Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy

Alicia K. Morgans*, Kang Hsien Fan, Tatsuki Koyama, Peter C. Albertsen, Michael Goodman, Ann S. Hamilton, Richard M. Hoffman, Janet L. Stanford, Antoinette M. Stroup, Matthew J. Resnick, Daniel A. Barocas, David F. Penson

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Purpose Observational data suggest that androgen deprivation therapy increases the risk of diabetes and cardiovascular disease. Using data from the population based PCOS we evaluated whether age at diagnosis and comorbidity impact the association of androgen deprivation therapy with incident diabetes and cardiovascular disease. Materials and Methods We identified men with nonmetastatic prostate cancer diagnosed from 1994 to 1995 who were followed through 2009 to 2010. We used multivariable logistic regression models to assess the relationship of androgen deprivation therapy exposure (2 or fewer years, greater than 2 years or none) with incident diabetes and cardiovascular disease, adjusting for age at diagnosis, race, stage and comorbidity. Results Of 3,526 eligible study participants 2,985 without diabetes and 3,112 without cardiovascular disease comprised the cohorts at risk. Androgen deprivation therapy was not associated with an increased risk of diabetes or cardiovascular disease in men diagnosed with prostate cancer before age 70 years. Prolonged androgen deprivation therapy and increasing age at diagnosis in older men was associated with an increased risk of diabetes (at age 76 years OR 2.1, 95% CI 1.0-4.4) and cardiovascular disease (at age 74 years OR 1.9, 95% CI 1.0-3.5). Men with comorbidities were at greater risk for diabetes (OR 4.3, 95% CI 2.3-7.9) and cardiovascular disease (OR 8.1, 95% CI 4.3-15.5) than men without comorbidities. Conclusions Prolonged androgen deprivation therapy exposure increases the risk of cardiovascular disease and diabetes in men diagnosed with prostate cancer who are older than approximately 75 years, especially those with other comorbidities. Older men who receive prolonged androgen deprivation therapy should be closely monitored for diabetes and cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)1226-1231
Number of pages6
JournalJournal of Urology
Volume193
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • antiandrogens
  • cardiovascular diseases
  • diabetes mellitus
  • prostatic neoplasms
  • risk

ASJC Scopus subject areas

  • Urology

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    Morgans, A. K., Fan, K. H., Koyama, T., Albertsen, P. C., Goodman, M., Hamilton, A. S., Hoffman, R. M., Stanford, J. L., Stroup, A. M., Resnick, M. J., Barocas, D. A., & Penson, D. F. (2015). Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy. Journal of Urology, 193(4), 1226-1231. https://doi.org/10.1016/j.juro.2014.11.006