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Metabolic Syndrome in Men With Prostate Cancer Undergoing Long-Term Androgen-Deprivation Therapy

Milena Braga-Basaria, Adrian S. Dobs, Denis C. Muller, Michael A. Carducci, Majnu John, Josephine Egan, Shehzad Basaria

From the Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine; National Institute on Aging, National Institutes of Health; and the Department of Oncology, Prostate Cancer Research Program, Kimmel Cancer Center at Johns Hopkins, Baltimore, MD

Address reprint requests to Shehzad Basaria, MD, Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Bayview Medical Center, 4940 Eastern Ave, Ste B-114, Baltimore, MD 21224; e-mail: sbasari1{at}jhmi.edu

PURPOSE: Prostate cancer (PCa) is one of the most common cancers in men. Men with recurrent or metastatic PCa are treated with androgen-deprivation therapy (ADT), resulting in profound hypogonadism. Because male hypogonadism is a risk factor for metabolic syndrome and men with PCa have high cardiovascular mortality, we evaluated the prevalence of metabolic syndrome in men undergoing long-term ADT.

PATIENTS AND METHODS: This was a cross-sectional study. We evaluated 58 men, including 20 with PCa undergoing ADT for at least 12 months (ADT group), 18 age-matched men with nonmetastatic PCa who had received local treatment and were recently found to have an increasing prostate-specific antigen (non-ADT group), and 20 age-matched controls (control group). Men in the non-ADT and control groups were eugonadal. Metabolic syndrome was defined according to the Adult Treatment Panel III criteria.

RESULTS: Mean age was similar among the groups. Men on ADT had significantly higher body mass index and lower total and free testosterone levels. The prevalence of metabolic syndrome was higher in the ADT group compared with the non-ADT (P < .01) and control (P = .03) groups. Among the components of metabolic syndrome, men on ADT had a higher prevalence of abdominal obesity and hyperglycemia. Androgen-deprived men also had elevated triglycerides compared with controls (P = .02). The prevalence of hypertension and low high-density lipoprotein levels were similar.

CONCLUSION: These data suggest that metabolic syndrome was present in more than 50% of the men undergoing long-term ADT, predisposing them to higher cardiovascular risk. Abdominal obesity and hyperglycemia were responsible for this higher prevalence. We recommend prospective studies to further delineate this association.

Supported by the Johns Hopkins University School of Medicine General Clinical Research Center Grant No. M01RR00052.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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