Body Composition Alterations, Energy Expenditure and Fat Oxidation in Elderly Males Suffering from Prostate Cancer, Pre and Post Orchiectomy

Reis, Caio Luiz Bitencourt; Liberman, Sami; Pompeo, Antônio Carlos Lima; Srougi, Miguel; Halpern, Alfredo

doi:10.1590/s1807-59322009000800012

Cited by 17 publications

(6 citation statements)

References 24 publications

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“…Fat is oxidised in the liver and extra-hepatic tissue such as skeletal muscle and this component of lipid metabolism may be influenced by testosterone. Adverse effects on energy expenditure and fat oxidation were observed in elderly males suffering from prostate cancer and undergoing androgen deprivation (Reis et al 2009). Decreased fat oxidation and increased glucose oxidation was observed post-orchiectomy compared with pre-treatment.…”

Section: Musclementioning

confidence: 99%

Testosterone: a metabolic hormone in health and disease

Kelly

Jones

2013

Journal of Endocrinology

393

304

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Testosterone is a hormone that plays a key role in carbohydrate, fat and protein metabolism. It has been known for some time that testosterone has a major influence on body fat composition and muscle mass in the male. Testosterone deficiency is associated with an increased fat mass (in particular central adiposity), reduced insulin sensitivity, impaired glucose tolerance, elevated triglycerides and cholesterol and low HDL-cholesterol. All these factors are found in the metabolic syndrome (MetS) and type 2 diabetes, contributing to cardiovascular risk. Clinical trials demonstrate that testosterone replacement therapy improves the insulin resistance found in these conditions as well as glycaemic control and also reduces body fat mass, in particular truncal adiposity, cholesterol and triglycerides. The mechanisms by which testosterone acts on pathways to control metabolism are not fully clear. There is, however, an increasing body of evidence from animal, cell and clinical studies that testosterone at the molecular level controls the expression of important regulatory proteins involved in glycolysis, glycogen synthesis and lipid and cholesterol metabolism. The effects of testosterone differ in the major tissues involved in insulin action, which include liver, muscle and fat, suggesting a complex regulatory influence on metabolism. The cumulative effects of testosterone on these biochemical pathways would account for the overall benefit on insulin sensitivity observed in clinical trials. This review discusses the current knowledge of the metabolic actions of testosterone and how testosterone deficiency contributes to the clinical disease states of obesity, MetS and type 2 diabetes and the role of testosterone replacement.

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Section: Musclementioning

confidence: 99%

Testosterone: a metabolic hormone in health and disease

Kelly

Jones

2013

Journal of Endocrinology

393

304

View full text Add to dashboard Cite

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“…38,41,42 Both body composition and REE may be affected by the disease state and therapy modalities, 48 but do not always change in accordance with each other. 22,[49][50][51][52][53][54] Thus, alterations in REE must be considered in the context of body weight and composition variations, which occur throughout the disease trajectory. Importantly, changes in body composition and energy expenditure in advanced cancer may be markedly different compared with changes that occur during simple starvation.…”

Section: Body Compositionmentioning

confidence: 99%

Key determinants of energy expenditure in cancer and implications for clinical practice

et al. 2016

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Great discrepancies exist in the reported prevalence of altered energy metabolism (hypo- or hypermetabolism) in cancer patients, which is likely due to the vast array of phenomena that can affect energy expenditure in these patients. The purpose of this review was to critically evaluate key determinants of energy expenditure in cancer and the relevance for clinical practice. Resting energy expenditure (REE) is the largest and most commonly measured component of total energy expenditure. In addition to the energetic demand of the tumor itself, REE may be increased due to changes in inflammation, body composition and brown adipose tissue activation. Energy expenditure from physical activity is often lower in cancer compared with healthy populations, and there is evidence to suggest that the thermic effect of food might also be blunted and affected by cancer therapy. Although accurate assessment of energy metabolism is a cornerstone of adequate nutritional therapy, prediction methods often do not capture the true energy expenditure of most cancer patients. In fact, limits of agreement of prediction equations may range from 40% below to 30% above measured REE. Such variability highlights the need for a more comprehensive understanding of energy expenditure in cancer and the value of accurately assessing the energy needs of these patients.

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“…Visceral adipocytes are known to have androgen receptors and it has been proposed that testosterone might be directly involved in fatty acid mobilization. 20 Changes in fat distribution during ADT may be due to loss of androgen-mediated inhibition of stem cell differentiation into adipocytes. 21 It has also been suggested that accumulation of visceral fat in these men could be due to reduced lipolysis as a result of the low testosterone levels.…”

Section: Adt and Obesitymentioning

confidence: 99%

Adverse effects of androgen deprivation therapy in patients with prostate cancer: focus on metabolic complications

Tzortzis

Samarinas

Zachos

et al. 2017

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Prostate cancer is the most common cancer among men and androgen deprivation therapy (ADT) is the most effective treatment for this disease. The cornerstone of the treatment of prostate cancer is inhibition of testosterone production which interrupts testosterone-induced growth of the prostate tumor. The dramatic decrease in testosterone levels, however, has several undesirable effects on the metabolic profile and bone metabolism and can also lead to fatigue, loss of libido, gynecomastia, and anemia, provoke vasomotor flushing, and generally affect the quality of life. Due to the long-term survival rates of patients with prostate cancer, treatmentrelated adverse effects are highly relevant and thus, in each clinical setting, the benefits of ADT must be weighed against treatment-related adverse effects. The current review focuses on the more recently described metabolic complications of androgen deprivation therapy, including obesity, diabetes, lipid alterations, metabolic syndrome, and cardiovascular disease. In addition, it provides practical management recommendations drawn from the available guidelines issued

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Body Composition Alterations, Energy Expenditure and Fat Oxidation in Elderly Males Suffering from Prostate Cancer, Pre and Post Orchiectomy

Cited by 17 publications

References 24 publications

Testosterone: a metabolic hormone in health and disease

Testosterone: a metabolic hormone in health and disease

Key determinants of energy expenditure in cancer and implications for clinical practice

Adverse effects of androgen deprivation therapy in patients with prostate cancer: focus on metabolic complications

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