[Androgen deprivation therapy and morbid obesity: do they share cardiovascular risk through metabolic syndrome?]

Actas Urol Esp. 2011 May;35(5):259-65. doi: 10.1016/j.acuro.2011.01.011. Epub 2011 Apr 2.
[Article in Spanish]


Background: Although the use of androgen deprivation therapy (ADT) has resulted in improved survival in men with advanced prostate cancer, the resulting hypogonadism is associated with profound adverse effects comparable to those found in morbid obesity, being cardiovascular risk among the most lethal.

Objectives: Evaluate metabolic syndrome, metabolic abnormalities and cardiovascular risk in patients with prostate cancer under ADT, not under ADT and morbid obese men.

Methods: This is a cross-sectional study that involves 79 men presenting prostate cancer, of whom 54 under ADT and 25 not under ADT and 91 morbidly obese patients paired by sex and age. To define metabolic syndrome, we used the International Diabetes Federation (IDF) criteria. Metabolic abnormalities, metabolic markers and Framingham score to predict the ten year coronary heart disease risk were compared among patients under ADT, not under ADT and morbid obese.

Results: Patients under ADT presented significantly greater occurrence of diabetes and central obesity and higher levels of total cholesterol and low density lipoprotein (LDL) compared to eugonadal men. The mean cardiovascular risk was significantly higher in patients under ADT (39.97±12.53% vs. 26.09±14.80%; p=0.021). Morbidly obese subjects had increased ten year coronary heart disease risk; comparable to patients under ADT (p=0.054).

Conclusion: This study suggests that patients under ADT show higher prevalence of metabolic abnormalities and cardiovascular risk similar to those found in morbidly obese subjects. It is possible that both processes share cardiovascular risk through metabolic syndrome.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery
  • Adenocarcinoma / therapy*
  • Aged
  • Androgens*
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Biomarkers
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Combined Modality Therapy
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Incidence
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / chemically induced
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Neoplasms, Hormone-Dependent / surgery
  • Neoplasms, Hormone-Dependent / therapy*
  • Obesity, Morbid / complications*
  • Obesity, Morbid / physiopathology
  • Orchiectomy / adverse effects*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / surgery
  • Prostatic Neoplasms / therapy*
  • Risk


  • Androgens
  • Antineoplastic Agents, Hormonal
  • Biomarkers
  • Gonadotropin-Releasing Hormone