoconstrictor pathways, which may explain the inconsistent results .…”

“…39 However, several observational studies reported no change in blood pressure after 12 months of treatment with GnRH agonists. 11,12,40 Testosterone has been shown to activate both vasodilator and vasoconstrictor pathways, which may explain the inconsistent results. 38,41 In our study, use of GnRH agonists and PCa diagnosis were associated with lower blood pressure in men with type 2 diabetes.…”

Retrospective cohort study of androgen deprivation therapy and the risk of diabetes in men with prostate cancer in Lithuania

“…Intermittent ADT treatment was suggested as an alternative treatment to continuous ADT with possibly fewer complications and better quality of life. 19 Rezaei et al 20 study's results showed that in short-term treatment with intermittent ADT there was no difference in fasting blood glucose, which suggests lower risks of diabetes mellitus in this group of patients. Thus, difference in diabetes risk increase between non-users and ADT users could be mitigated by the proportion of intermittent ADT user in our cohort, whom we could not identify from our database.…”

Clinical significance of androgen secretion disorders in men with a malignancy

“…A decrease in testosterone concentration leads to an increase in fasting insulin and low-density lipoproteins (LDL) as early as 3 months after androgen deprivation therapy (ADT) commencement. Moreover, serum glucose, total cholesterol and high-density lipoproteins (HDL) increase 1 year later, accompanied by increasing waist circumference [ 44 ] and triglycerides concentration [ 45 ]. According to a meta-analysis, the relative risk of metabolic syndrome and diabetes in men undergoing ADT is 1.75 and 1.36, respectively [ 46 ].…”