Related Experiment Video
Updated: Aug 12, 2026
Isolation of Adipose Derived Regenerative Cells for the Treatment of Erectile Dysfunction Following Radical Prostatectomy
Published on: December 28, 2021
Profiling of Skeletal Muscle and Adipose Tissue Depots in Men with Advanced Prostate Cancer Receiving Different Forms
Tahj A Blow1, Anirudh Murthy1, Rahul Grover1
1Weill Cornell Medicine, New York, NY, USA.
Background:
Androgen deprivation therapy (ADT) is a common treatment modality for men with prostate cancer. Increases in adipose tissue mass and decreases in skeletal muscle mass are known on-target adverse effects of standard ADT. The effects of newer agents such as abiraterone acetate (ABI) and enzalutamide (ENZA) on body composition and how these compare with standard luteinizing hormone-releasing hormone agonists (aLHRHs) are unclear.
Objective:
To assess the effects of different forms of androgen deprivation therapy on body composition in men with prostate cancer.
Design Setting And Participants:
Using a retrospective design, 229 patients receiving aLHRHs alone (n = 120) or in combination with ABI (n = 53) or ENZA (n = 56) were studied.
Outcome Measurements And Statistical Analysis:
Muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were assessed at baseline, 6 mo, and 18 mo after initiating therapy using a cross-sectional densitometry analysis performed on standard of care computed tomography images. Response trajectories for all treatment groups were calculated via a two-way analysis of variance post hoc test, for both within-group and between-group differences.
Results And Limitations:
Treatment with aLHRHs, ABI, and ENZA was associated with a median muscle volume loss of -1.4%, -4.8%, and -5.5% at 6 mo, and -7.1%, -8.1%, and -8.3% at 18 mo, respectively. Therapy with aLHRHs was associated with minimal changes in VAT (0.3% at 6 mo and -0.1% at 18 mo). ABI therapy was associated with significant increases in VAT at 6 mo (4.9%) but not at 18 mo (0.5%), and ENZA therapy was associated with significant decreases in VAT (-4.6% at 6 mo and -5.4% at 18 mo). With respect to SAT, treatment with aLHRHs was associated with increases over time (8.6% at 6 mo and 4.7% at 18 mo), ABI was associated with decreases over time (-3.6% at 6 mo and -6.8% at 18 mo), and ENZA had no clear effects (1.7% at 6 mo and 3.3% at 18 mo).
Conclusions:
ADT regimens cause significant short-term losses in muscle mass, with the most rapid effects occurring with ABI and ENZA. The three regimens have disparate effects on SAT and VAT, suggesting distinct roles of androgens in these tissues.
Patient Summary:
Androgen deprivation therapy alters body composition in men with prostate cancer. Abiraterone and enzalutamide are associated with losses in muscle mass compared with luteinizing hormone-releasing hormone agonists. These treatments impact subcutaneous and visceral fat mass, suggesting distinct roles of androgens in these tissues.
Insights
Androgen deprivation therapy (ADT) significantly impacts body composition in prostate cancer patients. Newer agents like abiraterone acetate and enzalutamide cause greater muscle loss than standard treatments.
Area of Science:
- Oncology
- Endocrinology
- Body Composition Analysis
Background:
- Androgen deprivation therapy (ADT) is a standard treatment for prostate cancer.
- ADT is known to cause adverse effects on body composition, including changes in adipose and skeletal muscle tissue.
- The comparative effects of newer ADT agents (abiraterone acetate, enzalutamide) versus standard agents (aLHRHs) on body composition are not well understood.
Purpose of the Study:
- To evaluate and compare the effects of different androgen deprivation therapy regimens on body composition in men with prostate cancer.
- To assess changes in muscle mass, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) across various ADT treatments.
Main Methods:
- Retrospective study of 229 prostate cancer patients on ADT (aLHRHs alone, or with abiraterone acetate/enzalutamide).
- Body composition (muscle, VAT, SAT) assessed via computed tomography (CT) densitometry at baseline, 6 months, and 18 months.
- Statistical analysis using two-way ANOVA with post hoc tests to determine within-group and between-group differences.
Main Results:
- All ADT regimens led to significant short-term muscle volume loss, with abiraterone acetate and enzalutamide showing more rapid and pronounced effects.
- Luteinizing hormone-releasing hormone agonists (aLHRHs) showed minimal changes in VAT but increased SAT.
- Abiraterone acetate increased VAT initially but not long-term, and decreased SAT; enzalutamide decreased VAT and had minimal impact on SAT.
Conclusions:
- ADT regimens significantly alter body composition, particularly muscle mass, in men with prostate cancer.
- Abiraterone acetate and enzalutamide are associated with greater muscle mass reduction compared to aLHRHs.
- Disparate effects on fat depots suggest distinct roles for androgens in regulating subcutaneous and visceral adipose tissue.
