SFEBES2018 Poster Presentations Adrenal and steroids (38 abstracts)
Androgen deprivation therapy causes selective loss of levator ani and leg muscle volumes
Jeffrey D Zajac 1, , Ada S Cheung 1, , Vivian Ly 1 , Christopher Cunningham 1 , Dong-Kyoon Ko 1 , Hans Gray 3 , Rudolf Hoermann 1 , Boyd J G Strauss 4 , Ebrahim Bani Hassan 5 , Gustavo Duque 5 , Marcus G Pandy 3 & Mathis Grossmann 1,
1Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia; 2Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia; 3Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia; 4Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; 5Department of Medicine - Western Precinct and Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, Victoria, Australia.
Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) leads to a global loss of lean mass. ADT leads to sexual dysfunction and a selective loss of leg muscle function, however individual muscle volumes have never been evaluated. We aimed to assess in men undergoing ADT, the muscle volumes of levator ani, which in mice is androgen-responsive, and of lower-limb muscles.
Methods: We conducted a prospective case-control study involving 34 men newly commencing ADT and 29 age-matched PCa controls. Levator ani and leg muscle volumes (litres) of primary muscles involved in walking (iliopsoas, quadriceps, gluteus maximus, gluteus medius, calf) were measured using MRI and quantitated using Slice-O-Matic software at 0, 6 and 12 months. Generalised linear models determined the mean adjusted difference (MAD) (95% confidence interval) between groups over time.
Results: Compared with controls over 12 months, men receiving ADT had a mean reduction in total testosterone level from 14.1 to 0.4 nmol/l and demonstrated greater decreases in levator ani (MAD −0.005 litres (−0.007, −0.002), P=0.002, −16% of initial median value), gluteus maximus (MAD −0.032 litres (−0.063, −0.002), P=0.017, −5%), iliopsoas (MAD −0.005 litres (−0.001, 0.000), P=0.013, −5%) and quadriceps (MAD −0.050 litres (−0.088, −0.012), P=0.031, −3%). No significant differences were observed in gluteus medius and calf muscles.
Conclusion: Testosterone deprivation causes marked decreases in levator ani muscle, demonstrating that it’s androgen responsiveness is evolutionarily conserved across men and mice. Further studies are required to investigate whether loss of levator ani muscle mass contributes to the profound sexual dysfunction seen in men on ADT. Consistent with previously reported functional deficits, ADT selectively decreases volume of muscles that support body weight. Future interventional studies aimed at reducing ADT-related sarcopenia and sexual dysfunction should evaluate the role of targeting these muscle groups, including the pelvic floor.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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