The influence of androgen deprivation therapy on hip geometric properties and bone mineral density in Japanese men with prostate cancer and its relationship with the visceral fat accumulation

Figures & data

Figure 1. The targeted part of the advanced hip assessment is the narrowest part of the femoral neck. The cross-sectional area is calculated using a quadrature via the parts method of a small area (⊿A) for the area surrounded by a profile curve, which was obtained by dual-energy X-ray absorptiometry. The cross-sectional moment of inertia which surrounds the central axis and goes through the profile center of mass is calculated by summing the square of the distance (r) from ⊿A to the profile center of mass and the product of ⊿A across the entire area.

Table 1. Patient characteristics.

Characteristics
Total	N (%)	65 (100)
Age (years)	Median (range)	74 (60–89)
Duration of ADT (month)	Median (range)	13.1 (12.2–14.8)
Reason for ADT
ADT monotherapy	N (%)	42 (64.6)
ADT with RT or RP	N (%)	23 (35.3)
PSA (ng/ml)	Median (range)	11.7 (5.77–58.6)
AC (cm)	Median (IQR)	85.8 (81.5–89.2)
<85	N (%)	32 (49.2)
≥85	N (%)	33 (50.8)
BMI (kg/m^2)	Median (IQR)	23.1 (20.6–25.2)
≤23	N (%)	32 (49.2)
>23	N (%)	33 (50.8)
SFA (cm^2)	Median (IQR)	122.5 (102.0–148.5)
VFA (cm^2)	Median (IQR)	121.2 (95.0–146.1)
<100	N (%)	19 (29.2)
≥100	N (%)	46 (70.8)
BMD (T-score)
Lumbar spine (L1–4)	Mean ± SD	0.28 ± 1.7
Femoral neck	Mean ± SD	−1.6 ± 1.1
Total hip	Mean ± SD	−1.1 ± 1.2

AC: abdominal circumference; ADT: androgen deprivation therapy; BMD: bone mineral density; BMI: body mass index; IQR: interquartile range; PSA: prostate-specific antigen; RP: radical prostatectomy; RT: radiation therapy; SFA: subcutaneous fat area; VFA: visceral fat area.

Table 2. Changes in factors associated with bone strength caused by 1 year of ADT.

	Baseline	1 year after ADT	Percent change (%)	p-Value
BMD (g/cm^2)
Lumbar spine (L1–4)	1.159 ± 0.258	1.137 ± 0.255	−1.65 ± 2.85	<0.0001
Femoral neck	0.819 ± 0.129	0.801 ± 0.115	−1.91 ± 3.59	0.0002
Total hip	0.888 ± 0.158	0.866 ± 0.138	−2.20 ± 3.61	0.0006
Narrow femoral neck
CSA (mm^2)	135.3 ± 23.6	131.4 ± 22.2	−2.55 ± 6.27	0.0016
CSMI (mm^4)	12126.8 ± 2938.5	11657.4 ± 2901.9	−3.50 ± 10.4	0.0045
SM (mm^3)	615.1 ± 133.8	593.5 ± 128.9	−3.14 ± 8.92	0.0027
BR	6.0 ± 2.62	5.84 ± 1.95	9.48 ± 52.1	0.5825

Data are expressed as means ± SD. ADT: androgen deprivation therapy; BMD: bone mineral density; BR: buckling ratio; CSA: cross-sectional area; CSMI: cross-sectional moment of inertia; SM: section modulus.

Table 3. Clinical parameters associated with the deterioration of bone strength due to ADT.

	N	BMD						AHA parameter
		Lumbar spine		Femoral neck		Total hip		CSA		CSMI		SM
		Median	p-Value	Median	p-Value	Median	p-Value	Median	p-Value	Median	p-Value	Median	p-Value
BMI
>23 kg/m^2	33	−1.95	0.0978	−0.99	0.2563	−1.76	0.4077	−1.88	0.9948	−2.33	0.9738	−3.91	0.5075
≤23 kg/m^2	32	−0.39		−2.25		−2.14		−1.78		−4.05		−5.03
AC
≥85 cm	33	−2.05	0.2143	−0.99	0.577	−1.69	0.3712	−2.54	0.1564	−4.37	0.0787	−4.99	0.4624
<85 cm	32	−0.77		−1.58		−2.08		−0.75		−0.16		−3.68
VFA
≥100 cm^2	46	−0.97	0.25	−1.79	0.0498	−2.08	0.5347	−1.86	0.5351	−4.49	0.2698	−4.33	0.9712
<100 cm^2	19	−2.38		−0.28		−1.28		−0.87		1.12		−4.72
SFA
≥Median	34	−2.35	0.0535	−1.53	0.5722	−2.39	0.1606	−2.46	0.7726	−4.29	0.6984	−5.49	0.5501
<Median	31	−0.82		−0.99		−1.59		−1.71		−1.88		−3.99

AC: abdominal circumference; ADT: androgen deprivation therapy; AHA: advanced hip assessment; BMD: bone mineral density; BMI: body mass index; CSA: cross-sectional area; CSMI: cross-sectional moment of inertia; SFA: subcutaneous fat area; SM: section modulus; VFA: visceral fat area.