Prevalence of osteopenia and osteoporosis by central and peripheral bone mineral density in men with prostate cancer during androgen-deprivation therapy

Objectives. To determine the prevalence of osteopenia and osteoporosis by central (spine and hip) and peripheral (radius) bone mineral density [BMD] in men with prostate cancer undergoing androgen-deprivation therapy (ADT). Low BMD and fractures are prevalent in this group of men. Most published studies on ADT-related bone loss have documented the loss of BMD in the spine and hip as measured by dual x-ray absorptiometry. In one study, the loss of BMD was most pronounced at the radius. Methods. In a chart review of patients receiving ADT, the spine and hip BMD results were recorded in 89 patients. Of these 89 patients, the BMD of the radius was also recorded in 53. Results. In the 89 patients with BMD measurements of the spine and hip, 24 (26.9%) had osteoporosis of the hip or spine as defined by a T score of -2.5 or less, and 45 patients (50.6%) had osteopenia (T score -1.0 to -2.5). In the subset of 53 patients who also had the BMD of the radius measured, the results of the BMD of the radius changed the category of diagnosis in 18 patients (34%). The prevalence of osteoporosis increased from 25% to 53% when the results of the radius were included. Conclusions. Men with prostate cancer treated with ADT have a high prevalence of osteopenia and osteoporosis as determined by peripheral and central BMD measurements. The use of the peripheral BMD measurement appears to identify more patients with osteoporosis and suggests its use in the evaluation of osteoporosis in men receiving ADT.