Wong Chris, Chu Peggy, Teoh Jeremy, Chiu Peter, Yee C H, Chau Lysander, Chan Marco, Wan Helen, Leung Steven, Ng C F
SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Int Urol Nephrol. 2022 May;54(5):993-1000. doi: 10.1007/s11255-022-03151-2. Epub 2022 Feb 25.
Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We are looking into the relationship between ADT and development of metabolic diseases in Chinese patients.
This is a prospective multi-centre cohort yielded from the READT database (Real-life experience of ADT in Asia), in which patients diagnosed of PCa and offered ADT were prospectively recruited since 2016. Chinese patients recruited from Hong Kong were selected and compared to another cohort of newly diagnosed PCa patients in Hong Kong (HK-Cap database), which was collected prospectively and retrieved retrospectively for this study. Patient outcomes are followed through for 2 years. We compared between the groups the new diagnoses of hypertension, diabetes and hyper-lipidaemia, as well as the initiation of related medication for these conditions. Baseline characteristics including pre-treatment comorbidities, medications and tumour characteristics are documented.
151 patients receiving ADT (from READT database) and 447 patients not receiving ADT (from HK-Cap database) were analysed. ADT is related to higher risks of developing any of concerned medical co-morbidities (23.8% vs 13.0*, p = 0.001) and new-onset DM (16.6% vs 4.4%, p < 0.001). Initiation of new medications is also more common in ADT patients. New anti-hypertensives (37.8% vs 12.5%, p < 0.001), oral hypoglycemic agents (12.6% vs 4.9%, p = 0.001), insulin (4.0% vs 0.05%, p = 0.001) and statin (23.7% vs 12.8%, p = 0.023) are more commonly added in ADT cohort.
Chinese receiving ADT are exposed to increased risks of new-onset hypertension, diabetes and hyper-lipidaemia, and a higher likelihood of stepping up pharmaceutical control for pre-existing comorbidities. This highlights physicians' role to monitor metabolic profiles in at-risk men upon offering ADT.
前列腺癌（PCa）患者中雄激素剥夺疗法（ADT）的使用呈上升趋势。我们正在研究中国患者中ADT与代谢性疾病发生之间的关系。
这是一项前瞻性多中心队列研究，数据来源于READT数据库（亚洲ADT的真实生活经验），自2016年起前瞻性招募被诊断为PCa并接受ADT的患者。选取从香港招募的中国患者，并与香港另一组新诊断的PCa患者队列（HK-Cap数据库）进行比较，该队列是前瞻性收集并为本研究进行回顾性检索的。对患者的结局进行2年的随访。我们比较了两组中高血压、糖尿病和高脂血症的新诊断情况，以及针对这些病症开始使用相关药物的情况。记录了包括治疗前合并症、用药情况和肿瘤特征在内的基线特征。
分析了151例接受ADT的患者（来自READT数据库）和447例未接受ADT的患者（来自HK-Cap数据库）。ADT与发生任何相关医疗合并症的较高风险相关（23.8%对13.0%*，p = 0.001）以及新发糖尿病（16.6%对4.4%，p < 0.001）。在接受ADT的患者中开始使用新药物也更为常见。新的抗高血压药（37.8%对12.5%，p < 0.001）、口服降糖药（12.6%对4.9%，p = 0.001）、胰岛素（4.0%对0.05%，p = 0.001）和他汀类药物（23.7%对12.8%，p = 0.023）在ADT队列中更常被添加。
接受ADT的中国患者患新发高血压、糖尿病和高脂血症的风险增加，并且加强对既往合并症药物控制的可能性更高。这突出了医生在为有风险的男性提供ADT时监测代谢状况的作用。
