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雄激素剥夺疗法(ADT)对亚洲前列腺癌患者的不良代谢后果:亚洲雄激素剥夺疗法真实体验研究(READT)的初步结果。

Adverse metabolic consequences of androgen deprivation therapy (ADT) on Asian patients with prostate cancer: Primary results from the real-life experience of ADT in Asia (READT) study.

机构信息

Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong.

Department of Surgery, Division of Urology, Prince of Wales Hospital, Shatin, Hong Kong.

出版信息

Prostate. 2023 Jun;83(8):801-808. doi: 10.1002/pros.24519. Epub 2023 Mar 20.

DOI:10.1002/pros.24519
PMID:36938957
Abstract

BACKGROUND

Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We investigated the relationship between ADT and adverse changes in metabolic parameters in an Asian population.

METHODS

This is an international prospective multicenter single-arm cohort yielded from the real-life experience of ADT in Asia (READT) registry. Consecutive ADT-naïve patients diagnosed of PCa and started on ADT were prospectively recruited from 2016 and analyzed. Baseline patient characteristics, PCa disease status, and metabolic parameters were documented. Patients were followed up at 6-month interval for up to 5 years. Metabolic parameters including body weight, lipid profiles, and glycemic profiles were recorded and analyzed.

RESULTS

589 patients were eligible for analysis. ADT was associated with adverse glycemic profiles, being notable at 6 months upon ADT initiation and persisted beyond 1 year. Comparing to baseline, fasting glucose level and hemoglobin A1c level increased by 4.8% (p < 0.001) and 2.7% (p < 0.001), respectively. Triglycerides level was also elevated by 16.1% at 6th month and by 20.6% at 12th month compared to baseline (p < 0.001). Mean body weight was 1.09 kg above baseline at 18th month (p < 0.001).

CONCLUSION

ADT was associated with adverse metabolic parameters in terms of glycemic profiles, lipid profiles, and body weight in the Asian population. These changes developed early in the treatment and can persist beyond the first year. Regular monitoring of the biochemical profiles during treatment is paramount in safeguarding the patients' metabolic health.

摘要

背景

在前列腺癌(PCa)中,雄激素剥夺疗法(ADT)的使用呈上升趋势。我们调查了 ADT 在亚洲人群中与代谢参数不良变化之间的关系。

方法

这是一项国际前瞻性多中心单臂队列研究,源自亚洲 ADT 的真实临床经验(READT)登记处。连续招募了 2016 年开始接受 ADT 治疗且为 ADT 初治的 PCa 患者,并进行了前瞻性分析。记录了基线患者特征、PCa 疾病状态和代谢参数。患者每 6 个月随访一次,最长随访 5 年。记录和分析代谢参数,包括体重、血脂谱和血糖谱。

结果

589 例患者符合分析条件。ADT 与不良的血糖谱有关,在 ADT 开始后 6 个月即可观察到,并持续超过 1 年。与基线相比,空腹血糖水平和糖化血红蛋白水平分别升高了 4.8%(p<0.001)和 2.7%(p<0.001)。在第 6 个月和第 12 个月,甘油三酯水平也分别比基线升高了 16.1%和 20.6%(p<0.001)。与基线相比,18 个月时平均体重增加了 1.09kg(p<0.001)。

结论

ADT 与亚洲人群的血糖谱、血脂谱和体重的代谢参数不良变化相关。这些变化在治疗早期发生,并可在第一年持续存在。在治疗过程中定期监测生化谱对于保护患者的代谢健康至关重要。

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