Castration Aggravates Insulin Resistance, Reduces Immune Function and Improves Quality of Life of Prostate Cancer Patients

J BUON. Mar-Apr 2020;25(2):1148-1154.

Abstract

Purpose: To investigate the influence of castration on insulin resistance, quality of life and immune function of prostate cancer (PCa) patients.

Methods: A total of 57 PCa patients definitely diagnosed via prostate biopsy underwent bilateral orchiectomy. No patient had history of diabetes mellitus before operation. The hemoglobin, leukocyte count, platelet count, albumin and alkaline phosphatase in the blood before operation and at 1 year after operation were analyzed using a full-automatic biochemistry analyzer, and the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the peripheral blood were calculated.

Results: The levels of serum testosterone (T) and free testosterone (FT) in PCa patients declined remarkably at 1 month after castration. Compared with those before operation, the levels of serum T and FT were decreased significantly at 1, 2, 4 and 8 months as well as 1 year after castration. The levels of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were elevated gradually with the prolongation of time after operation. The level of high-density lipoprotein cholesterol (HDL-C) displayed an apparent rising trend from 2 months after surgical castration. The results of flow cytometry indicated that the levels of cluster of differentiation (CD) 4+ and CD4+/CD8+ were lowered markedly, while that of CD8+ was raised significantly in comparison with those before castration (p<0.05) After castration, both fasting blood glucose and fasting insulin were increased obviously in the patients (p<0.05). The 2 h postprandial blood glucose and insulin were raised distinctly at 1 month after castration (p<0.05). The insulin resistance index was increased persistently and prominently (p<0.05).

Conclusion: The treatment of PCa through castration can aggravate the insulin resistance, reduce the immune function and improve the patient quality of life.