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Effect of metabolic syndrome on testosterone in patients with metastatic prostate cancer

andrology
epidemiology
oncology
metabolic-sciences
obesity

Abstract

Objective To explore the impact of metabolic syndrome (MetS)-related factors on testosterone levels before and after treatment and testosterone decline time in patients with metastatic prostate cancer (mPCa).

Methods The clinical data of 212 patients with mPCa diagnosed by pathology and related auxiliary examinations were retrospectively analyzed. The study included 94 patients in the Non-MetS group and 118 patients in the combined MetS group. The objective was to analyze the effects of MetS and its components on initial testosterone levels, lowest testosterone value, and the time it took for testosterone to decline to the lowest value in mPCa patients. Additionally, the study aimed to identify independent risk factors that affect the time for testosterone decline through multifactor logistic regression analysis.

Results Compared to the Non-MetS group, the combined MetS group had a higher proportion of patients with high tumor burden, T stage ≥ 4, and Gleason score ≥ 8 points (P<0.05). Patients in the combined MetS group also had higher lowest testosterone values and it took longer for their testosterone to reach the lowest level (P<0.05). MetS was found to be an independent risk factor for testosterone falling to the lowest value for more than 6 months. The risk of testosterone falling to the lowest value for more than 6 months in patients with MetS was 2.157 times higher than that of patients with Non-MetS group (P=0.031). Patients with hyperglycemia had a significantly higher nadir value of testosterone (P=0.015). Additionally, patients with a BMI≥25kg/m2 exhibited lower initial testosterone levels (P=0.007). Furthermore, patients with TG≥1.7mmol/L experienced a longer time for testosterone to drop to the nadir (P=0.023). The lowest value of testosterone in the group with a composite metabolic score of 3 or 4-5 was higher than that in the 0-2 group, and the time required for testosterone to decrease to the lowest value was also longer (P<0.05).

Conclusion mPCa combined with MetS leads to a more aggressive condition, with a higher minimum testosterone level after treatment and a longer time for it to reach the lowest value. MetS independently increases the risk of testosterone dropping to the lowest level for more than 6 months. The testosterone levels before and after treatment and testosterone decline time in mPCa patients is influenced by the components of MetS and the composite metabolic score. Therefore, when monitoring testosterone in mPCa patients, it is important to consider the impact of MetS and its components, and make timely adjustments to individualized treatment strategies.

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