All of us on androgen deprivation therapy (ADT) know that without testosterone our bodies change and we will develop insulin resistance, the precursor to diabetes.

In a just very small, just published study investigators examined if endurance training would improve insulin sensitivity and body composition in men being treated with ADT for their advanced prostate cancer.

The study was designed so that nine men undergoing ADT for advanced prostate cancer and 10 healthy men with normal testosterone levels underwent 12 weeks of endurance training. The researcher’s primary endpoints were insulin sensitivity (euglycemic hyperinsulinemic clamps with concomitant glucose-tracer infusion) and body composition (dual-energy x-ray absorptiometry and magnetic resonance imaging). The secondary endpoint was systemic inflammation.

The researchers performed a two way ANOVA. Endurance training increased VO2max (ml(O2)/min/kg) by 11% and 13% in patients and controls, respectively (p< 0.0001). The patients and controls demonstrated an increase in peripheral insulin sensitivity of 14% and 11%, respectively (p< 0.05), with no effect on hepatic insulin sensitivity (p=0.32). Muscle protein content of GLUT4 and total Akt was also increased in response to the training (p< 0.05 and p< 0.01, respectively). Body weight (p< 0.0001) and whole-body fat mass (p< 0.01) were reduced, while lean body mass (p=0.99) was unchanged. Additionally, reductions were noted in abdominal (p< 0.01), subcutaneous (p< 0.05) and visceral fat mass (p< 0.01). Plasma markers of systemic inflammation were unchanged in response to the training. No group×time interactions were found, except for thigh intermuscular adipose tissue (IMAT) (p=0.01), reflecting a significant reduction in IMAT in controls (p< 0.05) not observed in patients (p=0.64). After all these statistics the researchers concluded that in response to endurance training, ADT-treated prostate cancer patients improved insulin sensitivity and body composition to a similar degree as healthy men with testosterone. Since we already know that weight bearing exercise in men on ADT helps maintain muscle mass we now need to add endurance training to control weight and insulin resistance. Reference: Endocr Relat Cancer. 2013 Jun 6. Epub ahead of print.
doi: 10.1530/ERC-12-039: Hvid T, Winding K, Rinnov A, Dejgaard T, Thomsen C, Iversen P, Brasso K, Mikines KJ, van Hall G, Lindegaard B, Solomon TP, Pedersen BK.
Department of Infectious Diseases, M7641, Centre of Inflammation and Metabolism, Copenhagen, 2100, Denmark.

PubMed Abstract
PMID: 23744766

Joel T. Nowak, M.A., M.S.W.