Galvão Daniel A, Spry Nigel A, Taaffe Dennis R, Newton Robert U, Stanley John, Shannon Tom, Rowling Chris, Prince Richard
Vario Health Institute, Edith Cowan University, Joondalup, Australia.
BJU Int. 2008 Jul;102(1):44-7. doi: 10.1111/j.1464-410X.2008.07539.x. Epub 2008 Mar 11.
To assess the effects of androgen deprivation therapy (ADT) on whole-body and regional muscle, fat and bone mass in men with prostate cancer without metastatic bone disease.
Seventy-two men aged 44-88 years underwent spine, hip and whole-body dual-energy X-ray absorptiometry scans at baseline and after 36 weeks of ADT. The change in whole-body and regional lean mass (LM), fat mass (FM), and bone mineral content and density (BMD) were determined. In addition, the prostate specific antigen (PSA), serum testosterone and haemoglobin levels were measured, and the level of physical activity and fatigue assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30.
The upper limb, lower limb, trunk and whole-body LM decreased by a mean (sem) of 5.6 (0.6)%, 3.7 (0.5)%, 1.4 (0.5)% and 2.4 (0.4)% (P < 0.01), respectively, while FM increased by 20.7 (3.3)%, 18.7 (2.7)%, 12.0 (2.5)% and 13.8 (2.3)% (P < 0.001). Hip, spine, whole-body and upper limb BMD decreased by 1.9 [corrected] (0.3)% [corrected], 3.3 [corrected] (0.4)%, 1.6 [corrected] (0.3)% and 1.3 (0.3%) (P < 0.001), but not lower limb BMD. Serum testosterone, PSA and haemoglobin levels decreased by 93.3 (0.4)%, 98.2 (0.5)%, and 8.8 (0.9)% (P < 0.001), respectively. In addition, physical activity levels decreased and levels of fatigue increased.
After 36 weeks of ADT there was a significant decrease in whole-body and regional LM and bone mass, while whole-body and regional FM increased in older men with prostate cancer. Strategies to counteract changes in soft tissue and bone mass during ADT should be formulated to minimize the risk of sarcopenia, osteoporosis and obesity.
评估雄激素剥夺疗法（ADT）对无骨转移的前列腺癌男性患者全身及局部肌肉、脂肪和骨量的影响。
72名年龄在44 - 88岁的男性在基线时以及接受ADT 36周后接受了脊柱、髋部和全身双能X线吸收测定扫描。测定全身及局部瘦体重（LM）、脂肪量（FM）以及骨矿物质含量和密度（BMD）的变化。此外，测量前列腺特异性抗原（PSA）、血清睾酮和血红蛋白水平，并使用欧洲癌症研究与治疗组织生活质量问卷-30评估身体活动水平和疲劳程度。
上肢、下肢、躯干和全身的LM平均（标准误）分别下降了5.6（0.6）%、3.7（0.5）%、1.4（0.5）%和2.4（0.4）%（P < 0.01），而FM分别增加了20.7（3.3）%、18.7（2.7）%、12.0（2.5）%和13.8（2.3）%（P < 0.001）。髋部、脊柱、全身和上肢的BMD分别下降了1.9[校正后]（0.3）%[校正后]、3.3[校正后]（0.4）%、1.6[校正后]（0.3）%和1.3（0.3%）（P < 0.001），但下肢BMD未下降。血清睾酮、PSA和血红蛋白水平分别下降了93.3（0.4）%、98.2（0.5）%和8.8（0.9）%（P < 0.001）。此外，身体活动水平下降，疲劳程度增加。
在接受ADT 36周后，无骨转移的老年前列腺癌男性患者的全身及局部LM和骨量显著下降，而全身及局部FM增加。应制定应对ADT期间软组织和骨量变化的策略，以尽量降低肌肉减少症、骨质疏松症和肥胖症的风险。
