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• W1978242571 abstract "No AccessJournal of UrologyAdult urology1 Aug 2006The Effect of Androgen Deprivation Therapy on Fasting Serum Lipid and Glucose Parameters Jennifer Yannucci, Judi Manola, Marc B. Garnick, Gajanan Bhat, and Glenn J. Bubley Jennifer YannucciJennifer Yannucci Beth Israel Deaconess Medical Center, Waltham, Massachusetts More articles by this author , Judi ManolaJudi Manola Dana Farber Cancer Institute, Waltham, Massachusetts More articles by this author , Marc B. GarnickMarc B. Garnick Beth Israel Deaconess Medical Center, Waltham, Massachusetts Boston and Praecis Pharmaceuticals, Inc., Waltham, Massachusetts Financial interest and/or other relationship with Praecis Pharmaceutical. More articles by this author , Gajanan BhatGajanan Bhat Boston and Praecis Pharmaceuticals, Inc., Waltham, Massachusetts Financial interest and/or other relationship with Praecis Pharmaceutical. More articles by this author , and Glenn J. BubleyGlenn J. Bubley Beth Israel Deaconess Medical Center, Waltham, Massachusetts More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.03.057AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although prostate cancer specific mortality is decreasing, there is little effect on overall mortality in this population, suggesting the possibility of an increased risk of death from nonprostate cancer related causes. Androgen deprivation therapy could adversely affect cardiovascular health. We investigated changes in lipid and glucose during androgen deprivation therapy. Materials and Methods: We performed an exploratory analysis of pooled data from 3 prospective clinical trials aimed at achieving medical castration by comparing the gonadotropin releasing hormone antagonist abarelix, the gonadotropin releasing hormone agonist leuprolide acetate and leuprolide acetate plus the antiandrogen bicalutamide. Most patients were treated in the neoadjuvant setting or because of biochemical recurrence. Fasting serum lipid, glucose and hemoglobin A1C were determined in 1,102 men at baseline, and on treatment days 85 and 169. In the current study men were categorized into 3 treatment groups according to the type of androgen deprivation therapy, that is leuprolide acetate, leuprolide acetate plus bicalutamide or abarelix, and statin therapy. Results: Significant increases in total cholesterol, triglyceride and high density lipoprotein-cholesterol were observed in patients on leuprolide acetate or abarelix but not in patients on leuprolide acetate plus bicalutamide. Consistent changes in low density lipoprotein-cholesterol were not detected. Increased total cholesterol was usually due to an increase in high density lipoprotein-cholesterol. Hemoglobin A1C increased from baseline to day 85 only and there were no significant changes in fasting glucose measurements. The type of androgen deprivation therapy did not affect these parameters. Conclusions: Short-term androgen deprivation therapy affects serum lipid and hemoglobin A1C independent of statin therapy. References 1 : Long-term trends in cancer mortality in the United States, 1930–1998. Cancer2003; 97: S3133. Google Scholar 2 : Cancer surveillance series: interpreting trends in prostate cancer—part III: quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality. J Natl Cancer Inst1999; 91: 1033. Google Scholar 3 : The influence of androgen deprivation therapy on metabolism in patients with prostate cancer. J Clin Endocrinol Metab2005; 90: 657. Google Scholar 4 : The effects of induced hypogonadism on arterial stiffness, body composition and metabolic parameters on males with prostate cancer. J Clin Endocrinol Metab2001; 86: 4261. Google Scholar 5 : Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med1999; 341: 1781. Google Scholar 6 : Low bone density and high percentage of body fat among men who were treated with androgen deprivation therapy for prostate carcinoma. Cancer2002; 95: 2136. Google Scholar 7 : Changes in bone mineral density and body composition during initial and long-term gonadotropin-releasing hormone agonist treatment for prostate carcinoma. Cancer2005; 104: 1633. Google Scholar 8 : The metabolic syndrome. Lancet2005; 365: 1415. Google Scholar 9 : Low levels of endogenous androgens increase risk of atherosclerosis in elderly men: further supportive data. J Clin Endocrinol Metab2003; 88: 1403. Google Scholar 10 : Testosterone replacement in hypogonadal men with angina improves ischemic threshold and quality of life. Heart2004; 90: 871. Google Scholar 11 : Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. Aging Male2003; 6: 1. Google Scholar 12 : Bicalutamide (150mg) versus placebo as immediate therapy alone or as adjuvant therapy with curative intent for early nonmetastatic prostate cancer: 5.3-year median followup from the Scandinavian Prostate Cancer Group Study Number 6. J Urol2004; 172: 1871. Google Scholar 13 : Immediate versus deferred treatment for advanced prostate cancer: initial results of the Medical Research Council Trial. Br J Urol1997; 79: 235. Google Scholar 14 : Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate The Radiation Therapy Oncology Group Protocol 92-02. J Clin Oncol2003; 21: 3972. Fox Chase Cancer Center and Radiation Oncology Group, Philadelphia, PA. Google Scholar 15 : A phase 3, multicenter, open-label, randomized study of abarelix versus leuprolide acetate in men with prostate cancer. Adult Urol2001; 58: 756. Google Scholar 16 : A phase 3, multicenter, open label, randomized study of abarelix versus leuprolide plus daily antiandrogen in men with prostate cancer. J Urol2002; 167: 1670. Google Scholar 17 : The effects of varying doses of testosterone on insulin sensitivity, plasma lipids, apolipoproteins and C-Reactive protein in healthy young men. J Clin Endocrinol Metab2002; 87: 136. Google Scholar 18 : Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974–2000. Fertil Steril2001; 75: 898. Google Scholar 19 : Lipid, glucose and homocysteine metabolism in women treated with a GnRH agonist with or without raloxifene. Human Reprod2004; 19: 415. Google Scholar 20 : Marked hyperglycemia after androgen-deprivation therapy for prostate cancer and usefulness of pioglitazone for its treatment. Metab Clin Exp2005; 54: 55. Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 176Issue 2August 2006Page: 520-525 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordslipidsprostatic neoplasmsandrogen antagonistsglucoseprostateAcknowledgmentsTrials 149-98-02, 149-98-03 and 149-99-03 were initiated at Praecis Pharmaceuticals, Inc.MetricsAuthor Information Jennifer Yannucci Beth Israel Deaconess Medical Center, Waltham, Massachusetts More articles by this author Judi Manola Dana Farber Cancer Institute, Waltham, Massachusetts More articles by this author Marc B. Garnick Beth Israel Deaconess Medical Center, Waltham, Massachusetts Boston and Praecis Pharmaceuticals, Inc., Waltham, Massachusetts Financial interest and/or other relationship with Praecis Pharmaceutical. More articles by this author Gajanan Bhat Boston and Praecis Pharmaceuticals, Inc., Waltham, Massachusetts Financial interest and/or other relationship with Praecis Pharmaceutical. More articles by this author Glenn J. Bubley Beth Israel Deaconess Medical Center, Waltham, Massachusetts More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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