Basaria Shehzad
Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, 5200 Eastern Ave, Suite 4300, Baltimore, MD 21224, USA.
J Androl. 2008 Sep-Oct;29(5):534-9. doi: 10.2164/jandrol.108.005454. Epub 2008 Jun 20.
Prostate cancer (PCa) is the most common cancer in men. Androgen deprivation therapy (ADT) is used in the treatment of locally advanced and metastatic PCa. Although its use as an adjuvant therapy has resulted in improved survival in some patients, ADT has negative consequences. Complications like osteoporosis, sexual dysfunction, gynecomastia, and adverse body composition are well known. Recent studies have also found metabolic complications in these men. Studies show that short-term ADT (3-6 months) results in development of hyperinsulinemia without causing hyperglycemia. Studies of men undergoing long-term (>or=12 months) ADT reveal higher prevalence of diabetes and metabolic syndrome compared with controls. In addition, men undergoing ADT also experience higher cardiovascular mortality. Long-term prospective studies of ADT are needed to determine the timing of onset of these complications and to employ strategies to prevent them. In the meantime, baseline and serial screening for fasting glucose and other cardiac risk factors in men receiving ADT is prudent. In selected cases, glucose tolerance testing and cardiac evaluation may be required.
前列腺癌（PCa）是男性中最常见的癌症。雄激素剥夺疗法（ADT）用于治疗局部晚期和转移性PCa。尽管其作为辅助疗法的使用已使一些患者的生存率提高，但ADT也有负面影响。骨质疏松、性功能障碍、男性乳房发育和不良身体成分等并发症是众所周知的。最近的研究还在这些男性中发现了代谢并发症。研究表明，短期ADT（3 - 6个月）会导致高胰岛素血症的发生而不引起高血糖。对接受长期（≥12个月）ADT的男性的研究显示，与对照组相比，糖尿病和代谢综合征的患病率更高。此外，接受ADT的男性心血管死亡率也更高。需要进行ADT的长期前瞻性研究，以确定这些并发症的发病时间并采用预防策略。与此同时，对接受ADT的男性进行空腹血糖和其他心脏危险因素的基线和系列筛查是明智的。在某些特定情况下，可能需要进行葡萄糖耐量试验和心脏评估。
