A multicenter prospective study of the risk factors affecting bone mineral density in Korean patients with prostate cancer

Abstract

Purpose: Androgen deprivation therapy (ADT) is associated with loss of bone mineral density (BMD). Preexisting bone losses in men with prostate cancer are of great concern because of accelerated bone loss during ADT. We sought to identify the risk factors associated with osteoporosis in Korean patients with prostate cancer who had not received ADT. Materials and Methods: Patients who underwent biopsy of the prostate because of a high prostate-specific antigen (PSA) level or a palpable nodule in a digital rectal examination were included in this study. The patients (n=90) were divided into 2 major groups according to biopsy results: the prostate cancer group (group 1, n=41) and non-prostate cancer group (group 2, n=49). The age, body mass index (BMI), lifestyle, testosterone concentration, BMD, and disease variables in prostate cancer were obtained and analyzed prospectively. BMD of the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. Results: In group 1, 41.4% had osteopenia (36.6%) or osteoporosis (4.8%); in group 2, 26.5% had osteopenia (22.4%) or osteoporosis (4.1%). The estimated mean T-score was significantly (p=0.037) lower in group 1 (-0.668±1.364) than in group 2 (-0.041±1.426). The significant factors correlated with BMD (T-score) in prostate cancer were age (p=0.012), serum testosterone level (p=0.019), and BMI (p=0.004). Conclusions: BMDs were lower in men with prostate cancer who had not received ADT than in the control group. Consideration should be given to counseling on risk factors and lifestyle issues in prostate cancer patients with old age, low serum testosterone, and slender stature before initiating ADT. © The Korean Urological Association, 2009.