scholarly journals Relationships between insulin resistance and frailty with body composition and testosterone in men undergoing androgen deprivation therapy for prostate cancer

2016 ◽  
Vol 175 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Ada S Cheung ◽  
Rudolf Hoermann ◽  
Philippe Dupuis ◽  
Daryl Lim Joon ◽  
Jeffrey D Zajac ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Insulin Resistance ◽  
Body Composition ◽  
Androgen Deprivation Therapy ◽  
Fat Mass ◽  
Lean Mass ◽  
Androgen Deprivation ◽  
Total Testosterone ◽  
The Mean ◽  
Control Prospective Study

Objective While androgen deprivation therapy (ADT) has been associated with insulin resistance and frailty, controlled prospective studies are lacking. We aimed to examine the relationships between insulin resistance and frailty with body composition and testosterone. Design Case–control prospective study. Methods Sixty three men with non-metastatic prostate cancer newly commencing ADT (n=34) and age-matched prostate cancer controls (n=29) were recruited. The main outcomes were insulin resistance (HOMA2-IR), Fried’s frailty score, body composition by dual x-ray absorptiometry and short physical performance battery (SPPB) measured at 0, 6 and 12months. A generalised linear model determined the mean adjusted difference (95% CI) between groups. Results Compared with controls over 12months, men receiving ADT had reductions in mean total testosterone level (14.1–0.4nmol/L, P<0.001), mean adjusted gain in fat mass of 3530g (2012, 5047), P<0.02 and loss of lean mass of 1491g (181, 2801), P<0.02. Visceral fat was unchanged. HOMA2-IR in the ADT group increased 0.59 (0.24, 0.94), P=0.02, which was most related to the increase in fat mass (P=0.003), less to lean mass (P=0.09) or total testosterone (P=0.088). Frailty increased with ADT (P<0.0001), which was related to decreased testosterone (P=0.028), and less to fat mass (P=0.056) or lean mass (P=0.79). SPPB was unchanged. Conclusions ADT is associated with increased insulin resistance and frailty within 12months of commencement, independently of confounding effects of cancer or radiotherapy. Insulin resistance appears to be mediated by subcutaneous or peripheral sites of fat deposition. Prevention of fat gain is an important strategy to prevent adverse ADT-associated cardiometabolic risks.

scholarly journals Persisting adverse body composition changes 2 years after cessation of androgen deprivation therapy for localised prostate cancer

2018 ◽  
Vol 179 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Ada S Cheung ◽  
Alistair J Tinson ◽  
Stefan V Milevski ◽  
Rudolf Hoermann ◽  
Jeffrey D Zajac ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Insulin Resistance ◽  
Body Composition ◽  
Androgen Deprivation Therapy ◽  
Mixed Model ◽  
Androgen Deprivation ◽  
Interquartile Range ◽  
Total Testosterone ◽  
Model Assessment ◽  
Composition Changes

Objective Hypogonadism from androgen deprivation therapy (ADT) for prostate cancer causes adverse body composition changes associated with insulin resistance and decreased quality of life (QoL). Our objective was to assess whether adverse body composition changes improve after cessation of ADT. Design Prospective case–control study in a tertiary referral hospital. Thirty-four men newly commencing ADT (cases, median age: 67.6 years (interquartile range: 64.6–72.0)) and 29 age-matched (70.6 years (65.3–72.9)) prostate cancer controls not on ADT were assessed 2 years after cessation of ADT (median: 4.4 years). Methods Serum testosterone, body composition, handgrip strength, frailty and QoL were measured. Using a mixed model, the mean adjusted differences (MADs (95% CI)) between groups from baseline to study end are reported. Results Twenty-seven cases and 19 controls completed the study. Median duration of ADT was 2.3 years (interquartile range: 1.8–3.1). Two years after cessation of ADT, total testosterone remained lower (MAD: −3.4 nmol/L (−6.3 to −0.5), P < 0.022), fat mass (2214 g (490–3933), P = 0.025) and insulin resistance (homeostasis model assessment of insulin resistance: 0.69 (0.31–1.07), P < 0.001) remained higher in cases, whereas lean mass (−1450 g (−2259 to −640), P < 0.001) and physical component of QoL remained lower than controls (−11.9 (−16.4 to −7.4), P < 0.001). Conclusion Two years after ADT cessation, metabolically adverse changes in body composition, increased insulin resistance and reduced QoL persisted. This may be related to incomplete testosterone recovery. Persisting adverse effects need to be considered in the risk to benefit assessment of ADT and proactive mitigation should continue after cessation of treatment.

scholarly journals Dietary interventions to improve body composition in men treated with androgen deprivation therapy for prostate cancer: a solution for the growing problem?

