diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM10343diaendo-10343Research ArticleОбзорыReviewМетаболические изменения у пациентов с раком предстательной железы при андроген-депривационной терапииMetabolic changes in patients with prostate cancer with androgen deprivation therapyhttps://orcid.org/0000-0002-1497-8646ПешковМаксим НиколаевичPeshkovMaxim N.

к.м.н.

MD, PhD

Drpeshkov@gmail.comhttps://orcid.org/0000-0002-3336-4025ПешковаГалина ПетровнаPeshkovaGalina P.

к.м.н.

MD, PhD

gppeshkova@gmail.comhttps://orcid.org/0000-0002-5739-3170РешетовИгорь ВладимировичReshetovIgor V.

д.м.н.

MD, PhD

reshetoviv@mail.ruФедеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентстваРоссияFederal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of RussiaRussian FederationРязанский государственный медицинский университет имени академика И.П. ПавловаРоссияRyazan State Medical UniversityRussian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical UnivesityRussian Federation202026062020232192200Copyright © Пешков М.Н., Пешкова Г.П., Решетов И.В., 20202020Пешков М.Н., Пешкова Г.П., Решетов И.В.Peshkov M.N., Peshkova G.P., Reshetov I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/10343

Рак предстательной железы является наиболее распространенным видом рака среди мужчин, а андрогенная депривационная терапия (АДТ) – наиболее эффективное лечение этого заболевания. Краеугольным камнем лечения рака предстательной железы является ингибирование выработки тестостерона, которое прерывает вызванный тестостероном рост опухоли предстательной железы. Резкое снижение уровня тестостерона, однако, имеет несколько нежелательных эффектов на метаболический профиль и метаболизм кости, а также может привести к усталости, потере либидо, гинекомастии и анемии, провоцировать вазомоторную гиперемию и в целом влиять на качество жизни. Из-за хорошей (длительной) выживаемости пациентов с раком предстательной железы побочные эффекты, связанные с лечением, имеют большое значение, и поэтому в каждой клинической ситуации преимущества АДТ необходимо сопоставлять с побочными эффектами, связанными с лечением. В настоящей статье основное внимание уделяется описанным метаболическим осложнениям АДТ, включая ожирение, диабет, изменения липидов, метаболический синдром и сердечно-сосудистые заболевания. Также содержатся практические рекомендации по управлению побочными эффектами и осложнениями, основанные на доступных руководствах, выпущенных профессиональными медицинскими сообществами.

Prostate cancer is the most common type of cancer among men. Androgen deprivation therapy (ADT) is the most effective treatment for this disease. The cornerstone of prostate cancer treatment is the inhibition of testosterone production, which interrupts testosterone-induced growth of the prostate tumour. A sharp decrease in testosterone, however, has several undesirable effects on the metabolic profile and bone metabolism and can also lead to fatigue, loss of libido, gynecomastia and anaemia, provoke vasomotor hyperaemia and generally affect the quality of life. To increase the good (long-term) survival of patients with prostate cancer, studying the side effects associated with treatment is important, and therefore, in every clinical situation, the benefits of ADT must be compared with the side effects associated with the treatment. This article focuses on the described metabolic complications of ADT, including obesity, diabetes, lipid changes, metabolic syndrome and cardiovascular diseases. It also contains practical recommendations for managing the side effects and complications based on the available guidelines issued by the medical professional community.

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The authors declare that there are no conflicts of interest present.