The clinical relevance of adiposity when assessing muscle health in men treated with androgen deprivation for prostate cancer

J Cachexia Sarcopenia Muscle. 2019 Oct;10(5):1036-1044. doi: 10.1002/jcsm.12446. Epub 2019 May 8.

Abstract

Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) may prospectively decrease absolute lean mass (LM) and increase absolute fat mass (FM). Given that estimates of LM by dual-energy X-ray absorptiometry may be overestimated in obese people, this study examined the influence of adiposity on muscle health in men treated with ADT for PCa.

Methods: This cross-sectional study examined the influence of adiposity on total and appendicular LM (ALM), muscle cross-sectional (CSA), and muscle strength in 70 men treated with ADT [mean (standard deviation) age, 71 (6) years] for PCa compared with age-matched PCa (n = 52) and healthy controls (n = 70). Total body LM, FM and ALM, and 66% tibia and radius muscle CSA were quantified by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. ALM was further divided by height (m2 ) or body mass index, with muscle CSA expressed as a per cent of total limb CSA. Upper and lower body and back (three-repetition maximum and dynamometry) muscle strength were expressed per kilogram of body weight.

Results: On average, ADT-treated men had 4.4-6.4 kg greater FM compared with controls (P ≤ 0.014) and there were no differences in total body or ALM. Total body per cent LM and ALMBMI were 3.8-5.4% (P ≤ 0.001) and 7.8-9.4% (P ≤ 0.001) lower, respectively, in ADT-treated men compared with both controls. Percentage muscle CSA at both sites and muscle strength (except leg) were 3.0-6.0% (P ≤ 0.031) and 15-17% (P ≤ 0.010) lower, respectively, in ADT-treated men compared with both controls.

Conclusions: The findings from this study indicate muscle mass, size, and strength are compromised in men treated with ADT after accounting for their increased adiposity or body size.

Keywords: Adipose tissue; Atrophy; Body composition; Prostatic neoplasms; Sarcopenia.

MeSH terms

  • Absorptiometry, Photon
  • Adiposity / drug effects*
  • Aged
  • Androgen Antagonists / adverse effects*
  • Androgen Antagonists / therapeutic use
  • Biomarkers
  • Body Composition / drug effects
  • Body Mass Index
  • Cross-Sectional Studies
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / metabolism
  • Muscle, Skeletal / pathology*
  • Organ Size
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / epidemiology
  • Sarcopenia / diagnostic imaging
  • Sarcopenia / etiology
  • Sarcopenia / pathology

Substances

  • Androgen Antagonists
  • Biomarkers