Evidence for reduced neuromuscular function in men with a history of androgen deprivation therapy for prostate cancer

Clin Physiol Funct Imaging. 2014 May;34(3):209-17. doi: 10.1111/cpf.12084. Epub 2013 Sep 30.

Abstract

Background: Indices of body composition and muscular strength were compared between men with prostate cancer (PCa) treated with androgen deprivation therapy (ADT) and asymptomatic matched men.

Methods: Nine subjects aged 63-83 years with PCa who received ADT (PCa+ADT; duration 6-180 months) and 11 asymptomatic aged-matched eugonadal men (HM) aged 59-80 years were assessed for prostate-specific antigen (PSA) and total testosterone (TT). Total body non-osseous lean mass (TBLM) and right thigh non-osseous fat-free mass (RTLM) were assessed using dual-energy X-ray absorptiometry. Peak torque of the right knee extensors at 0° s(-1) (ISO) and 60° s(-1) (CON), maximal handgrip strength of the dominant hand (MHS) and whole-body strength (WBS) were assessed. ISO and CON per unit mass of RTLM and MHS and WBS per unit mass of TBLM were calculated.

Results: Age, height, mass, body mass index and prostate-specific antigen were comparable between groups (P>0·05), while TT was lower in PCa+ADT (P<0·01). RTLM was similar between groups (P≥0·075). Absolute ISO and CON were lower for PCa+ADT (P<0·01) as were CON per unit of RTLM and ISO per unit of RTLM (P<0·05). Absolute MHS, WBS and MHS per unit of TBLM and WBS per unit of TBLM were lower for PCa+ADT (P<0·01; P<0·05).

Conclusions: Men with PCa who receive ADT experience significant losses in whole-body muscular strength compared with asymptomatic age-matched men, which may impair functional capacity. These losses in muscular strength appear to involve neuromuscular mechanisms that are yet to be identified.

Keywords: lean muscle mass; muscle quality; muscle strength; neuromuscular mechanisms; normalized peak torque; peak torque.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / adverse effects*
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Biomechanical Phenomena
  • Body Composition / drug effects
  • Case-Control Studies
  • Cross-Sectional Studies
  • Humans
  • Kallikreins / blood
  • Male
  • Middle Aged
  • Muscle Strength / drug effects
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / drug therapy*
  • Testosterone / blood
  • Torque

Substances

  • Androgen Antagonists
  • Antineoplastic Agents, Hormonal
  • Testosterone
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen