We often talk about the assumed fact that androgen deprivation therapy (ADT) changes both the blood glucose levels as well as cholesterol levels in men who are under treatment. Researchers at the Division of General Internal Medicine & Clinical Epidemiology, University Health Network, University of Toronto, Toronto, ON. decided to formally evaluate this theory over a 12 month period in a prospective matched cohort study.
Men with non-metastatic prostate cancer who were being treated at the Princess Margaret Hospital were recruited to participate in this study. The men were divided into two cohorts: ADT users and controls. The ADT users were frequency matched to controls on age, education and body mass index (BMI).
The study used two visits. Socio-demographic and clinical information, medication use, physical fitness, height and weight were collected before initiation of ADT. Twelve months later, fasting morning blood work was obtained to measure plasma glucose, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. Statistical analyses included univariate and multivariable linear regression.
Seventy five (75) men with a mean age 68.9, were recruited. Thirty eight (38) of these men were undergoing ADT. Twelve men with prior diabetes and 29 patients taking cholesterol-lowering medication at baseline were excluded from the glucose and cholesterol analysis, respectively.
1- In adjusted analyses, ADT users had a significantly higher glucose level compared
to controls (5.88 vs. 5.52 mmol/L, p = 0.024).
2- Overall, ADT users had higher levels of total cholesterol, HDL, LDL, and triglycerides
than controls, although none of the differences reached statistical significance.
The study confirmed that even one year of ADT use is associated with elevated fasting glucose levels and may increase all lipid fractions in men with prostate cancer.
Unfortunately, many oncologists do not adequately monitor these levels in their patients who are undergoing ADT. All men on ADT should be regularly have their serum glucose and cholesterol levels monitored regularly. Men who are already diabetic and who have cholesterol levels that require cholesterol lowering treatment are at an even higher risk and must be monitored extensively.
Reference: Can Urol Assoc J. 2011 Feb;5(1):28-32.
doi: 10.5489/cuaj.09172; Mohamedali HZ, Breunis H, Timilshina N, Alibhai SM.
Joel T Nowak, M.A., M.S.W.