Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA.
J Urol. 2012 Mar;187(3):889-93. doi: 10.1016/j.juro.2011.10.136. Epub 2012 Jan 15.
Whether race influences bone loss and fracture risk during androgen deprivation therapy for prostate cancer is unknown. Using data from a prospective clinical trial we compared bone mineral density and fracture between African-American and Caucasian men receiving androgen deprivation therapy.
A total of 516 subjects were in the placebo group of a 2-year randomized placebo controlled fracture prevention trial, and were African-American (68) or Caucasian (448). We compared baseline characteristics, changes in bone mineral density and rates of new fractures between races.
Compared to Caucasian men, African-American men had higher baseline hip bone mineral density (mean ± SD 0.98 ± 0.15 vs 0.91 ± 0.15 gm/m(2), p = 0.001) and similar spine bone mineral density (1.09 ± 0.22 vs 1.11 ± 0.22, p = 0.51). There was no difference in prevalent vertebral fractures between African-American and Caucasian men (7.4% vs 15.0%, p = 0.13). The percentage change in hip bone mineral density at 2 years was similar between African-American and Caucasian men (mean ± SE -2.21% ± 0.59% vs -2.54% ± 0.26%, p = 0.65). Changes in bone mineral density of the lumbar spine were also similar between African-American and Caucasian men (-1.74% ± 0.69% vs -1.30% ± 0.33%, p = 0.64). No new vertebral fractures were reported in African-American men but 2 fractures were reported in Caucasian men.
In a clinical trial African-American men receiving androgen deprivation therapy for prostate cancer have a greater hip bone mineral density and tended to have fewer prevalent vertebral fractures than Caucasian men. Despite a lower baseline risk of osteoporosis and fracture, African-American men experience a decrease in bone mineral density similar to that of Caucasian men.
目前尚不清楚种族是否会影响接受雄激素剥夺疗法治疗前列腺癌患者的骨质流失和骨折风险。我们利用一项前瞻性临床试验的数据，比较了接受雄激素剥夺治疗的非裔美国人和高加索人之间的骨密度和骨折情况。
共有 516 名受试者参加了一项为期 2 年的随机安慰剂对照骨折预防试验的安慰剂组，其中包括 68 名非裔美国人和 448 名高加索人。我们比较了种族之间的基线特征、骨密度变化和新发骨折率。
与高加索男性相比，非裔美国男性的髋部骨密度更高（平均±标准差 0.98±0.15 与 0.91±0.15 g/m²，p=0.001），而脊椎骨密度相似（1.09±0.22 与 1.11±0.22，p=0.51）。非裔美国男性与高加索男性的椎体骨折患病率无差异（7.4%与 15.0%，p=0.13）。非裔美国男性和高加索男性髋部骨密度在 2 年时的变化百分比相似（平均±SE-2.21%±0.59%与-2.54%±0.26%，p=0.65）。非裔美国男性和高加索男性的腰椎骨密度变化也相似（-1.74%±0.69%与-1.30%±0.33%，p=0.64）。非裔美国男性未报告新发椎体骨折，但高加索男性报告了 2 例骨折。
在一项临床试验中，接受雄激素剥夺疗法治疗前列腺癌的非裔美国男性的髋部骨密度更高，且与高加索男性相比，椎体骨折的患病率更低。尽管非裔美国男性骨质疏松症和骨折的基线风险较低，但他们的骨密度下降与高加索男性相似。
