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Androgen Deprivation Therapy Differentially Impacts Bone and Muscle in the Short Term in Physically Active Men With Prostate Cancer

Authors :
Naim M. Maalouf
Avneesh Chhabra
Jason Zafereo
Ross Querry
Dwight A. Towler
Uma J. Thakur
Joseph Frankl
John R. Poindexter
Bayan Mogharrabi
May Xac
Orhan K. Öz
Craig D. Rubin
Source :
JBMR Plus, Vol 6, Iss 1, Pp n/a-n/a (2022)
Publication Year :
2022
Publisher :
Oxford University Press, 2022.

Abstract

ABSTRACT Androgen deprivation therapy (ADT) is a cornerstone of advanced prostate cancer (PCa) therapy. Its use is associated with a loss of bone mineral density (BMD) and a greater risk of falls and osteoporotic fractures. In this prospective cohort study, we examined the impact of ADT on muscle and bone strength in men initiating ADT for PCa. Participants were evaluated at three time points: immediately before (week 0), and 6 and 24 weeks after ADT initiation. Study measures included fasting blood levels (for markers of muscle and bone metabolic activity), MRI and QCT imaging (for muscle fat content, and bone density and architecture), and validated clinical tests of muscle strength and gait. Sixteen men completed all study visits. At baseline and throughout the study, participants exercised a median of four times/week, but still experienced weight gain (+2.0 kg at week 24 versus week 0, p = 0.004). Biochemically, all men sustained dramatic early and persistent reductions in sex hormones post‐ADT, along with a progressive and significant increase in serum C‐telopeptide of type I collagen (CTX, +84% at week 24 versus week 0). There was a trend for rise in serum sclerostin (p = 0.09) and interleukin 6 (IL‐6) (p = 0.08), but no significant change in serum myostatin (p = 0.99). Volumetric BMD by QCT declined significantly at the femoral neck (−3.7% at week 24 versus week 0), particularly at the trabecular compartment. On MRI, there were no significant changes in thigh muscle fat fraction. On physical testing, men developed weaker grip strength, but experienced no worsening in lower extremity and lumbar spine muscle strength, or on functional tests of gait. In conclusion, in physically active men, ADT for 24 weeks results in a significant increase in bone resorption and reduction in BMD, but nonsignificant changes in thigh muscle quality (on imaging) or strength and gait (on functional testing). © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Details

Language :
English
ISSN :
24734039
Volume :
6
Issue :
1
Database :
Directory of Open Access Journals
Journal :
JBMR Plus
Publication Type :
Academic Journal
Accession number :
edsdoj.ba243cf05fe844e882cc911d182f738a
Document Type :
article
Full Text :
https://doi.org/10.1002/jbm4.10573