Publication Abstract

Authors: Gild P, Cole AP, Krasnova A, Dickerman BA, von Landenberg N, Sun M, Mucci LA, Lipsitz SR, Chun FK, Nguyen PL, Kibel AS, Choueiri TK, Basaria S, Trinh QD

Title: Liver Disease in Men Undergoing Androgen Deprivation Therapy for Prostate Cancer.

Journal: J Urol :-

Date: 2018 Apr 16

Abstract: PURPOSE: Androgen deprivation therapy is associated with development of diabetes and metabolic syndrome. Its effect on developing non-alcoholic fatty liver disease, a condition frequently co-occuring with metabolic syndrome, and other subsequent liver conditions (liver cirrhosis, hepatic necrosis, any liver disease) has not been investigated.
 MATERIALS & METHODS: We identified 82,938 men aged 66 and older diagnosed with localized prostate cancer within the Surveillance, Epidemiology and End Results- Medicare database, 1992-2009. Men with pre-existing non-alcoholic fatty liver disease, liver disease, diabetes, and metabolic syndrome were excluded. Propensity score adjusted Competing-risk regression models compared the risk of non-alcoholic fatty liver disease between men who received androgen deprivation with those who did not. We also explored the influence of cumulative exposure to androgen deprivation therapy, calculated as monthly equivalent doses of gonadotropin-releasing hormone agonists/antagonists (<7, 7- 11, >11 doses).
 RESULTS: Overall, 37.5% of men received androgen deprivation therapy. These were more likely to be diagnosed with non-alcoholic fatty liver disease (hazard ratio [HR] 1.54, 95 % confidence interval [CI] 1.40-1.68), liver cirrhosis (HR 1.35, 95 % CI 1.12 -1.60), liver necrosis (HR 1.41, 95% CI 1.15-1.72) and any liver disease (HR 1.47, 95% CI 1.35-1.60). A dose-response relationship was observed between the number of doses of androgen deprivation therapy, non-alcoholic fatty liver disease and any liver disease. CONCLUSIONS: Androgen deprivation therapy in men with prostate cancer is associated with diagnosis of non-alcoholic fatty liver disease. Usual limitations of observational study design apply, including a possible inaccuracy to define outcomes in a population-based registry.