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Vigorous activity reduces waist line

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Tony B and Sandy

This problem is not just something that happens on a forum.

The same thing would have happened in an email.

A number of websites on the Internet (like Medscape) require you to register to view their information.

Registration is often simple and free.

Those of us who have already registered with sites like Medscape, and asked the computer to remember our password, see the information without any notice that it is only for registered people.

So, we will unknowingly from time to time put links to pages that others can't see.

I have gone to Sandy's link and copied the relevant portion for Tony B and others to read.

Copying the whole may breach copyright.

Side Effects from ADT

Androgen Deprivation and Sarcopenia-related Disorders

Body Composition. Several studies have documented marked alterations in body composition in men receiving ADT for prostate cancer. Smith et al. [19] reported a 9.4% increase in whole body fat and a 2.7% reduction in whole body lean mass assessed by dual energy X-ray absorptiometry (DXA) following 48 weeks of ADT. Recently, Greenspan et al. [20] observed comparable changes in whole body fat (10.4%) and lean mass (-3.5%) during the initial 12 months of ADT. Cross-sectional studies comparing ADT- versus non-ADT-treated prostate cancer patients and healthy matched individuals have also indicated lower whole-body lean mass, higher percent and whole body fat mass in ADT-treated men.[21,22] Importantly, reduction of lean mass following ADT can reduce musculoskeletal fitness, compromising muscle strength, physical function and physical reserve capacity[9] (Figure 1). Such changes have implications in terms of reducing the age at which the individual falls below the functional capacity threshold, requiring a shift away from independent living and a reduced quality of life. Moreover, the increase in fat mass during ADT can lead to increased levels of total cholesterol and triglycerides[19,23] and consequently the possible development of cardiovascular complications.[24]

Figure 1. Theoretical model of musculoskeletal fitness reduction during aging and ADT. Potential role of resistance exercise providing an increase in musculoskeletal fitness and physical reserve capacity in ADT-treated men. ADT, androgen deprivation therapy.

Bone Mass and Skeletal Fracture. Apart from a decline in muscle mass and strength, ADT-treated men suffer a reduction in bone mass, and consequently bone strength, that contributes to an increased incidence of fracture and associated disability.[25,26] The ADT-related bone losses are significant and exceed those of women experiencing early menopause.[27] Recently, Greenspan et al. [20] indicated that men with prostate cancer initiating ADT have a 5- to 10-fold loss of bone mineral density (g/cm2) compared to healthy controls or men with prostate cancer not on ADT. Importantly, following ADT, there is a significant dose-response relation between fracture risk and the number of LHRHa doses administrated.[25] The reduced structural bone strength is compounded by the reduction in muscle strength and power, which has been related to increased falls incidence[28] resulting in two separate side effects of ADT combining to greatly increase fractures due to falls.

Insulin Resistance and Lipoprotein Profile. Recently, Basaria et al. [29] suggested that men with prostate cancer undergoing long-term ADT can develop insulin resistance and hyperglycemia and these metabolic alterations are independent of age and body mass index. In this cross-sectional study,[29] ADT-treated men had significantly higher fasting levels of glucose, insulin and leptin when compared to healthy aged-matched controls and prostate cancer patients not on ADT. Moreover, significant negative correlations were reported between total and free testosterone levels with fasting glucose, insulin and leptin. Further, data from the same research group also indicated that long-term ADT-induced hypogonadal men have higher fasting levels of total cholesterol, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol than non-ADT prostate cancer men and aged-matched controls.[23] Other studies[19] have also indicated the long-term negative alterations in lipoprotein profile in men treated with ADT with increases in serum total cholesterol (9%) and triglycerides (26.5%) following 48 weeks of therapy.

Androgen Deprivation Syndrome and Quality of Life

Quality of Life, Depression and Cognitive Function. Testosterone suppression for prostate cancer has been shown to negatively affect health-related quality of life. As such, reduced physical function and general health have also been reported in men on ADT- compared to non-ADT-treated men and healthy matched controls.[30] For example, Spry et al. [31] reported results from a large longitudinal, multicenter study examining the dynamic change in quality of life and testosterone in men initiating an intermittent maximal androgen blockade program. ADT lead to a significant reduction in health-related quality of life during the initial 9 months of therapy with substantial changes occurring by 3 months. Further, during the recovery phase (off-ADT), improvements in quality of life occurred in a more gradual manner and were of smaller magnitude than the changes observed during the ADT phase.

Bioavailable testosterone has been positively associated with cognitive function in older men.[32] Further, the hypogonadal condition has been associated with an increased incidence of depressive illness.[33] Despite the limited number of controlled studies examining the effects of testosterone suppression on depressive and cognitive function during ADT, a recent large population-based study reported an increased incidence of depressive and cognitive disorders in ADT-treated men, although the effects were diminished after adjustment for potential confounders.[18]

I have copied the graph in the next posting (posting images is Forums 201).



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Resistance exercise gives ADT men better musculoskeletal fitness than ordinary men.


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