Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy
Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy
复制标题
DOI：
10.1200/jco.2006.05.9741
复制
发表时间：
2006-08-20
影响因子：
45.3
通讯作者：
Basaria, Shehzad
中科院分区：
文献类型：
--
作者：
Braga-Basaria, Milena;Dobs, Adrian S.;Basaria, Shehzad
目的 前列腺癌 (PCa) 是男性最常见的癌症之一。患有复发性或转移性前列腺癌的男性接受雄激素剥夺疗法（ADT）治疗，导致严重的性腺功能减退症。由于男性性腺功能减退症是代谢综合征的危险因素，而患有 PCa 的男性心血管死亡率较高，因此我们评估了接受长期 ADT 的男性代谢综合征的患病率。患者和方法这是一项横断面研究。我们评估了 58 名男性，其中包括 20 名接受 ADT 至少 12 个月的前列腺癌患者（ADT 组）、18 名接受过局部治疗且最近发现前列腺特异性抗原增加的年龄匹配的非转移性前列腺癌男性（非 ADT 组），以及 20 名年龄匹配的对照组（对照组）。非 ADT 组和对照组的男性性腺功能正常。代谢综合征根据成人治疗小组 III 标准进行定义。结果 各组的平均年龄相似。接受 ADT 的男性体重指数明显较高，总睾酮和游离睾酮水平较低。与非 ADT 组 (P < .01) 和对照组 (P = .03) 相比，ADT 组代谢综合征的患病率较高。在代谢综合征的组成部分中，接受 ADT 的男性腹部肥胖和高血糖的患病率较高。与对照组相比，雄激素剥夺男性的甘油三酯也升高（P = .02）。高血压和低高密度脂蛋白水平的患病率相似。 结论 这些数据表明，超过 50% 接受长期 ADT 的男性存在代谢综合征，使他们面临更高的心血管风险。腹部肥胖和高血糖是导致患病率较高的原因。我们建议进行前瞻性研究以进一步描述这种关联。
Purpose Prostate cancer (PCa) is one of the most common cancers in men. Men with recurrent or metastatic PCa are treated with androgen-deprivation therapy (ADT), resulting in profound hypogonadism. Because male hypogonadism is a risk factor for metabolic syndrome and men with PCa have high cardiovascular mortality, we evaluated the prevalence of metabolic syndrome in men undergoing long-term ADT.Patients and Methods This was a cross-sectional study. We evaluated 58 men, including 20 with PCa undergoing ADT for at least 12 months (ADT group), 18 age-matched men with nonmetastatic PCa who had received local treatment and were recently found to have an increasing prostate-specific antigen (non-ADT group), and 20 age-matched controls (control group). Men in the non-ADT and control groups were eugonadal. Metabolic syndrome was defined according to the Adult Treatment Panel III criteria.Results Mean age was similar among the groups. Men on ADT had significantly higher body mass index and lower total and free testosterone levels. The prevalence of metabolic syndrome was higher in the ADT group compared with the non-ADT (P < .01) and control (P = .03) groups. Among the components of metabolic syndrome, men on ADT had a higher prevalence of abdominal obesity and hyperglycemia. Androgen-deprived men also had elevated triglycerides compared with controls (P = .02). The prevalence of hypertension and low high-density lipoprotein levels were similar.Conclusion These data suggest that metabolic syndrome was present in more than 50% of the men undergoing long-term ADT, predisposing them to higher cardiovascular risk. Abdominal obesity and hyperglycemia were responsible for this higher prevalence. We recommend prospective studies to further delineate this association.