Risks of metabolic diseases and androgen deprivation therapy for prostate cancer in a Chinese population: a prospective multi-centre cohort study
Int Urol Nephrol . 2022 May;54(5):993-1000.
Androgen deprivation therapy (ADT) is the key treatment used in prostate cancer in particular for locally advanced and metastatic cancer. While it is an effective treatment for prostate cancer, ADT could also causing changes in the metabolic and cardiovascular function of the patients and might lead to some potential problems. Therefore, we performed a comparison from two prospective collected databases to assess the incidence of newly diagnoses of hypertension, diabetes and hyper-lipidaemia, as well as the initiation of related medication for these conditions between prostate cancer patients with or without the use of ADT.
There were 151 patients receiving ADT and 447 patients not receiving ADT analysed. In patients using ADT, they have increased risks of developing one of the conditions (hypertension, diabetes and hyper-lipidaemia) Also they have more new initiation of medications for the treatment of these diseases, including anti-hypertensives, hypoglycemic agents, insulin and statin (23.7% vs 12.8%, p = 0.023) which suggested drug escalation was also common in patients with known cardiovascular and metabolic conditions.
Therefore, we concluded 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.
Therefore, besides regular monitoring of the body weight, blood pressure, blood sugar and lipid levels, we should also encourage our patients to cease cigarette smoking, have a balanced diet control and more exercise in order to decrease the risk of developing these conditions.