Impact of Androgen Deprivation Therapy on Non-Alcoholic Fatty Liver Disease in Patients with Prostate Cancer: A CT Evaluation

Abstract

Purpose: The aim of this study was to investigate the influence of androgen deprivation therapy (ADT) on the progression of non-alcoholic fatty liver disease (NAFLD) in patients with prostate cancer (PCa) by evaluation of hepatic steatosis on computed tomography (CT). Methods: The study included 77 PCa patients who underwent abdominal CT at baseline and after 6 months of ADT. The degree of hepatic steatosis was evaluated according to the attenuation value for liver parenchyma (CT LP ), the attenuation ratio for liver and spleen (LS ratio ), and the difference in attenuation between LS (LS dif ). The associations between these 3 indices and various metabolic syndrome-related factors were analyzed. Results: The number of NAFLD patients increased from 9 (11.6%) at baseline to 16 (20.7%) after ADT. The CT LP , LS ratio , and LS dif values were significantly lower after ADT than before (p < 0.05). There were significant correlations between the percent change in CT LP and the percent change in HbA 1c , between the percent change in LS ratio and the percent change in abdominal circumference, and between the percent change in LS dif and the percent change in BMI. Conclusions: Six months of ADT was associated with significant progression of NAFLD in PCa patients. This progression was strongly correlated with changes in HbA 1c , abdominal circumference, and BMI.

Endogenous sex hormones and nonalcoholic fatty liver disease in US adults

“…A dose–response relationship was noted between the number of androgen deprivation therapy doses and NAFLD 44 . Another study showed that 6 months of androgen deprivation therapy was associated with significant progression in NAFLD in patients with prostate cancer 45 …”

“…44 Another study showed that 6 months of androgen deprivation therapy was associated with significant progression in NAFLD in patients with prostate cancer. 45 TA B L E 4 Multivariable odds ratios of risk factors for NAFLD using Hepatic Steatosis Index according to sex hormone levels in postmenopausal women (n = 2209). TA B L E 5 Multivariable odds ratios of risk factors for NAFLD.…”

Nonalcoholic fatty liver disease and risk of prostatic diseases: Roles of insulin resistance

“…It was suggested that the prostate gland and liver have developed earlier than other primary sites of cancer (Gild et al., 2018). At present, there are six studies that evaluated the relationship between NAFLD and PCa (Allen et al., 2019; Arase et al., 2012; Choi et al., 2014, 2018; Kim et al., 2017; Sawazaki et al., 2020). A study conducted in Japan indicated that the prevalence of PCa in the NAFLD Japanese population was recorded at 1.3 per cent (Arase et al., 2012), but this study did not provide the prevalence of PCa in those without NAFLD.…”

“…(2019) observed that NAFLD was significantly correlated with a high risk of PCa after adjusting for age (HR = 1.8, 95% CI: 1.2–2.7). Besides, Sawazaki et al demonstrated that six months of androgen deprivation therapy was related to the remarkable progression of NAFLD in PCa patients (Sawazaki et al., 2020).…”

Sex hormones abnormalities in non-alcoholic fatty liver disease: pathophysiological and clinical implications

“…Epidemiological studies demonstrated that the diagnosis of NAFLD and even cirrhosis was more common after ADT in patients without known liver disease at baseline, with an apparent dose-response relationship [69]. In addition, in patients with diagnosed NAFLD, 6 months of ADT was associated with the progression of hepatic steatosis on abdominal CT [70].…”