Study Objective: to assess the impacts of androgen deprivation therapy (ADT) in prostate cancer (PCa) management on glucose metabolism Study Design: follow-up study
Materials and Methods: A total of 99 consecutive patients with PCa who received ADT followed-up at Pletnev and 62th Moscow Hospitals. The mean age was 69±8,64 y.o. Fasting plasma glucose (FPG) , HbA1c, body mass index (BMI) , waist circumference (WC) , were measured at baseline, after 3, 6 and 12 months ADT with gonadotropin releasing hormone agonists (GnRH agonists) . Ambulatory glycemic profiles (AGP) were obtained in patients with elevated glycemia who received ADT with GnRH agonists for at least 6 months by Flash glucose monitoring systems. Glucose variability indices (AUC, CONGA, JINDEX) were calculated.
Study Results: During ADT there were an increase in FPG and HbA1c over 12 months of ADT regardless of baseline age, BMI, WC, with a maximum increase during the first 3 months of treatment, and progressively after 6 months and 12 months. FPG (mmol/l) initially, 3, 6 and 12 months, were respectively 5,18±0,91; 5,67±0,93; 5,77±0,96; 5,90±1,12 (for all differences p ≤ 0.001) . HbA1c (%) 5,36+0,66; 5,66±0,83; 5,77±0,82; 5,89±0,83 (for all differences p ≤ 0.001) . The proportion of individuals with prediabetes were increased, according to ADA criteria (5,6-6.9 mmol/l) after 3 months 36%, after 6 months 41%, and after 12 months 66%. The impact on glucose metabolism ware in also AGP changes, manifested by an increase in the total daily glycemic load (mean AUC 172,49 (p≤0.001) , glycemic variability (mean CONGA 6,817 (p≤0.001) , and an increased in postprandial glycemia (JINDEX 22,945 (p≤0.001) . Conclusion: ADT with GnRH agonists did worsen metabolic parameters: early, progressive, clinically significant impair of glucose metabolism regardless of baseline age, BMI, WC. AGP deteriorations were increased of glucose variability, total glycemic load gained and peak glycemic values rose.
E.Y.Gritskevich: None. A.Gritskevich: None. T.Demidova: None.