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雄激素剥夺疗法对前列腺癌患者非酒精性脂肪肝的影响:CT 评估。

Impact of Androgen Deprivation Therapy on Non-Alcoholic Fatty Liver Disease in Patients with Prostate Cancer: A CT Evaluation.

机构信息

Department of Urology, Tama-Hokubu Medical Center, Higashimurayama, Japan,

Department of Urology, National Defense Medical College, Tokorozawa, Japan.

出版信息

Urol Int. 2020;104(5-6):425-430. doi: 10.1159/000507351. Epub 2020 May 12.

Abstract

PURPOSE

The aim of this study was to investigate the influence of androgen deprivation therapy (ADT) on the progression of non-alcoholic fatty liver disease (NAFLD) in patients with prostate cancer (PCa) by evaluation of hepatic steatosis on computed tomography (CT).

METHODS

The study included 77 PCa patients who underwent abdominal CT at baseline and after 6 months of ADT. The degree of hepatic steatosis was evaluated according to the attenuation value for liver parenchyma (CTLP), the attenuation ratio for liver and spleen (LSratio), and the difference in attenuation between LS (LSdif). The associations between these 3 indices and various metabolic syndrome-related factors were analyzed.

RESULTS

The number of NAFLD patients increased from 9 (11.6%) at baseline to 16 (20.7%) after ADT. The CTLP, LSratio, and LSdif values were significantly lower after ADT than before (p < 0.05). There were significant correlations between the percent change in CTLP and the percent change in HbA1c, between the percent change in LSratio and the percent change in abdominal circumference, and between the percent change in LSdif and the percent change in BMI.

CONCLUSIONS

Six months of ADT was associated with significant progression of NAFLD in PCa patients. This progression was strongly correlated with changes in HbA1c, abdominal circumference, and BMI.

摘要

目的

本研究旨在通过评估计算机断层扫描(CT)上的肝脂肪变性来探讨去势治疗(ADT)对前列腺癌(PCa)患者非酒精性脂肪性肝病(NAFLD)进展的影响。

方法

本研究纳入了 77 例在基线和 ADT 后 6 个月行腹部 CT 的 PCa 患者。根据肝实质衰减值(CTLP)、肝脾衰减比(LSratio)和 LS 差值(LSdif)评估肝脂肪变性程度。分析了这 3 个指标与各种代谢综合征相关因素之间的关系。

结果

NAFLD 患者的数量从基线时的 9 例(11.6%)增加到 ADT 后的 16 例(20.7%)。ADT 后 CTLP、LSratio 和 LSdif 值明显低于治疗前(p < 0.05)。CTLP 的变化百分比与 HbA1c 的变化百分比之间、LSratio 的变化百分比与腰围的变化百分比之间、LSdif 的变化百分比与 BMI 的变化百分比之间存在显著相关性。

结论

6 个月的 ADT 与 PCa 患者 NAFLD 的显著进展相关。这种进展与 HbA1c、腰围和 BMI 的变化密切相关。

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