Abstract

Purpose

Osteoporosis is a well-known adverse effect of androgen deprivation therapy for prostate cancer. This study aimed to reveal the factors associated with the diagnosis of osteoporosis in prostate cancer patients undergoing androgen deprivation therapy.

Methods

This retrospective cross-sectional study included 106 prostate cancer patients treated with androgen deprivation therapy. Patients with bone metastasis at the initiation of androgen deprivation therapy and those with castration-resistant prostate cancer were excluded. Bone mineral density was measured at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Osteoporosis was defined as bone mineral density equal to or below either −2.5 SD or 70% of the mean in young adults. The association between clinicopathological variables and bone mineral density or diagnosis of osteoporosis was investigated.

Results

Thirty-six (34%) patients were found to have osteoporosis. The incidence of osteoporosis increased in a stepwise manner depending on the duration of androgen deprivation therapy. Multivariate logistic regression analysis identified a longer duration of androgen deprivation therapy (months, odd’s ratio = 1.017, P = 0.006), lower body mass index (kg/m², odd’s ratio = 0.801, P = 0.005) and higher serum alkaline phosphatase value (U/l, odd’s ratio 1.007, P = 0.014) as the factors independently associated with the diagnosis of osteoporosis. Eleven out of 50 (22%), 14 out of 35 (40%) and 11 out of 20 patients (55%) were osteoporotic in the patients with serum alkaline phosphatase values <238 U/l, 238–322 U/l and >322 U/l, respectively (P = 0.022).

Conclusions

Osteoporosis is common in prostate cancer patients undergoing androgen deprivation therapy; furthermore, its incidence increases depending on the duration of androgen deprivation therapy. Bone mineral density testing should be considered for all patients on androgen deprivation therapy, especially for those with a lower body mass index and higher serum alkaline phosphatase value.

中文翻译：

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较高的血清碱性磷酸酶值表明需要在接受雄激素剥夺治疗的非转移性前列腺癌患者中进行骨矿物质密度检测

摘要

目的

骨质疏松症是众所周知的前列腺癌雄激素剥夺疗法的副作用。本研究旨在揭示与接受雄激素剥夺治疗的前列腺癌患者骨质疏松症诊断相关的因素。

方法

这项回顾性横断面研究包括 106 名接受雄激素剥夺治疗的前列腺癌患者。雄激素剥夺治疗开始时发生骨转移的患者和去势抵抗性前列腺癌患者被排除在外。使用双能 X 射线骨密度仪在腰椎和股骨颈处测量骨矿物质密度。骨质疏松症被定义为骨矿物质密度等于或低于 -2.5 SD 或年轻人平均值的 70%。研究了临床病理学变量与骨矿物质密度或骨质疏松症诊断之间的关联。

结果

36 名 (34%) 患者被发现患有骨质疏松症。根据雄激素剥夺治疗的持续时间，骨质疏松症的发病率逐步增加。多变量逻辑回归分析确定了更长的雄激素剥夺治疗持续时间（月，奇数比 = 1.017，P  = 0.006），更低的体重指数（kg/m ²，奇数比 = 0.801，P  = 0.005）和更高的血清碱性磷酸酶值（U/l，奇数比 1.007，P  = 0.014）作为与骨质疏松症诊断独立相关的因素。在血清碱性磷酸酶值 <238 U/l、238–322 U/l 和>322 U/l，分别（P  = 0.022）。

结论

骨质疏松症在接受雄激素剥夺治疗的前列腺癌患者中很常见；此外，其发病率随着雄激素剥夺治疗的持续时间而增加。所有接受雄激素剥夺治疗的患者，尤其是体重指数较低和血清碱性磷酸酶值较高的患者，都应考虑进行骨矿物质密度检测。