Kim Do Kyung, Lee Joo Yong, Kim Kwang Joon, Hong Namki, Kim Jong Won, Hah Yoon Soo, Koo Kyo Chul, Kim Jae Heon, Cho Kang Su
Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Korea.
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
J Clin Med. 2019 Jan 18;8(1):113. doi: 10.3390/jcm8010113.
We aimed to evaluate the change in bone mineral density (BMD) in patients with prostate cancer (PCa) receiving androgen deprivation therapy (ADT) compared to those with PCa or other urologic conditions not receiving ADT. Literature searches were conducted throughout October 2018. The eligibility of each study was assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the Participant, Intervention, Comparator, Outcome, and Study design method. The outcomes analyzed were the mean difference (MD) of percent changes in BMD of lumbar spine, femur neck, and total hip. Five prospective cohort studies with a total of 533 patients were included in the present study. Statistically significant decreases of BMD change relative to the control group were observed in the ADT treatment group in the lumbar spine (MD -3.60, 95% CI -6.72 to -0.47, = 0.02), femoral neck (MD -3.11, 95% CI -4.73 to -1.48, = 0.0002), and total hip (MD -1.59, 95% CI -2.99 to -0.19, = 0.03). There is a significant relationship between ADT and BMD reduction in patients with PCa. Regular BMD testing and the optimal treatment for BMD loss should, therefore, be considered in patients with PCa undergoing ADT.
我们旨在评估接受雄激素剥夺治疗（ADT）的前列腺癌（PCa）患者与未接受ADT的PCa患者或其他泌尿系统疾病患者相比，骨矿物质密度（BMD）的变化。于2018年10月进行了文献检索。根据系统评价和Meta分析的首选报告项目指南，采用参与者、干预措施、对照、结局和研究设计方法对每项研究的纳入资格进行评估。分析的结局是腰椎、股骨颈和全髋关节BMD百分比变化的平均差值（MD）。本研究纳入了5项前瞻性队列研究，共533例患者。在ADT治疗组中，观察到腰椎（MD -3.60，95%CI -6.72至-0.47，P = 0.02）、股骨颈（MD -3.11，95%CI -4.73至-1.48，P = 0.0002）和全髋关节（MD -1.59，95%CI -2.99至-0.19，P = 0.03）的BMD变化相对于对照组有统计学意义的降低。ADT与PCa患者的BMD降低之间存在显著关联。因此，对于接受ADT的PCa患者，应考虑定期进行BMD检测以及对BMD丢失进行最佳治疗。
