The term metabolic syndrome does not adequately describe the effects of GnRH agonists in men with prostate cancer

This open-label prospective study was aimed to investigate the effects of gonadotropin-releasing hormone (GnRH) agonist therapy on components of the metabolic syndrome in men with prostate cancer. GnRH agonists were previously reported to increase fat mass, to decrease insulin sensitivity, and to increase triglycerides. A total of 26 men with recurrent or locally advanced prostate cancer participated in the study. After 12 months of open-label leuprolide treatment, fat mass significantly increased and the percentage lean body mass significantly decreased (P<0.001 for both). The total abdominal fat area significantly increased by a mean of 16.5%, with the accumulation of subcutaneous fat accounting for 94% of the observed increase. By contrast, waist-to-hip ratio, blood pressure, resistin and C-reactive protein levels did not change significantly, whereas serum HDL-cholesterol concentrations and serum adiponectin levels rose significantly. Based on these findings, the authors conclude that the classical metabolic syndrome phenotype definition does not appropriately describe the effects of GnRH agonists in men with prostate cancer, since the changes in metabolic syndrome components and their correlates were not consensual, with subcutaneous fat mass, HDL-cholesterol and adiponectin increasing whilst waist-to-hip ratio, blood pressure, or C-reactive protein were not significantly altered.

Abstract

Keywords:
Abdominal obesity – Adiponectin – Adipose tissue – Blood pressure – CRP – HDL-C – Metabolic syndrome – Subcutaneous fat – Waist-to-hip ratio