Effects of androgen deprivation therapy on body composition and bone health - 2 year follow-up of men attending a dedicated Men's Health service. (#156)
Androgen deprivation therapy (ADT), an effective treatment for prostate cancer, has been associated with accelerated bone loss, visceral fat gain, and insulin resistance.
Aim: To evaluate bone and metabolic outcomes in men with non-metastatic prostate cancer receiving ADT.
Methods: A prospective cohort study of men receiving long-term ADT (2007-2011) was performed. All men attended the Austin Health Men’s Health Clinic (MHC) and underwent standardised assessments according to current guidelines1. Baseline data at ADT commencement was presented at ESA 2011 (abstract #240). Men were followed for 2 years and paired data was analysed using Student’s t test.
Results: 126 men were eligible for 2-year follow up. 95 men had data available for analysis (16 failed to attend, 6 deceased, 6 moved away from local area, 3 ADT ceased prior to 2 year follow up). Comparison of co-morbidities at baseline and 2 years are presented in tables 1 and 2 (stratified according to treatment for the co-morbidity at 2 years).
Non-diabetic patients had a significant rise in HbA1c associated with an increased prevalence of type 2 diabetes at 2 years. Despite increases in BMI and waist circumference, patients had a lowering of blood pressure, and improvement in lipid profile.
Total hip BMD declined despite increases in vitamin D to optimal levels. BMD was maintained in those who received anti-osteoporosis therapies, whereas a decline was seen in those untreated over 2 years.
Conclusion: ADT is associated with adverse effects on body composition and bone health. Active treatment of cardiovascular risk factors and osteoporosis according to current guidelines is effective in minimising cardiovascular risk and maintaining bone density. Larger studies are needed to determine effects on cardiovascular outcomes and fracture prevention.
- (1) Grossmann M, Hamilton EJ, Gilfillan C, Bolton D, Joon DL, Zajac JD: Bone and metabolic health in patients with non-metastatic prostate cancer who are receiving androgen deprivation therapy. Med J Aust 2011, 194:301-306