Levy Matthew E, Perera Subashan, van Londen Gijsberta J, Nelson Joel B, Clay Cheryl A, Greenspan Susan L
Division of Geriatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Urology. 2008 Apr;71(4):735-9. doi: 10.1016/j.urology.2007.09.018. Epub 2008 Feb 15.
To investigate the influence of androgen deprivation therapy (ADT) in men with nonmetastatic prostate cancer.
We conducted a 2-year controlled, prospective study. Twenty-three men on 6 months or longer of ADT (chronic), 12 men on less than 6 months of ADT (acute), and 13 men not on ADT (healthy controls or prostate cancer patients not on ADT) were studied. We used validated, objective tests for physical and visual-motor function and dual X-ray absorptiometry for body composition at baseline and at 24 months.
We found the baseline percentage of body fat increased and baseline percentage of lean mass decreased with duration of ADT (P <0.002 across groups for both). After 24 months, men on chronic ADT had significant declines in lean body mass percentage (P = 0.058) and increases in body fat percentage (P = 0.029). Men on acute ADT had smaller but still significant differences in body composition at baseline and similar trends at 24 months. At baseline, men on chronic ADT had longer chair rise times than men on no ADT (P = 0.073) or acute ADT (P = 0.035). Four-meter walk velocities at 24 months were slower in men on acute (P = 0.006) and chronic ADT (P <0.001).
Declines in lean body mass and increases in body fat percentage over 2 years are observed in men on ADT. Lower body physical function performance is reduced in men on chronic ADT. Changes in body composition and physical function should be considered in men on long-term ADT.
研究雄激素剥夺疗法（ADT）对非转移性前列腺癌男性患者的影响。
我们开展了一项为期2年的对照前瞻性研究。研究对象包括23名接受6个月或更长时间ADT治疗的男性（慢性组）、12名接受ADT治疗时间少于6个月的男性（急性组）以及13名未接受ADT治疗的男性（健康对照组或未接受ADT治疗的前列腺癌患者）。我们在基线和24个月时使用经过验证的客观测试评估身体和视觉运动功能，并采用双能X线吸收法测量身体成分。
我们发现，随着ADT治疗时间的延长，身体脂肪的基线百分比增加，瘦体重的基线百分比下降（两组的组间P值均<0.002）。24个月后，慢性ADT组男性的瘦体重百分比显著下降（P = 0.058），身体脂肪百分比增加（P = 0.029）。急性ADT组男性在基线时身体成分的差异较小，但仍具有统计学意义，且在24个月时呈现相似趋势。基线时，慢性ADT组男性从椅子上起身的时间比未接受ADT治疗的男性更长（P = 0.073），也比急性ADT组男性更长（P = 0.035）。24个月时，急性ADT组（P = 0.006）和慢性ADT组（P <0.001）男性的4米步行速度较慢。
接受ADT治疗的男性在2年内出现瘦体重下降和身体脂肪百分比增加的情况。慢性ADT治疗的男性下肢身体功能表现降低。对于长期接受ADT治疗的男性，应考虑身体成分和身体功能的变化。
