BES2020 BES 2020 Early effects of androgen deprivation on bone and mineral homeostasis in adult men: a prospective cohort study (1 abstracts)
Early effects of androgen deprivation on bone and mineral homeostasis in adult men: A prospective cohort study
Khalil Rougin 1 , Antonio Leen 1 , Laurent Michaël R. 2 , David Karel 1 , Kim Na Ri 1 , Evenepoel Pieter 3 , Eisenhauer Anton 4 , Heuser Alexander 4 , Cavalier Etienne 5 , Khosla Sundeep 6 , Claessens Frank 7 , Vanderschueren Dirk 1 & Decallonne Brigitte 1
1Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; 2Center for Metabolic Bone Diseases, Geriatrics Department, University Hospitals Leuven, Leuven, Belgium; 3Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; 4GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany; 5Department of Clinical Chemistry, University of Liège (ULg CHU), Liège, Belgium; 6Kogod Center on Aging and Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA; 7Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
Objective: Long-term androgen deprivation therapy (ADT) negatively influences bone. The short-term effects on bone and mineral homeostasis are less known. Therefore, we aimed to investigate the early effects of ADT on calcium/phosphate homeostasis and bone turnover.
Design: Prospective cohort study.
Methods: Eugonadal adult male sex offenders, who were referred for ADT to the endocrine outpatient clinic, received cyproterone acetate. Changes in blood markers of calcium/phosphate homeostasis and bone turnover between baseline and first follow-up visit were studied.
Results: Of 26 screened patients, 17 were included. The median age was 44 (range 20–75) years. The median time interval between baseline and first follow-up was 13 (6–27) weeks. Compared to baseline, an 81% decrease was observed for median total testosterone (to 3.4 nmol/l (0.4–12.2); P<0.0001) and free testosterone (to 0.06 nmol/l (0.01–0.18); P<0.0001). Median total estradiol decreased 71% (to 17.6 pmol/l (4.7–35.6); P<0.0001). Increased serum calcium (P<0.0001) and phosphate (P=0.0016) was observed, paralleled by decreased PTH (P=0.0156) and 1.25-dihydroxyvitamin D3 (P=0.0134). The stable calcium isotope ratio (δ44/42Ca) decreased (P=0.0458), indicating net calcium loss from bone. Bone-specific alkaline phosphatase and osteocalcin decreased (P<0.0001 and P=0.0056, respectively), periostin tended to decrease (P=0.0500) whereas sclerostin increased (P<0.0001), indicating suppressed bone formation. Serum bone resorption markers (TRAP, CTX) were unaltered.
Conclusions: In adult men, calcium release from the skeleton occurs early following sex steroid deprivation, reflecting early bone resorption. The increase of sclerostin and reduction of bone formation markers, without changes in resorption markers, suggests a dominant negative effect on bone formation in the acute phase.
Volume 71
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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