Terapia de privación de andrógenos y obesidad mórbida: ¿tienen en común el riesgo cardiovascular por síndrome metabólico?

Cleffi, S.; Neto, Ary Serpa; Reis, Leonardo Oliveira; Maia, Priscila Masson; Fonseca, Fernando; Wroclawski, Marcelo Langer; Neves, M.; Pompeo, Antônio Carlos Lima; Giglio, Auro del; Faria, Eliney Ferreira; Tobias-Machado, Marcos

doi:10.1016/j.acuro.2011.01.011

Cited by 12 publications

(3 citation statements)

References 27 publications

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“…12,32,33 It is of note that these studies were carried out in white populations, whereas our study involved African men. In a study by Cleffi et al 14 of Hispanic men, the mean glucose levels of patients with CaP receiving ADT and those with CaP not receiving ADT were comparable.…”

Section: Discussionmentioning

confidence: 87%

“…Smith et al 23,25 also observed increases in BMI, fat mass, and total body weight after ADT when compared with baseline. In a study by Cleffi et al, 14 patients receiving ADT had a greater waist circumference compared with those not receiving ADT. However, BMI was similar in both groups, supporting the occurrence of visceral obesity in the ADT group in their study.…”

Section: Discussionmentioning

confidence: 93%

“…10,11 Studies have reported increases in hyperlipidemia, obesity, and hyperglycemia as a consequence of ADT in patients with CaP. 11-14 All these are cardiovascular risk factors and may result in a double burden of disease in patients with CaP. Most of these research studies were conducted in white, Hispanic, and Japanese populations; we wondered if similar observations would be found in African patients with CaP undergoing ADT, who would have different diet, environmental, lifestyle, and genetic factors compared with previous study populations.…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

Essien

Bassey

Gali

et al. 2017

JGO

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PurposeCardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population.Patients and MethodsThe design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT.ResultsMean total cholesterol (P = .010), LDL cholesterol (P = .021), BMI (P = .001), and waist circumference (P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone.ConclusionThis study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

Essien

Bassey

Gali

et al. 2017

JGO

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Old issues and new perspectives on prostate cancer hormonal therapy: the molecular substratum

Reis

2011

Med Oncol

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Secondary hormonal therapy is a treatment option in patients with castration-resistant prostate cancer (CRPC); however, it is underutilized and is room for optimization and improvement. In this context, androgen receptor (AR) is the Achilles' heel, being critically important and various mechanisms ranging from receptor mutations to secondary signaling pathways are responsible for some of the biological heterogeneity, demanding a multimodal approach. A comprehensive review of the peer-reviewed literature is performed on the topic of molecular mechanisms supporting secondary hormonal therapies, including expanded alternative hormonal therapies for CRPC. Essential concepts in clinical treatment of patients with progression on primary hormonal therapy are maintaining the castrate state, accounting for the intermittency phenomenon and sequentially using oral antiandrogens and adrenolytics heading to androgen depletion microenvironment. Survival prolongation, pain relief or measurable improvement in tumor-related symptoms should be persecuted and are considered to be a tangible benefit of obvious worth to the patient. Understanding the underlying molecular substratum is of paramount importance to hormonal therapy optimization in this context once current androgen-depletion strategies are incomplete, and residual androgens as well as alternative routes contribute to sustained AR activity and disease progression to a lethal phenotype. One or many mechanisms may be playing a role, even within the same patient and lastly are potential targets for treatment. Five fundamental mechanisms mediated through the AR to promote tumor growth (three of which depend on ligand signaling) added to the stem cell pathway must be recognized in CRPC. They are persistence of intratumoral androgens as a result of in situ steroidogenesis or adrenal source; AR mutations that allow promiscuous activation by otherwise nonsignaling ligands; wild-type AR gene amplification; alterations in AR coactivator-to-corepressor ratio that impact transcription; outlaw AR pathways that bypass the need for androgens by signaling through crosstalk with other ligand-bound receptors, cytokines, or transactivation of activated tyrosine kinase receptors in the cytosol.

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Impacto de la supresión androgénica sobre el perfil lipídico y el riesgo aterogénico en pacientes con cáncer de próstata

Salvador

Planas

Raventós

et al. 2012

Actas Urológicas Españolas

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Terapia de privación de andrógenos y obesidad mórbida: ¿tienen en común el riesgo cardiovascular por síndrome metabólico?

Cited by 12 publications

References 27 publications

Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

Old issues and new perspectives on prostate cancer hormonal therapy: the molecular substratum

Impacto de la supresión androgénica sobre el perfil lipídico y el riesgo aterogénico en pacientes con cáncer de próstata

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