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  • br ADT treated men had and lower

    2020-08-18


    ADT-treated men had 7.2% and 7.8% lower lumbar spine aBMD compared to PCa (P = 0.037) and healthy controls (P = 0.010), re-spectively (Table 2). While there was a significant main effect for total hip aBMD between groups (P = 0.040), corrected pairwise comparisons revealed only a trend for lower (5.9%) total hip aBMD in ADT-treated men compared to PCa controls (P = 0.068). Although ADT-treated men had 2.8% to 3.8% lower femoral neck aBMD compared to PCa and healthy controls, there were no significant differences between groups. There were also no differences in aBMD between PCa and healthy controls at any site. Overall, 7.1% of ADT-treated men were classified as osteoporotic compared to 1.4% and 1.9% of PCa and healthy controls, respectively. However, the prevalence of JQ 1 and osteopenia 
    did not differ significantly between groups.
    3.3. Volumetric BMD, bone structure and strength
    At the distal tibia, total area was 7.3% and 6.2% higher in ADT-treated men compared to PCa (P = 0.005) and healthy controls (P = 0.009), respectively (Table 2 and Fig. 1). In contrast, total vBMD of the distal tibia was 8.4% and 8.7% lower in ADT-treated men com-pared to PCa (P = 0.003) and healthy controls (P < 0.001), respec-tively. There were no significant group differences in trabecular vBMD of the distal tibia, despite ADT-treated men having 4.5% to 4.6% lower vBMD compared to both control groups (P = 0.160). BSI of the distal tibia was 10.8% lower in ADT-treated men compared to healthy con-trols (P = 0.030), but not PCa controls. There were no significant dif-ferences between groups for any bone structure, density or strength outcomes at the proximal tibia.
    At the distal radius, total area did not differ between groups, despite being 3.5% to 4.5% higher in ADT-treated men compared to controls. In contrast, ADT-treated men had significantly lower distal radius total vBMD (14.4% and 12.2%, both P = 0.001) and trabecular vBMD (14.8%, P = 0.003; 10.7%, P = 0.029) compared to PCa and healthy controls, respectively. BSI of the distal radius was 27.5% and 23.6% lower in ADT-treated men compared to PCa and healthy controls, re-spectively (both P < 0.001). There were no significant differences between groups for any bone structure, density or strength outcomes at the proximal radius. Similarly, there were no differences between PCa and healthy controls for any vBMD, structure or strength outcomes at the tibia or radiusFig. 2.
    Table 2
    Adjusted mean (95% CI) areal and volumetric bone mineral density (BMD), bone structure and strength in men with prostate cancer (PCa) treated with androgen deprivation therapy (ADT), PCa controls and healthy controls.
    N Healthy controls N PCa controls N ADT-treated men P-value
    Lumbar spine (g/cm2)
    pQCT
    Data are chorionic villi sampling (CVS) adjusted means with 95% confidence interval, and results are adjusted for BMI and tibia or radius length (for pQCT outcomes). aP < 0.05, bP < 0.01, cP < 0.001 compared to healthy controls. dP < 0.05, eP < 0.01, fP < 0.001 compared to PCa controls. #Analyses completed using natural log-transformed data. DXA, dual-energy X-ray absorptiometry; pQCT, peripheral quantitative computed tomography; vBMD, volumetric bone mineral density; BSI, bone strength index; Ipolar, density-weighted polar cross-sectional moment of inertia.
    Table 3
    Adjusted mean (95% CI) cortical bone density distribution in men with prostate cancer (PCa) treated with androgen deprivation therapy (ADT), PCa controls and healthy controls.
    N Healthy controls N PCa controls N ADT-treated men P-valuea
    Endocortical vBMD (mg/cm3)
    Endocortical vBMD (mg/cm3)
    Data are adjusted mean with 95% confidence interval, and results adjusted for BMI and tibia or radius length. vBMD, volumetric bone mineral density.
    a Analyses completed using natural log-transformed data.
    A Distal Tibia B Distal Radius
    Total Area Total Area
    Trabecular vBMD Trabecular vBMD
    mg/cm
    Bone Strength Index
    Bone Strength Index
    Healthy PCa ADT-treated controls controls men 
    Healthy PCa ADT-treated
    controls controls men
    Fig. 1. Mean ( ± standard error) pQCT-derived outcomes at distal sites of the A) tibia and B) radius in healthy controls, PCa controls and ADT-treated men, adjusted for BMI and tibia or radius length. *P < 0.05 compared to healthy controls, #P < 0.05 compared to PCa controls. vBMD, volumetric bone mineral density; PCa, prostate cancer; ADT, androgen deprivation therapy; pQCT, peripheral quantitative computed tomography.
    A Proximal Tibia B Proximal Radius
    Cortical Area Cortical Area
    Cortical vBMD
    Cortical vBMD
    Ipolar
    I
    polar
    Healthy PCa ADT-treated
    controls controls men 
    Healthy PCa ADT-treated
    controls controls men
    Fig. 2. Mean ( ± standard error) pQCT-derived outcomes at proximal sites of the A) tibia and B) radius in healthy controls, PCa controls and ADT-treated men, adjusted for BMI and tibia or radius length. vBMD, volumetric bone mineral density; I polar, density-weighted polar cross-sectional moment of inertia; PCa, prostate cancer; ADT, androgen deprivation therapy; pQCT, peripheral quantitative computed tomography.