Department of Diabetes, The Ayr Hospital, Ayr, Scotland.
Am J Clin Oncol. 2012 Oct;35(5):504-9. doi: 10.1097/COC.0b013e318201a406.
Prostate cancer is the most frequently diagnosed malignancy among UK men and accounts for 12% of male deaths. Androgen deprivation therapy (ADT) is commonly used as part of the treatment for prostate cancer. It is effective at suppressing prostate-specific antigen, stabilizing disease, alleviating symptoms in advanced disease, and potentially prolonging survival. However ADT, presumably at least in part owing to low testosterone levels is associated with insulin resistance, the development of metabolic syndrome plus increased overall and cardiovascular disease mortality. We have reviewed the relationship between prostate cancer, ADT, metabolic syndrome, type 2 diabetes, and cardiovascular disease. We have not reviewed other potential medical problems such as osteoporosis. We suggest that there should be a baseline assessment of patients' risk for cardiovascular disease before starting ADT. Consideration should be given to starting appropriate therapies including lifestyle advice, antihypertensive and lipid-lowering agents, insulin sensitizer, plus possibly aspirin. Having started ADT, the patients should have a regular (possibly annual) assessment of their cardiovascular risk factors.
在英国男性中，前列腺癌是最常见的恶性肿瘤，占男性死亡人数的 12%。雄激素剥夺疗法（ADT）常用于前列腺癌的治疗。它能有效抑制前列腺特异性抗原，稳定疾病，缓解晚期疾病的症状，并可能延长生存时间。然而，ADT（可能至少部分由于睾酮水平降低）与胰岛素抵抗、代谢综合征的发展以及总死亡率和心血管疾病死亡率的增加有关。我们已经回顾了前列腺癌、ADT、代谢综合征、2 型糖尿病和心血管疾病之间的关系。我们没有回顾其他潜在的医学问题，如骨质疏松症。我们建议，在开始 ADT 之前，应该对患者的心血管疾病风险进行基线评估。应考虑开始适当的治疗，包括生活方式建议、抗高血压和降脂药物、胰岛素增敏剂，以及可能的阿司匹林。开始 ADT 后，患者应定期（可能每年）评估其心血管危险因素。
