Gritskevich, E.Yu, Pirogov Russian National Research Medical University, Russia
Title : Assessment of Thyroid Function and Metabolic Disorders in Management of Prostate Cancer with Agonists of GnRH
Study Objective: to assess thyroid function and metabolic disorders in patients with local prostate cancer (pT3N0M0) or biochemical relapse after total prostatectomy for local prostate cancer, who were treated with agonists of gonadotropin-releasing hormone (aGnRH).
Study Design: follow-up study.
Materials and Methods. 102 patients were enrolled to the study, 99 subjects were followed up till the study completion. The mean age was 69 years old (95% confidence range: 61.5-79.2 years old). To assess thyroid function, thyroid-stimulating hormone (TSH) and free T4 were measured prior to and in 12 months after androgen deprivation therapy (ADT). To see metabolic disorders, waist circumference (WC), body mass index (BMI), and total cholesterol (TC) were measured prior to and 3, 6 and 12 months after ADT initiation.
Study Results. The following changes were noted in test parameters: thyroid hormones (basic and 12 months later, respectively): TSH (mU/L): 1.67506 and 1.90684 (p < 0.001), free T4 — 11.6266 and 11.0555 (p < 0.001). Metabolic parameters (basic, 3, 6 and 12 months, respectively): WC (cm): 91.5, 95.4 (+4.2%), 96.1 (+5.0%), 96.4 (+5.4%) (for all differences p ? 0.017); BMI (kg/m2): 27.4, 28.2 (+2.9%), 28.4 (+3.6%), 28.4 (+3.6%) (p ? 0.004 for all differences, save for differences between values in 6 and 12 months — p = 0.995); TC (mmol/L): 5.2, 5.6 (+7.7%), 5.8 (+11.5%), 5.9 (+13.5%) (for all differences p ? 0.001). Statistically significant positive correlation was recorded between TSH and TC dynamics (R = 0.285, p = 0.004), statistically significant negative correlation — between TSH and free T4 (R = –0.315, p = 0.001).
Conclusion. aGnRH monotherapy led to the trend of increase in WC, body mass, TSH raise and free T4 reduction one year after ADT, though mean hormone values were within acceptable range; TH demonstrated an increase. The highest increase in WC, BMI, TC was recorded within first 3 months of therapy, then the rate of increase diminished. Further study of metabolic and hormonal complications from ADT and evidence base enhancement are required in order to check the data and develop measures to prevent complications.