Adiposity and Muscle Strength in Men With Prostate Cancer and Cardiovascular Outcomes
Objectives: The primary objective of this study was to evaluate the relationships of measures of adiposity and strength to cardiovascular outcomes (cardiovascular death, myocardial infarction, stroke, heart failure, arterial revascularization, peripheral arterial disease, and venous thromboembolism) in patients with PC. A secondary objectives was to characterize the relationships between ADT use and 12-month changes in these physical measures.
Methods: This international, prospective cohort study included 3,967 patients with PC diagnosed in the prior 12 months or being treated with ADT for the first time. Median follow-up duration was 2.3 years.
Results: Participants’ mean age was 68.5 years, and 1,731 (43.6%) were exposed to ADT. ADT was associated with a 1.6% increase in weight, a 2.2% increase in waist circumference, a 1.6% increase in hip circumference, a 0.1% increase in waist-to-hip ratio, a 27.4% reduction in handgrip strength, and a 0.1% decrease in gait speed. High waist circumference and low handgrip strength were associated with adverse cardiovascular outcomes. Adjusting for age, education, race, tobacco and alcohol use, physical activity, cardiovascular disease, glomerular filtration rate, and ADT use, waist circumference above the highest quartile (110 cm) and handgrip strength below the lowest quartile (29.5 kg) were associated with higher likelihoods of a future cardiovascular event, with respective HRs of 1.40 (95% CI: 1.03-1.90; P = 0.029) and 1.59 (95% CI: 1.14-2.22; P = 0.006).
Conclusions: ADT was associated with increased adiposity and reduced strength over 12-month follow-up. High waist circumference and low baseline strength were associated with future adverse cardiovascular outcomes.
Darryl P. Leong MBBS, MPH, MBiostat, PhD a b, Vincent Fradet MD, PhD c, Tamim Niazi MD d, Joseph B. Selvanayagam MBBS, DPhil e, Robert Sabbagh MD, MSc f, Celestia S. Higano MD g, Steven Agapay BSc a, Sumathy Rangarajan MSc a, Rajibul Mian PhD a, Carlos A.K. Nakashima MD, PhD h, Negareh Mousavi MD i, Ian Brown MD j, Felipe H. Valle MD, PhD k, Luke T. Lavallée MDCM, MSc l, Bobby Shayegan MD m, Kelvin K.H. Ng MBBS b, Darin D. Gopaul MD n, Germano D. Cavalli MD b, Sonia Saavedra MD o, Jose P. Lopez-Lopez MD p, Cristiano Freitas de Souza MD, PhD q, Emmanuelle Duceppe MD, PhD r, Lívia F. Avezum Oliveira MD s, Avirup Guha MBBS, MPH t, Juan Esteban Gomez-Mesa MD u, Luis Eduardo Silva Móz MD, PhD v, Philippe D. Violette MDCM, MSc w, Álvaro Avezum MD, PhD x, Gustavo B.F. Oliveira MD, PhD x, Ariel G. Kann MD x, Edilson Walter MD y, Cesar O.L. Dusilek MD z, Nicolas Villareal Trujillo MD aa, Patricia Beato MD bb, Ludhmila A. Hajjar MD, PhD cc, Patrick P.W. Luke MD dd, Eduardo Schlabendorff MD ee, David Sarid MD ff, Jehonathan Pinthus MD, PhD gg
a Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
b Department of Medicine, McMaster University, Hamilton, Ontario, Canada
c Centre de Recherche du CHU de Québec, Université Laval, Quebec City, Quebec, Canada
d Jewish General Hospital, Montreal, Quebec, Canada
e Southern Area Local Health Network and Flinders University of South Australia, Adelaide, Australia
f Faculty of Medicine, University of Sherbrooke, Montreal, Quebec, Canada
g University of British Columbia and Madrona Oncology, Seattle, Washington, USA
h Faculdades Pequeno Príncipe, Sociedade Hospitalar Angelina Caron, Araçatuba, Brazil
i McGill University Health Centre, Montreal, Quebec, Canada
j Division of Urology, Niagara Health System, St. Catharines, Ontario, Canada
k Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
l Division of Urology, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
m Division of Urology, Department of Surgery, St. Joseph’s Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
n Grand River Regional Cancer Centre, Kitchener, Ontario, Canada
o Faculty of Medicine, University of La Frontera, Temuco, Chile
p Masira Research Institute, Universidad de Santander, Bucaramanga, Colombia
q Núcleo de Pesquisa Clínica – Rede São Camilo and Instituto Brasileiro de Controle do Cancer, São Paolo, Brazil
r Department of Medicine, Centre Hospitalier de l’Université de Montreal, Montreal, Quebec, Canada
s Centro de Pesquisa Clínica do HC-UFTM, Uberaba, Brazil
t Augusta University, Augusta, Georgia, USA
u Department of Health Sciences and Fundacíon Valle del Lili, Universidad Icesi, Cali, Colombia
v Clinical Oncology Department, Santa Casa de São Paolo Hospital, São Paolo, Brazil
w Woodstock Hospital, McMaster University, Woodstock, Ontario, Canada
x International Research Center, Hospital Alemão Oswaldo Cruz, São Paolo, Brazil
y Centro de Oncologia do Hospital de Clínicas Ijuí, Ijuí, Brazil
z Hospital Rocio, Curitiba, Brazil
aa FOSCAL Internacional Clinic, Floridablanca, Colombia
bb Centro de Pesquisas Clínicas da Fundação Doutor Amaral Carvalho, São Paolo, Brazil
cc Faculdade de Medicina da Universidade de São Paolo, São Paolo, Brazil
dd Department of Surgery, London Health Science Centre, London, Ontario, Canada
ee Mãe de Deus Hospital, Porto Alegre, Brazil
ff Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
gg Department of Surgery, McMaster University, Hamilton, Ontario, Canada
Source: Leong DP., Fradet V., Niazi T. et al. Adiposity and Muscle Strength in Men With Prostate Cancer and Cardiovascular Outcomes. JACC: CardioOncology. 2024. ISSN 2666-0873, https://doi.org/10.1016/j.jaccao.2024.07.011.