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

doi:10.1016/j.juro.2014.11.006

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

Journal article

Open access

Peer reviewed

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, …

The Journal of urology, Vol.193(4), pp.1226-1231

04/2015

DOI: 10.1016/j.juro.2014.11.006

PMCID: PMC4542148

PMID: 25451829

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Abstract

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. 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. 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. 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.

Prospective Studies

Age Factors

Humans

Middle Aged

Survivors

Male

Risk

Diabetes Complications - complications

Incidence

Diabetes Complications - chemically induced

Cardiovascular Diseases - complications

Diabetes Mellitus - epidemiology

Aged, 80 and over

Androgen Antagonists - therapeutic use

Cardiovascular Diseases - epidemiology

Diabetes Complications - epidemiology

Diabetes Mellitus - chemically induced

Aged

Cardiovascular Diseases - chemically induced

Prostatic Neoplasms - complications

Prostatic Neoplasms - drug therapy

Cohort Studies

Details

Title: Subtitle: Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy
Creators: Alicia K Morgans - School of Medicine, Vanderbilt University, Nashville, Tennessee. Electronic address: alicia.morgans@vanderbilt.edu
Kang-Hsien Fan - School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
Tatsuki Koyama - School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
Peter C Albertsen - University of Connecticut Health Center, Farmington, Connecticut
Michael Goodman - Emory University, Atlanta, Georgia
Ann S Hamilton - Keck School of Medicine, University of Southern California, Los Angeles, California
Richard M Hoffman - University of New Mexico, Albuquerque, New Mexico
Janet L Stanford - Fred Hutchinson Cancer Research Center, Seattle, Washington
Antoinette M Stroup - University of Utah, Salt Lake City, Utah
Matthew J Resnick - School of Medicine, Vanderbilt University, Nashville, Tennessee
Daniel A Barocas - School of Medicine, Vanderbilt University, Nashville, Tennessee
David F Penson - School of Medicine, Vanderbilt University, Nashville, Tennessee; Geriatric Research, Education and Clinical Center, Tennessee Valley Veterans Administration Healthcare System, Nashville, Tennessee
Resource Type: Journal article
Publication Details: The Journal of urology, Vol.193(4), pp.1226-1231
DOI: 10.1016/j.juro.2014.11.006
PMID: 25451829
PMCID: PMC4542148
NLM abbreviation: J Urol
ISSN: 0022-5347
eISSN: 1527-3792
Grant note: N01-PC-67006 / NCI NIH HHS N01-PC-67005 / NCI NIH HHS N01-PC-67007 / NCI NIH HHS N01-PC-67009 / NCI NIH HHS N01-PC-67000 / NCI NIH HHS R01-CA114524 / NCI NIH HHS R01 CA114524 / NCI NIH HHS
Language: English
Date published: 04/2015
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094743102771

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