Reported by Reuters, Feb 9, We add the abstract from the article, below this report

By Megan Rauscher

NEW YORK (Reuters Health) - Men with recurrent or advanced prostate cancer may be put on hormone therapy to block testosterone production in an effort to halt or slow the growth of the tumor. However, new research shows, this may put them at increased risk for developing insulin resistance and elevated blood sugar levels, which can affect heart health.

These complications of what doctors call androgen-deprivation therapy or ADT may contribute to the high rate of heart disease in men with prostate cancer, Baltimore-based investigators report in the journal Cancer.

Roughly half of men who develop prostate cancer die of other, unrelated causes, explain Dr. Shehzad Basaria from Johns Hopkins University and colleagues. Heart disease is one of the most common causes of death in men with prostate cancer.

In a study of 53 men with prostate cancer, the researchers found that those treated with testosterone-lowering ADT for at least one year were more resistant to the action of insulin - the body’s key sugar-regulating hormone - and had higher glucose levels than men who had only received local surgery and/or radiation and had normal testosterone levels, and age-matched healthy men with normal testosterone levels.

According to the study, 44 percent of men in the ADT group had blood sugar levels greater than 126, which is among the criteria for the diagnosis of diabetes. In contrast, only about 12 percent of men in the other groups had blood sugar levels this high.

In an e-mail to Reuters Health, Basaria said: “If these observations are confirmed in long-term prospective studies, then insulin resistance and diabetes should be regarded as additional side effects of androgen deprivation in these men.”

In the meantime, the investigators think men with prostate cancer who have received ADT for at least one year should be screened for high blood sugar.

More study, they add, is needed to determine the value of anti-diabetes drugs in men with prostate cancer.

Source at Reuters Health

Journal source: Cancer, February 1, 2006.
Article abstract:

Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy.

Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS.

Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland.

BACKGROUND: Prostate carcinoma (PCa) is one of the most common malignancies in men. Androgen-deprivation therapy (ADT) is used frequently in the treatment of recurrent and metastatic PCa, rendering these men hypogonadal. Because male hypogonadism is associated with an unfavorable metabolic profile, and men with PCa have high cardiovascular mortality, the authors evaluated the effects of long-term ADT on fasting glucose levels, insulin levels, and insulin resistance.

METHODS: To evaluate the long-term effects of ADT on fasting glucose and insulin resistance in men with PCa who received ADT and to determine whether these metabolic alterations are a result of hypogonadism, the authors conducted a cross-sectional study at a university-based research institution in the United States. In total, 53 men were evaluated, including 18 men with PCa who received ADT for at least 12 months prior to the onset of the study (the ADT group), 17 age-matched men with nonmetastatic PCa who had undergone prostatectomy and/or received radiotherapy and who were not receiving ADT (the non-ADT group), and 18 age-matched controls (the control group). None of the men had a known history of diabetes mellitus.

RESULTS: The mean age was similar in all 3 groups (P = 0.33). Serum total testosterone levels (P

CONCLUSIONS: The current data suggested that men with PCa who are receiving long-term ADT are at risk for developing insulin resistance and hyperglycemia, thus leading to their increased risk of cardiovascular disease. This adverse metabolic profile developed independent of age and BMI and appeared to be a direct result of androgen deprivation. Cancer 2006. (c) 2005 American Cancer Society.