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Androgen deprivation therapy for prostate cancer is associated with an increased incidence of diabetes and cardiovascular disease
Androgen
deprivation therapy with a gonadotropin-releasing hormone (GnRH) agonist
is associated with increased fat mass and insulin resistance in men with
prostate cancer, but the risk of obesity-related disease during treatment
has not been well studied. To assess whether androgen deprivation therapy
is associated with an increased incidence of diabetes and cardiovascular
disease, we studied care for more than 70,000 men diagnosed with local or
regional prostate cancer during 1991-1999 and followed for an average of
4.5 years. We found that men treated with GnRH agonists had a 44%
increased risk of developing diabetes, a 16% increased risk of coronary
heart disease, an 11% increased risk of a myocardial infarction, and a 16%
increased risk of sudden cardiac death. Because GnRH agonists are often
given in situations for which their benefits are unproven, we believe that
physicians and their patients should weight the potential benefits and
risks when deciding about use of these drugs. Additional research is
needed to identify populations of men at highest risk of treatment-related
complications and to develop strategies to prevent treatment-related
diabetes and cardiovascular disease.
Bibliographic reference:
Nancy L. Keating Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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