Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
Faculty of Health, Deakin University, Geelong, VIC, Australia.
Calcif Tissue Int. 2019 Oct;105(4):403-411. doi: 10.1007/s00223-019-00586-1. Epub 2019 Jul 17.
Androgen deprivation therapy (ADT) for prostate cancer (PCa) can compromise muscle health. Hence, we aimed to quantify the prevalence of sarcopenia (i.e., compromised lean mass, muscle strength, and physical function) in ADT-treated (> 12 week) men (n = 70) compared to similarly aged non-ADT-treated PCa (n = 52) and healthy controls (n = 70). Lean and fat mass were quantified by dual-energy X-ray absorptiometry. Muscle strength and function were measured using handgrip dynamometry and gait speed, respectively. Sarcopenia was defined as low adjusted appendicular lean mass [ALM; height-adjusted (ALMI), body mass index-adjusted (ALM) and height and fat mass-adjusted (ALM)] with weak handgrip strength and/or slow gait speed according to the following criteria: European Working Group on Sarcopenia in Older People [EWGSOP; both 2010 (EWGSOP1) and 2018 (EWGSOP2)], Foundation for the National Institutes of Health (FNIH) and International Working Group on Sarcopenia (IWGS). Overall the prevalence of sarcopenia was low and did not differ between the three groups. Only two (3.2%) ADT-treated men presented with sarcopenia as per EWGSOP1 and FNIH criteria, whereas no cases were observed using EWGSOP2 and IWGS criteria. The prevalence of low ALM was greater in ADT-treated men (32%) compared to PCa (15%; P = 0.037) and healthy controls (7.1%; P < 0.001). Similarly, low ALM was greater in ADT-treated men (29%) compared to healthy controls only (13%; P = 0.019). There was also a low prevalence of weak muscle strength and slow gait speed (0.0-11%) in all men, with no differences between the groups. Based on these findings, an adiposity-based adjustment of ALM is recommended to quantify risk of adverse outcomes associated with ADT in these men.
去势治疗（ADT）会损害前列腺癌（PCa）患者的肌肉健康。因此，我们旨在比较雄激素剥夺治疗（ADT）超过 12 周的男性（n=70）、相似年龄未接受 ADT 治疗的 PCa 患者（n=52）和健康对照者（n=70）中肌肉减少症（即肌肉质量、肌肉力量和身体功能受损）的患病率。使用双能 X 射线吸收法测量瘦体重和脂肪量。使用握力计和步态速度分别测量肌肉力量和功能。肌肉减少症根据以下标准定义为低调整后的四肢瘦体重[身高调整（ALMI）、体重指数调整（ALM）和身高和脂肪量调整（ALM）]，伴有握力弱和/或步态速度慢：欧洲老年人肌肉减少症工作组[EWGSOP；2010 年（EWGSOP1）和 2018 年（EWGSOP2）]、美国国立卫生研究院基金会（FNIH）和国际肌肉减少症工作组（IWGS）。总体而言，三组人群的肌肉减少症患病率较低且无差异。只有 2 名（3.2%）ADT 治疗男性符合 EWGSOP1 和 FNIH 标准患有肌肉减少症，而根据 EWGSOP2 和 IWGS 标准未观察到病例。ADT 治疗男性的低 ALM 患病率（32%）高于 PCa 患者（15%；P=0.037）和健康对照者（7.1%；P<0.001）。同样，ADT 治疗男性的低 ALM 患病率（29%）也高于健康对照者（13%；P=0.019）。所有男性的肌肉力量弱和步态速度慢的患病率均较低（0.0-11%），且组间无差异。根据这些发现，建议使用脂肪量调整 ALM 来量化这些男性接受 ADT 治疗相关不良结局的风险。
