Shahani S et al. - Baseline and serial screening for fasting glucose, lipids and other cardiovascular risk factors in men receiving androgen-deprivation therapy (ADT) is recommended. Glucose tolerance tests and cardiac evaluation may be required in selected cases. Methods
Metabolic complications are suspected to contribute into the increased cardiovascular mortality in pts on ADT
A MEDLINE search on key words androgen deprivation therapy AND insulin resistance, hyperglycemia, diabetes, dyslipidemia, metabolic syndrome and cardiovascular disease was conducted
Relevant studies in non-PCa population evaluating the association between testosterone and metabolism were also reviewed
Results
Prospective studies evaluating early (3–6 mos) metabolic changes of ADT showed development of hyperinsulinemia
However, glucose levels remained normal
Cross-sectional studies of men undergoing long-term (>=12 mos) ADT revealed higher prevalence of diabetes and metabolic syndrome vs. controls
Furthermore, men undergoing ADT also experienced higher cardiovascular mortality
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