1111 ALTERED ACTIVITY IN EACH PITUITARY-GONADAL, PITUITARY-ADRENAL, AND GH/IGF-1 ENDOCRINE AXIS IS ASSOCIATED WITH BONE METABOLIC DISORDER IN PATIENTS WITH PROSTATE CANCER RECEIVING ANDROGEN DEPRIVATION THERAPY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111111 ALTERED ACTIVITY IN EACH PITUITARY-GONADAL, PITUITARY-ADRENAL, AND GH/IGF-1 ENDOCRINE AXIS IS ASSOCIATED WITH BONE METABOLIC DISORDER IN PATIENTS WITH PROSTATE CANCER RECEIVING ANDROGEN DEPRIVATION THERAPY Fumio Ishizaki, Noboru Hara, Tsutomu Nishiyama, Etsuko Isahaya, Itsuhiro Takizawa, Tatsuhiko Hoshii, and Kota Takahashi Fumio IshizakiFumio Ishizaki Niigata, Japan More articles by this author , Noboru HaraNoboru Hara Niigata, Japan More articles by this author , Tsutomu NishiyamaTsutomu Nishiyama Niigata, Japan More articles by this author , Etsuko IsahayaEtsuko Isahaya Niigata, Japan More articles by this author , Itsuhiro TakizawaItsuhiro Takizawa Niigata, Japan More articles by this author , Tatsuhiko HoshiiTatsuhiko Hoshii Niigata, Japan More articles by this author , and Kota TakahashiKota Takahashi Niigata, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2627AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Male anabolic activities represented by bone synthesis are promoted by growth hormone/insulin-like growth factor-1 (GH/IGF–1), pituitary luteinizing hormone (LH)-gonadal testosterone, and pituitary adrenocorticotropic hormone (ACTH)-adrenal androgen axes; however, their altered effects on bone metabolism during androgen deprivation therapy (ADT) are unknown. Also, there has been no biomarker that reflects bone mineral density (BMD) during ADT. This study was performed to elucidate the mechanism of bone loss during ADT in terms of activity of the mentioned three endocrine axes, and to identify useful bone resorption markers during ADT. METHODS Seventy patients with localized prostate cancer who received a subcutaneous injection of a gonadotropin releasing hormone agonist (GnRHa), goserelin acetate (3.6mg,every 4 weeks), and peroral non-steroidal anti androgen flutamide (375mg/day) for 6 months were prospectively studied. BMD and blood and urine samples were evaluated at the baseline and after ADT for 6months. RESULTS Before ADT, serum free-testosterone, dehydroepiandrosterone sulfate (DHEA-S), and IGF–1 levels were correlated with BMD (rs.=0.300, 0.344, and 0.264, respectively; p=0.004, 0.027, and 0.012, respectively). With multilinear logistic regression analysis, serum IGF1 and free-testosterone levels were independently correlated with BMD before ADT. These relationships disappeared after ADT (p=0.552, 0.278 and 0.662, respectively). Serum free-testosterone and DHEA-S levels decreased after ADT (p <0.001 in both), whereas the IGF–1 level after ADT was elevated compared with that before treatment (p<0.001). Serum LH level decreased after ADT (p<0.001), while posttreatment ACTH and GH levels were not changed (p=0.265 and 0.595). Posttreatment BMD had a correlation only with urine deoxypyridinoline (DPD) concentration (rs=–0.307, p=0.019) among the mentioned hormones and bone resorption markers including serum/urine N-telopeptide and alkaline phosphatase levels; all bone resorption markers were significantly elevated after ADT. CONCLUSIONS In untreated men, BMD was associated with serum free-testosterone, DHEA-S, and IGF–1 levels, and each relationship were disrupted by ADT. Urine DPD may be a sensitive marker to predict bone loss in the early period during ADT. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e446-e447 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fumio Ishizaki Niigata, Japan More articles by this author Noboru Hara Niigata, Japan More articles by this author Tsutomu Nishiyama Niigata, Japan More articles by this author Etsuko Isahaya Niigata, Japan More articles by this author Itsuhiro Takizawa Niigata, Japan More articles by this author Tatsuhiko Hoshii Niigata, Japan More articles by this author Kota Takahashi Niigata, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...