Onset of androgen deprivation therapy leads to rapid deterioration of body composition, physical performance, cardiometabolic health and quality-of-life in prostate cancer patients

Figures & data

Table 1. Patients’ baseline characteristics (n = 34).

Age (years)	70 ± 7
Body weight (kg)	82.2 ± 12.8
BMI (kg/m^2)	26.4 ± 3.6
Total body fat (%)	31.2 ± 5.2
Waist circumference (cm)	101 ± 10
Time since PCa diagnosis (months)	23 ± 40
Gleason score	8.4 ± 1.0
PSA (ng/ml)	37.0 ± 49.6
ADT duration (days)	26 ± 18
Bone metastases, n (%)	18 (52.9)
Previous prostatectomy, n (%)	10 (29.4)
Previous radiation therapy, n (%)	6 (17.6)
Previous chemotherapy, n (%)	0 (0)
Number of comorbidities,^a n (%)
0	10 (29.4)
1	10 (29.4)
≥ 2	14 (41.2)

Values are means ± SD, or number and (%) of participants.

BMI, body mass index; PCa, prostate cancer; ADT, androgen deprivation therapy.

^aComorbidities were assessed by the adapted Self-administered Comorbidity Questionnaire (SCQ) [29].

Figure 1. Individual values of quadriceps cross-sectional area (CSA, a) and whole-body fat mass (b) before and after 5 months androgen deprivation therapy in prostate cancer patients. *Significantly different from baseline (a, p < 0.001; b, p = 0.006).

Table 2. Changes in body composition in prostate cancer patients following 5 months androgen deprivation therapy.

	n	Baseline	5 Months	Difference	p-value
Body weight (kg)	33	82.8 ± 12.5	84.8 ± 13.0	2.0 ± 3.4	0.002
BMI (kg/m^2)	33	26.4 ± 3.7	27.0 ± 3.8	0.6 ± 1.1	0.003
Waist circumference (cm)	34	101 ± 10	103 ± 10	2 ± 3	0.011
Total lean body mass (kg)	29	55.3 ± 6.8	54.5 ± 6.7	−0.8 ± 2.4	0.064
Appendicular lean mass (kg)	29	24.4 ± 3.1	23.9 ± 3.0	−0.5 ± 1.3	0.041
Leg lean mass (kg)	29	17.7 ± 2.4	17.4 ± 2.4	−0.3 ± 1.0	0.133
Total body fat (kg)	29	26.2 ± 7.7	28.4 ± 8.3	2.1 ± 1.8	0.000
Total body fat (%)	29	31.2 ± 5.2	33.1 ± 5.6	1.9 ± 1.8	0.000
Quadriceps CSA (cm^2)	33	66.3 ± 9.1	65.0 ± 8.5	−1.3 ± 2.5	0.006

Values are means ± SD.

BMI, body mass index; CSA, cross-sectional area.

Figure 2. Individual values of one-repetition maximum (1RM) leg press (a) and peak oxygen uptake (VO_2peak, b) before and after 5 months androgen deprivation therapy in prostate cancer patients. * Significantly different from baseline (a, p = 0.003; b, p < 0.001).

Table 3. Changes in muscle strength, physical performance, aerobic capacity and habitual physical activity in prostate cancer patients following 5 months androgen deprivation therapy.

	n	Baseline	5 Months	Difference	p-value
Muscle strength
1RM Leg press (kg)	31	107 ± 27	100 ± 27	−6 ± 11	0.003
1RM Leg extension (kg)	29	52 ± 15	48 ± 16	−3 ± 8	0.030
Physical performance
Timed up and go test (s)	34	9.22 ± 0.98	9.11 ± 1.30	−0.11 ± 1.14	0.566
30-second chair stand test (repetitions)	34	13.6 ± 3.4	13.5 ± 4.0	−0.1 ± 2.8	0.857
Stair climb test (s)	34	9.56 ± 2.16	10.17 ± 2.55	0.61 ± 1.60	0.034
CPET
Wmax (W)	30	163 ± 39	148 ± 35	−15 ± 15	0.000
Wmax/kg BW (W/kg BW)	29	2.02 ± 0.53	1.79 ± 0.48	−0.23 ± 0.18	0.000
VO2peak (mL/min)	26	1,883 ± 360	1,685 ± 323	−198 ± 212	0.000
VO2peak/kg BW (mL/min/kg BW)	25	23.2 ± 3.7	20.3 ± 3.4	−2.9 ± 2.6	0.000
Maximum heart rate	26	145 ± 22	136 ± 18	−9 ± 15	0.007
RERpeak	26	1.19 ± 0.11	1.20 ± 0.10	0.01 ± 0.08	0.705
Physical activity levels
Step count (steps/day)	33	7,048 ± 2,277	5,842 ± 1,749	−1,207 ± 1,942	0.001
Sedentary (%)	33	72.4 ± 7.0	73.9 ± 6.7	−1.5 ± 6.5	0.200
Light (%)	33	21.4 ± 6.1	21.3 ± 5.8	−0.1 ± 5.4	0.928
Moderate to vigorous (%)	33	6.2 ± 3.4	4.8 ± 2.3	−1.4 ± 2.5	0.003

Values are means ± SD.

1RM, one-repetition maximum; CPET, cardiopulmonary exercise test; W_max, maximal wattage; BW, body weight; VO_2peak, peak oxygen uptake; RER_peak, peak respiratory exchange ratio.

Figure 3. Individual values of step count before and after 5 months androgen deprivation therapy in prostate cancer patients (a). Percentage of the day spent sedentary, performing light activities or performing moderate to vigorous activities before (b) and after (c) 5 months androgen deprivation therapy in prostate cancer patients. * Significantly different from baseline (a, p = 0.001; c, p = 0.003).

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