Korean J Urol.  2015 Jan;56(1):12-18. 10.4111/kju.2015.56.1.12.

Metabolic effects of androgen deprivation therapy

• Choi SM
• Kam SC

• KMID: 2070264
• DOI: http://doi.org/10.4111/kju.2015.56.1.12

Abstract

The therapeutic effects and side effects of androgen deprivation therapy (ADT), which is a main treatment method for metastatic prostate cancer, are well known, but the metabolic effects have only recently been studied. This review describes the effects of ADT on body habitus, insulin resistance, lipid profiles, diabetes, metabolic syndrome, and cardiovascular morbidity and mortality. The review was done by using KoreaMed and PubMed to search the medical literature related to prostate cancer, ADT, body habitus, lipid profile, diabetes, insulin resistance, metabolic syndrome, and cardiovascular disease. ADT increases fat mass and decreases lean body mass. Fat mostly accumulates in the subcutaneous area. ADT increases total cholesterol, triglycerides, and high-density lipoprotein, as well as the risk for insulin resistance and diabetes. ADT also increases the risk for cardiovascular events, but insufficient evidence is available for a correlation with mortality. ADT changes body habitus and lipid profiles and has different characteristics than those of classic metabolic syndrome, but it is related to insulin resistance and diabetes. ADT increases the risk for cardiovascular events. No consistent guidelines have been proposed for treating the metabolic effects of ADT, but the generally recommended treatment methods for lowering the risk of diabetes and cardiovascular disease should be fully understood. Additional studies are necessary.

Keyword

Androgens; Diabetes mellitus; Metabolic syndrome X; Prostatic neoplasms

MeSH Terms

Androgen Antagonists/*adverse effects/therapeutic use
Body Composition/drug effects
Cardiovascular Diseases/metabolism/mortality
Cholesterol/chemistry
Diabetes Mellitus/epidemiology/metabolism
Gonadotropin-Releasing Hormone/*agonists
Humans
Insulin Resistance
Lipids/blood
Lipoproteins, HDL/blood
Male
Metabolic Syndrome X/epidemiology/metabolism
Prostatic Neoplasms/*drug therapy
Risk Factors
Triglycerides/chemistry
Androgen Antagonists
Cholesterol
Lipids
Lipoproteins, HDL
Gonadotropin-Releasing Hormone
Triglycerides

Figure

• 

  Fig. 1 Adverse effects of androgen deprivation therapy (ADT). Inside the dotted line represents metabolic effects of ADT. DM, diabetes mellitus.

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