Objective. Prostate cancer (PCa) is a hormone-sensitive tumor, therefore, androgen-deprivation therapy (ADT) is one of the options in the treatment of this widespread disease. ADT aims to block the synthesis or action of androgens that stimulate the proliferation of prostate tissue through bilateral orchiectomy or the use of drugs. The main drugs used are luteinizing hormone-releasing hormone (aLHRH) agonists. Iatrogenic hypogonadism leads to inhibition of tumor proliferation, but increases the likelihood of complications associated with androgenic deprivation, including metabolic ones, which are associated with negative cardiovascular outcomes. However, it is still not entirely clear which mechanisms mediate the effect of aLHRH therapy on cardiovascular risks.
Design. Follow-up study.
Materials and Methods. The study included 99 patients. The mean age was 69 years old (95% confidence range: 61.5-79.2 years old). To assess metabolic consequences, waist circumference (WC), body mass index (BMI), fasting plasma glucose (FPG), HbA1c, total cholesterol (TС), triglycerides, were measured prior to and 3, 6 and 12 months after after androgen deprivation therapy (ADT). ADT initiation. To glucose and other metabolic parameters.
Results. The following changes were noted in test parameters: metabolic parameters (basic 3, 6 and 12 months later, respectively): WC (cm): 91.5, 95.4 (+4.2%), 96.1 (+5.0%), 96.4 (+5.4%) (for all differences p ≤ 0.05); BMI (kg/m2): 27.4, 28.2 (+2.9%), 28.4 (+3.6%), 28.4 (+3.6%) (p ≤ 0.004 for all differences, save for differences between values in 6 and 12 months — p = 0.995); FPG, mmol/l: 5,2– 5,7 (+9,6%)–5,8 (+11,5%) – 5,9 (+13,5%) (p≤0,003); HbA1c, %: 5,4–5,7 (+5,6%)–5,8 (+7,4%) –5,9 (+9,2%)(p<0,001); TG, mmol/l: 1,7–1,9 (+11,8%)–2,0 (+17,6%) – 2,1 (+23,5%) (p≤0,004), TC, mmol/l: 5,2–5,6 (+7,7%)–5,8 (+11,5%)–5,9 (+13,5%) (for all differences p ≤ 0.001). Statistically significant positive correlations were noted between baseline WC and FPG dynamics (R = 0.233, p = 0.020); baseline BMI and TG dynamics (R = 0.301, p = 0.002). The positive correlation between baseline WC and TG dynamics did not reach the level of statistical significance (R = 0.196, p = 0.052). Conclusion. aLHRH monotherapy led to the trend of increase in WC, body mass, TC demonstrated an increase. The highest increase in WC, BMI, FPG, HbA1c, TC, TG was recorded within first 3 months of therapy, then the rate of increase diminished. Further study of metabolic and hormonal complications from ADT and evidence base enhancement are required in order to check the data and develop measures to prevent complications.