牙买加男性雄激素剥夺疗法治疗前列腺癌后的骨密度。

Bone mineral density in Jamaican men on androgen deprivation therapy for prostate cancer.

机构信息

Department of Surgery, University of the West Indies, Mona, Jamaica.

出版信息

Infect Agent Cancer. 2011 Sep 23;6 Suppl 2(Suppl 2):S7. doi: 10.1186/1750-9378-6-S2-S7.

DOI:10.1186/1750-9378-6-S2-S7

PMID:21992436

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3194186/

Abstract

BACKGROUND

Androgen deprivation therapy (ADT) has been reported to reduce the bone mineral density (BMD) in men with prostate cancer (CaP). However, Afro-Caribbeans are under-represented in most studies. The aim was to determine the effect of androgen deprivation therapy (ADT) on the bone mineral density (BMD) of men with prostate cancer in Jamaica.

METHODS

The study consisted of 346 Jamaican men, over 40 years of age: 133 ADT treated CaP cases (group 1), 43 hormone-naïve CaP controls (group 2) and 170 hormone naïve controls without CaP (group 3). Exclusion criteria included metastatic disease, bisphosphonate therapy or metabolic disease affecting BMD. BMD was measured with a calcaneal ultrasound and expressed in S.D. units relative to young adult men (T score), according to the World Health Organization definition. Patient weight, height and BMI were assessed.

RESULTS

Mean ± sd, age of patients in group 1 (75± 7.4 yrs) was significantly greater than groups 2 and 3 (67 ± 8.1 yrs; 65±12.0 yrs). There was no significant difference in weight and BMI between the 3 groups. . The types of ADT (% of cases, median duration in months with IQR) included LHRH (Luteinizing hormone releasing hormone) analogues (28.6%, 17.9, IQR 20.4), oestrogens (9.8%, 60.5, IQR 45.6) anti-androgens (11.3%, 3.3, IQR 15.2) and orchiectomy (15.7%, 43.4, IQR 63.9). Unadjusted t score of group 1, mean ± sd, (-1.6± 1.5) was significantly less than group 2 (-0.9±1.1) and group 3 (-0.7±1.4), p <0.001. Ninety three (69.9%), 20 (45%) and 75 (42%) of patients in groups 1, 2 and 3 respectively were classified as either osteopenic or osteoporotic (p<0.001). Adjusting for age, there was a significant difference in t scores between groups 1 and 2 as well as between groups 1 and 3 (p<0.001). Compared with oestrogen therapy and adjusting for duration of therapy, the odds of low bone mineral density (osteopenia or osteoporosis) with LHRH analogue was 4.5 (95%CI, 14.3 to 3.4); with anti-androgens was 5.9 (95%CI, 32.7 to 5); with orchiectomy was 7.3 (95%CI, 30 to 5.8) and multiple drugs was 9.2 ((95%CI, 31 to 7.1).

CONCLUSIONS

ADT is associated with lower BMD in Jamaican men on hormonal therapy for prostate cancer.

摘要

背景

雄激素剥夺疗法（ADT）已被报道可降低前列腺癌（CaP）男性的骨密度（BMD）。然而，在大多数研究中，非裔加勒比人代表性不足。目的是确定雄激素剥夺疗法（ADT）对牙买加前列腺癌男性骨密度（BMD）的影响。

方法

该研究包括 346 名年龄在 40 岁以上的牙买加男性：133 名接受 ADT 治疗的 CaP 病例（第 1 组）、43 名激素初治 CaP 对照组（第 2 组）和 170 名无 CaP 的激素初治对照组（第 3 组）。排除标准包括转移性疾病、双膦酸盐治疗或影响 BMD 的代谢性疾病。BMD 通过跟骨超声测量，并根据世界卫生组织的定义，用相对于年轻成年男性（T 评分）的 S.D. 单位表示。评估了患者的体重、身高和 BMI。

结果

第 1 组患者的平均年龄为 75 ± 7.4 岁，明显大于第 2 组和第 3 组（67 ± 8.1 岁；65 ± 12.0 岁）。三组间体重和 BMI 无显著差异。ADT 的类型（病例百分比，中位数持续时间 IQR）包括促黄体激素释放激素（LHRH）类似物（28.6%，17.9，IQR 20.4）、雌激素（9.8%，60.5，IQR 45.6）、抗雄激素（11.3%，3.3，IQR 15.2）和睾丸切除术（15.7%，43.4，IQR 63.9）。第 1 组的未调整 t 评分，均值 ± sd，为-1.6 ± 1.5，明显低于第 2 组（-0.9 ± 1.1）和第 3 组（-0.7 ± 1.4），p <0.001。第 1、2 和 3 组分别有 93（69.9%）、20（45%）和 75（42%）名患者被归类为骨质疏松或骨质疏松症（p <0.001）。调整年龄后，第 1 组和第 2 组以及第 1 组和第 3 组之间的 t 评分存在显著差异（p <0.001）。与雌激素治疗相比，LHRH 类似物的低骨密度（骨质疏松症或骨质疏松症）的比值比为 4.5（95%CI，14.3 至 3.4）；抗雄激素的比值比为 5.9（95%CI，32.7 至 5）；睾丸切除术的比值比为 7.3（95%CI，30 至 5.8），多种药物的比值比为 9.2（95%CI，31 至 7.1）。