2021 ◽  
Author(s):  
Lisa Umlauff ◽  
Manuel Weber ◽  
Nils Freitag ◽  
Ciaran M. Fairman ◽  
Axel Heidenreich ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Composition ◽  
Androgen Deprivation Therapy ◽  
Fat Mass ◽  
Lean Mass ◽  
Muscle Wasting ◽  
Meta Analysis ◽  
Androgen Deprivation ◽  
Dietary Advice ◽  
Dietary Interventions

Abstract Background Androgen deprivation therapy (ADT) has adverse effects on body composition, including muscle wasting and body fat accumulation, which may be attenuated by nutrition therapy. This systematic review summarises available evidence on the effects of dietary interventions on lean mass, fat mass and body mass index (BMI) in men treated with ADT for prostate cancer. Methods MEDLINE, Embase, Web of Science and ClinicalTrials.org were searched from inception through December 2020. We included all controlled trials evaluating effects of supplementation or dietary interventions on body composition in men with prostate cancer receiving continuous ADT. Methodological quality of the studies was assessed using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was performed using a random effects model to calculate standardised mean differences between intervention and comparator groups. (PROSPERO; CRD42020185777). Results Eleven studies (n = 536 participants) were included. Seven studies investigated the effects of dietary advice interventions, e.g. individual or group counselling, and four studies included a nutritional supplement. Eight studies combined the dietary intervention with exercise. Nine studies reported sufficient data for inclusion in the meta-analysis. Dietary advice and supplementation interventions combined were not associated with significant changes in lean mass (0.05 kg; 95% CI: −0.17, 0.26; p = 0.674; n = 355), fat mass (−0.22 kg; 95% CI: −0.45, 0.01; p = 0.064; n = 336) or BMI (−0.16 kg*m−2; 95% CI: −0.37, 0.04; p = 0.121; n = 399). Dietary advice interventions alone were associated with a significant fat mass reduction (−0.29 kg; 95% CI: −0.54, −0.03; p = 0.028; n = 266). Conclusions Most studies were dietary advice interventions targeting caloric restriction, which showed the potential to reduce fat mass but did not increase lean mass in men treated with ADT. Future interventions should investigate whether a combination of dietary advice and protein supplementation with concomitant resistance exercise could counteract ADT-induced muscle wasting.

scholarly journals Responsiveness to Resistance-Based Multimodal Exercise Among Men With Prostate Cancer Receiving Androgen Deprivation Therapy

2019 ◽  
Vol 17 (10) ◽  
pp. 1211-1220 ◽  
Author(s):  
Dennis R. Taaffe ◽  
Robert U. Newton ◽  
Nigel Spry ◽  
David J. Joseph ◽  
Daniel A. Galvão
Keyword(s):  
Prostate Cancer ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Muscle Strength ◽  
Physical Function ◽  
Androgen Deprivation Therapy ◽  
Lean Mass ◽  
Androgen Deprivation ◽  
Whole Body ◽  
Appendicular Skeletal Muscle

Background: Androgen deprivation therapy (ADT) in the management of prostate cancer (PCa) results in an array of adverse effects, and exercise is one strategy to counter treatment-related musculoskeletal toxicities. This study assessed the prevalence of exercise responsiveness in men with PCa undergoing ADT in terms of body composition, muscle strength, and physical function. Methods: Prospective analyses were performed in 152 men (aged 43–90 years) with PCa receiving ADT who were engaged in resistance exercise combined with aerobic or impact training for 3 to 6 months. Whole-body lean mass and fat mass (FM), trunk FM, and appendicular skeletal muscle were assessed with dual x-ray absorptiometry; upper and lower body muscle strength were assessed with the one-repetition maximum; and physical function was assessed with a battery of tests (6-m usual, fast, and backward walk; 400-m walk; repeated chair rise; stair climb). Results: Significant improvements were seen (P<.01) in lean mass (0.4±1.4 kg [range, −2.8 to +4.1 kg]), appendicular skeletal muscle (0.2±0.8 kg [range, −1.9 to +1.9 kg]), and all measures of muscle strength (chest press, 2.9±5.8 kg [range, −12.5 to +37.5 kg]; leg press, 29.2±27.6 kg [range, −50.0 to +140.0 kg]) and physical function (from −0.1±0.5 s [range, +1.3 to −2.1 s] for the 6-m walk; to −8.6±15.2 s [range, +25.2 to −69.7 s] for the 400-m walk). An increase in FM was also noted (0.6±1.8 kg [range, −3.6 to +7.3 kg]; P<.01). A total of 21 men did not exhibit a favorable response in at least one body composition component, 10 did not experience improved muscle strength, and 2 did not have improved physical function. However, all patients responded in at least one of the areas, and 120 (79%) favorably responded in all 3 areas. Conclusions: Despite considerable heterogeneity, most men with PCa receiving ADT responded to resistance-based multimodal exercise, and therefore our findings indicate that this form of exercise can be confidently prescribed to produce beneficial effects during active treatment.

