Metabolic syndrome and androgen deprivation therapy in metabolic complications of prostate cancer patients

Background Incidence of prostate cancer in Chinese males grows significantly in the past decades. Androgen deprivation therapy has been generally employed in the treatment of locally advanced and metastatic prostate cancer for many years, yet only little data was known about the metabolic syndrome in patients receiving hormonal therapy. This study described the prevalence and the changing trends of hormone-related metabolic complications, and analyzed their correlation with different therapies. Methods In 125 patients treated with castration or maximal androgen blockage for at least 12 months, metabolic indicators were analyzed. Results Totally, 13.5% patients in castration group and 30.1% patients in maximal androgen blockage group were diagnosed metabolic syndrome 12 months after the beginning of treatments (chi(2)=4.739, P=0.029). In castration group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 12, increased fasting plasma glucose and blood pressure were significant at the month 4. In maximal androgen blockage group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 4, increased fasting plasma glucose and blood pressure were significant at the month 8. Total testosterone and free testosterone in maximal androgen blockage group were significantly lower than castration group at all visits, which were proved to show positive or negative correlations with metabolic indications. Severity of metabolic complications in maximal androgen blockage group was generally more serious than people received castration, with significantly statistical difference or not. Trends of high-density lipoprotein-cholesterol and fasting plasma glucose were significant different between two kinds of therapy (P=0.005, P=0.019, respectively). Conclusions Prostate cancer patients receiving androgen deprivation therapy were at high risk of suffering metabolic syndrome. Severity of metabolic complications under different hormonal therapies were not completely consistent, suggested that androgen deprivation therapy may be individualized. Chin Med J 2012;125(20):3725-3729