Effect of Androgen Deprivation Therapy on Bone Mineral Density in a Prostate Cancer Cohort in New Zealand: A Pilot Study

被引：17

作者：

Wang, Alice ^{[1
,2
]}

Karunasinghe, Nishi ^{[2
]}

Plank, Lindsay ^{[3
]}

Zhu, Shuotun ^{[2
]}

Osborne, Sue ^{[4
]}

Bishop, Karen ^{[2
]}

Brown, Charis ^{[5
]}

Schwass, Tiffany ^{[6
]}

Masters, Jonathan ^{[7
]}

Holmes, Michael

Huang, Roger ^{[8
]}

Keven, Christine ^{[9
]}

Ferguson, Lynnette ^{[1
,2
]}

Lawrenson, Ross

机构：

[1] Univ Auckland, Discipline Nutr & Dietet, Fac Med & Hlth Sci, Private Bag 92019, Auckland 1142, New Zealand

[2] Univ Auckland, Auckland Canc Soc Res Ctr, Fac Med & Hlth Sci, Auckland, New Zealand

[3] Univ Auckland, Dept Surg, Fac Med & Hlth Sci, Auckland, New Zealand

[4] North Shore Hosp, Urol Dept, Auckland, New Zealand

[5] Univ Waikato, Natl Inst Demog & Econ Anal, Hamilton, New Zealand

[6] Waikato Hosp, Urol Dept, Hamilton, New Zealand

[7] Auckland Hosp, Urol Dept, Auckland, New Zealand

[8] Waikato Hosp, Dept Radiat Oncol, Hamilton, New Zealand

[9] Univ Auckland, Liggins Inst, Auckland, New Zealand

来源：

CLINICAL MEDICINE INSIGHTS-ONCOLOGY | 2017年 / 11卷

关键词：

prostate cancer; androgen deprivation therapy; bone mineral density; osteoporosis; bone turnover markers; TESTOSTERONE RECOVERY; BODY-COMPOSITION; FRACTURE RISK; MEN; OSTEOPOROSIS; TURNOVER; PREVALENCE;

D O I：

10.1177/1179554917733449

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

INTRODUCTION: Reduction in bone mineral density (BMD) is a common side effect of androgen deprivation therapy (ADT). We aimed to examine the cross-sectional and longitudinal variation in BMD and associated bone markers in patients with nonmetastatic prostate cancer (PCa) managed with and without ADT. METHODS: Bone mineral density of the total body, lumbar spine, femoral neck, ultradistal forearm, and one-third distal radius was measured in 88 patients with PCa without bone metastases at baseline and at 6 months. Patients were categorized into 4 groups: (1) acute ADT (<= 6 months), (2) chronic ADT (> 6 months), (3) former ADT, and (4) no ADT (controls). Serum levels of bone metabolism markers, procollagen type I N-terminal propeptide (PINP) and C-terminal cross-linking telopeptide of type I collagen (CTX), were also measured. RESULTS: In the cross-sectional analysis, men receiving chronic ADT had significantly lower total body BMD as compared with former ADT users and men with no ADT. In longitudinal analysis, a significant reduction in ultradistal forearm BMD was observed in both acute and chronic ADT users after 6 months (4.08% and 2.7%, P = .012 and .026, respectively). A significant reduction in total body BMD was observed in acute ADT users (2.99%, P = .032). Former ADT users had a significant increase in both lumbar spine and femoral neck BMD (2.84% and 1.59%, P = .008 and .002, respectively). The changes in BMD were not significantly different between acute and chronic ADT users. In the cross-sectional analysis, higher levels of PINP and CTX were observed in acute and chronic ADT users than former ADT users or PCa controls. In longitudinal analysis, the level of serum PINP and CTX did not change significantly from baseline to 6 months in acute, chronic, and former ADT users, or PCa controls, and the percentage change did not differ among the 4 groups. CONCLUSIONS: Men on acute ADT had a similar rate of bone loss to men on chronic ADT. Reversibility in ADT-induced bone loss was observed in those who discontinued ADT. Serum levels of PINP and CTX were higher in acute and chronic ADT users and levels returned to the range of PCa controls when treatment was withdrawn.

引用

页数：11

共 28 条

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