scholarly journals Clinical Utility of miRNA-1, miRNA-29g and miRNA-133s Plasma Levels in Prostate Cancer Patients With High-Intensity Training After Androgen-Deprivation Therapy

2019 ◽  
pp. S139-S147
Author(s):  
A. GAZOVA ◽  
A. SAMAKOVA ◽  
E. LACZO ◽  
D. HAMAR ◽  
M. POLAKOVICOVA ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Composition ◽  
Exercise Training ◽  
Androgen Deprivation Therapy ◽  
Plasma Levels ◽  
Exercise Intervention ◽  
Free Testosterone ◽  
Androgen Deprivation ◽  
Control Group ◽  
The Impact

The randomized trials showed that the addition of training resistance program to androgen-deprivation therapy (ADT) had many beneficial effects for prostate cancer (PC) patients (significant protective effect on the volume of muscle mass) and the studies have revealed a panel of miRNAs, which are deregulate in PC and may serve as promising biomarkers of PC risk. The primary aim of our present study was to investigate the effect of exercise training to changes in body composition (muscle strength) and the secondary endpoint was to investigate the impact of an exercise training program on plasma levels of selected myogenic microRNAs (miRNAs) (miRNA-1, miRNA-29b, and miRNA-133) in PC patients undergoing the ADT. Effect of ADT and exercise intervention showed significant increase (experimental group vs. control group) the changes in body composition, free testosterone levels, IL-6 and plasma levels of myogenic miRNAs and significant reduced insulin serum levels. In conclusion, resistance training with ADT in the treatment of PC significantly changed the physical and metabolic function and the plasma levels of specific myogenic miRNAs. Our data support with the other publicized results.

Induced testosterone deficiency: from clinical presentation of fatigue, erectile dysfunction and muscle atrophy to insulin resistance and diabetes

2011 ◽  
Vol 8 (1) ◽  
Author(s):  
George Yu ◽  
Abdulmaged M. Traish
Keyword(s):  
Prostate Cancer ◽  
Insulin Resistance ◽  
Erectile Dysfunction ◽  
Adverse Effects ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
The Past ◽  
Research Findings ◽  
The Relationship

AbstractOver the past 60 years, androgen deprivation therapy has been the mainstay of treatment of metastatic prostate cancer. However, research findings suggest that androgen deprivation therapy inflicts serious adverse effects on overall health and reduces the quality of life. Among the adverse effects known to date are insulin resistance, diabetes, metabolic syndrome fatigue, erectile dysfunction, and cardiovascular disease. In this clinical perspective, we discuss the relationship between induced androgen deficiency and a host of pathologies in the course of treatment with androgen deprivation therapy for prostate cancer patients.

scholarly journals Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy

2013 ◽  
Vol 20 (5) ◽  
pp. 621-632 ◽  
Author(s):  
Thine Hvid ◽  
Kamilla Winding ◽  
Anders Rinnov ◽  
Thomas Dejgaard ◽  
Carsten Thomsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Composition ◽  
Insulin Sensitivity ◽  
Endurance Training ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Systemic Inflammation ◽  
Muscle Protein ◽  
Androgen Deprivation ◽  
Whole Body

Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12 weeks of endurance training. 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. Statistical analysis was carried out using two-way ANOVA. Endurance training increased VO2max(ml(O2)/min per kg) by 11 and 13% in the patients and controls respectively (P<0.0001). The patients and controls demonstrated an increase in peripheral tissue 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 (SLC2A4) and total AKT (AKT1) was also increased in response to the training (P<0.05 andP<0.01 respectively). Body weight (P<0.0001) and whole-body fat mass (FM) (P<0.01) were reduced, while lean body mass (P=0.99) was unchanged. Additionally, reductions were observed in abdominal (P<0.01), subcutaneous (P<0.05), and visceral (P<0.01) FM amounts. The concentrations of plasma markers of systemic inflammation were unchanged in response to the training. No group×time interactions were observed, except for thigh intermuscular adipose tissue (IMAT) (P=0.01), reflecting a significant reduction in the amount of IMAT in the controls (P<0.05) not observed in the patients (P=0.64). In response to endurance training, ADT-treated prostate cancer patients exhibited improved insulin sensitivity and body composition to a similar degree as eugonadal men.

Sign in / Sign up

Export Citation Format

Share Document