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Title: Structural decay of bone microarchitecture in men with prostate cancer treated with androgen deprivation therapy.
Austin Authors: Hamilton, E J;Ghasem-Zadeh, Ali ;Gianatti, Emily J;Lim-Joon, D;Bolton, Damien M ;Zebaze, Roger M D;Seeman, Ego ;Zajac, J D;Grossmann, Mathis 
Affiliation: Department of Medicine, Austin Health/Northern Health, University of Melbourne, Studley Road, Heidelberg, Victoria 3084, Australia
Issue Date: 29-Sep-2010
Publication information: The Journal of Clinical Endocrinology and Metabolism 2010; 95(12): E456-63
Abstract: Androgen deprivation therapy (ADT) used in the treatment of prostate cancer reduces bone mineral density (BMD) and predisposes to fractures. The structural basis of the BMD deficit and bone fragility is uncertain.We investigated changes in bone microarchitecture in 26 men (70.6±6.8 yr) with nonmetastatic prostate cancer during the first year of ADT using the new technique of high-resolution peripheral quantitative computed tomography.We conducted a 12-month prospective observational study in the setting of a tertiary referral center.After 12 months of ADT, total volumetric density decreased by 5.2±5.4% at the distal radius and 4.2±2.7% at the distal tibia (both P<0.001). This was due to a decrease in cortical volumetric BMD (by 11.3±8.6% for radius and 6.0±4.2% for tibia, all P<0.001) and trabecular density (by 3.5±6.0% for radius and 1.5±2.3% for tibia, all P<0.01), after correcting for trabecularization of cortical bone. Trabecular density decreased due to a decrease in trabecular number at both sites (P<0.05). Total testosterone, but not estradiol, levels were independently associated with total and corrected cortical volumetric BMD at the tibia.Sex steroid deficiency induced by ADT for prostate cancer results in microarchitectural decay. Bone fragility in these men may be more closely linked to testosterone than estradiol deficiency.
Gov't Doc #: 20881261
DOI: 10.1210/jc.2010-0902
Journal: The Journal of Clinical Endocrinology and Metabolism
Type: Journal Article
Subjects: Aged
Androgen Antagonists.therapeutic use
Body Composition
Body Mass Index
Bone Density.drug effects
Bone Resorption.chemically induced
Bone and Bones.drug effects.pathology.radiography
Follow-Up Studies
Middle Aged
Prostatic Neoplasms.drug therapy.epidemiology.pathology.radiography
Radius.drug effects.pathology
Tibia.drug effects.pathology
Appears in Collections:Journal articles

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