Complex metabolic and skeletal changes in men taking long-term androgen deprivation therapy

The objective of this study was to assess complex skeletal and metabolic changes in a single cohort of PCa patients taking long-term ADT.

Ninety-five patients with locally advanced PCa (mean age 73.3 ± 6.2 years) were treated with ADT for 24 months. Body mass index (BMI), waist-to-hip ratio (WHR), lipid profile, serum fasting glucose (SFG), and bone mineral density (BMD) of lumbar spine (L1-L4), femoral neck, and total hip BMD were examined at the baseline, and then every 12 months. These measurements were also made to the control group of 88 patients (mean age, 71.9 ± 6.7 years).

After 12 months of ADT, BMI, WHR, low-density lipoprotein, overall cholesterol, and SFG increased significantly; and total hip BMD and BMD L1-L4 decreased significantly in the study group. After 24 months of ADT, BMI, WHR, and SFG increased significantly. BMD was significantly lower in L1-L4, femoral neck, and total hip. Four patients (4.2%) were diagnosed with new onset diabetes. Overall, the incidence of fractures after 24 months of ADT was 7-fold higher in the study group.

ADT leads into unfavorable changes in body composition, unfavorable lipoprotein profile, increase in SFG level and decrease in BMD. The incidence of fractures was 7-fold higher in the study group.