Obese Frailty, Physical Performance Deficits, and Falls in Older Men with Biochemical Recurrence of Prostate Cancer on Androgen Deprivation Therapy: A Case-control Study
Obese Frailty, Physical Performance Deficits, and Falls in Older Men with Biochemical Recurrence of Prostate Cancer on Androgen Deprivation Therapy: A Case-control Study
复制标题
接受雄激素剥夺疗法的前列腺癌生化复发老年男性的肥胖、体能缺陷和跌倒： 病例对照研究
DOI：
10.1016/j.urology.2010.11.024
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发表时间：
2011-04-01
期刊：
影响因子：
2.1
通讯作者：
Dale, William
中科院分区：
文献类型：
--
作者：
Bylow, Kathryn;Hemmerich, Joshua;Dale, William
目的验证早期雄激素剥夺疗法(ADT)对前列腺癌生化复发(BCR)老年男性患者的生存优势，并可能导致老年衰弱。方法对63例60岁以上前列腺癌生化复发患者和71例前列腺癌未复发患者进行病例对照研究。比较了虚弱患病率、“肥胖”虚弱、短体能电池(SPPB)评分和跌倒。对脆弱的生物标志物(C反应蛋白、血沉、血红蛋白、白蛋白和总胆固醇)进行了探索性分析。结果接受ADT治疗的肥胖患者较多(体重指数和GT；30；46.2%vs20.6%；P=0.03)。SPPB(P=.41)和脆性(P=.20)两组间差异无统计学意义。使用建议的“肥胖”脆弱标准，ADT组8.7%的人虚弱，56.5%的人“早衰”，而对照组的这一比例分别为2.9%和48.8%(P=0.02)。ADT组过去一年的降幅更高(14.3%比2.8%；P=0.02)。在对年龄、临床特征和合并症进行控制的分析中，ADT组倾向于“肥胖”虚弱(P=.14)和跌倒(OR=4.74，P=.11)。共病显著增加“肥胖”虚弱(P=.01)和跌倒(OR 2.02，P=.01)的可能性。结论根据建议的修订的“肥胖”虚弱标准，ADT的BCR男性更虚弱。他们的表现状况可能较低，跌落的次数可能更多。有必要进行更大规模的前瞻性试验，以确定ADT的使用与虚弱和残疾进展之间的因果联系。泌尿外科77：934-940,2011。(C)2011年爱思唯尔公司。
OBJECTIVES To test the hypothesis that early androgen deprivation therapy (ADT) has no proven survival advantage in older men with biochemical recurrence (BCR) of prostate cancer (PCa), and it may contribute to geriatric frailty.METHODS We conducted a case-control study of men aged 60+ years with BCR on ADT (n = 63) vs PCa survivors without recurrence (n = 71). Frailty prevalence, "obese" frailty, Short Physical Performance Battery (SPPB) scores, and falls were compared. An exploratory analysis of frailty biomarkers (C-reactive protein, erythrocyte sedimentation rate, hemoglobin, albumin, and total cholesterol) was performed. Summary statistics and univariate and multivariate regression analyses were conducted.RESULTS More patients on ADT were obese (body mass index > 30; 46.2% vs 20.6%; P = .03). There were no statistical differences in SPPB (P = .41) or frailty (P = .20). Using a proposed "obese" frailty criteria, 8.7% in ADT group were frail and 56.5% were "prefrail," compared with 2.9% and 48.8% of controls (P = .02). Falls in the last year were higher in the ADT group (14.3% vs 2.8%; P = .02). In analyses controlling for age, clinical characteristics, and comorbidities, the ADT group trended toward significance for "obese" frailty (P = .14) and falls (OR = 4.74, P = .11). Comorbidity significantly increased the likelihood of "obese" frailty (P = .01) and falls (OR 2.02, P = .01).CONCLUSIONS Men with BCR on ADT are frailer using proposed modified "obese" frailty criteria. They may have lower performance status and more falls. A larger, prospective trial is necessary to establish a causal link between ADT use and progression of frailty and disability. UROLOGY 77: 934-940, 2011. (C) 2011 Elsevier Inc.