MP73-18 SARCOPENIC OBESITY ASSOCIATED WITH ANDROGEN DEPRIVATION THERAPY IN PATIENTS WITH PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVES: Weight gain derived from androgen deprivation therapy (ADT) should be based on the balance between fat accumulation and decreased lean mass (sarcopenic obesity). We used computed tomography (CT) to evaluate the association between weight gain and decreased lean mass in patients with prostate cancer treated using ADT. METHODS: Patients with newly diagnosed prostate cancer were recruited between 2011 and 2013. The method for ADT was limited to luteinizing hormone-releasing hormone agonist with or without bicalutamide. Body weight, abdominal circumference, and blood test results were recorded every 3 months, and cross-sectional areas of subcutaneous and visceral fat and psoas muscle were measured on CT before and after 1 year of ADT. Patients were divided into two subgroups according to weight gain to analyze the association with CT findings. Patients who presented with progression of disease during the study period were excluded from this study. RESULTS: Eighty patients completed CT examinations before and after 1 year of ADT as of September 2014. Median age was 74 years (range, 46-83 years), and median prostate-specific antigen level was 17 ng/ml (range, 3-3316 ng/ml). Mean increases in body weight and abdominal circumference after 1 year were 2.8% and 3.2%, respectively. Mean increases in total cholesterol, triglyceride, fasting blood sugar and hemoglobin A1c levels were 10.6%, 13.0%, 1.0% and 0.5%, respectively. Mean decrease in hemoglobin was 7.6%. Mean increases in areas of subcutaneous and visceral fat were 32.3% and 18.6%, while mean decreases in area and Hounsfield Unit of psoas muscle were 9.0% and 7.1%, respectively. Mean increases in areas of subcutaneous and visceral fat were more prominent in patients who gained 3.0% weight (subcutaneous, 43.0%; visceral, 29.0%) than in patients who gained <3.0% weight (subcutaneous, 19.0%; visceral, 4.7%), whereas the decrease in area of the psoas muscle did not differ significantly between patients who gained <3.0% weight (-10.6%) and those who gained 3.0% (-8.2%) (P1⁄40.22). CONCLUSIONS: One year of ADT significantly increased fat accumulation and reduced lean mass in patients with prostate cancer. Sarcopenic obesity should be recognized and managed even in patients who do not gain weight during ADT.