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Abstract

Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigates if endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men undergoing ADT for prostate cancer and 10 healthy men with normal testosterone levels underwent 12 weeks of endurance training. Primary endpoints were insulin sensitivity (euglycemic hyperinsulinemic clamps with concomitant glucose-tracer infusion) and body composition (dual-energy x-ray absorptiometry and magnetic resonance imaging). The secondary endpoint was systemic inflammation. Statistics: Two-way ANOVA. Endurance training increased VO2max (ml(O2)/min/kg) by 11% and 13% in patients and controls, respectively (p<0.0001). The patients and controls demonstrated an increase in peripheral insulin sensitivity of 14% and 11%, respectively (p<0.05), with no effect on hepatic insulin sensitivity (p=0.32). Muscle protein content of GLUT4 and total Akt was also increased in response to the training (p<0.05 and p<0.01, respectively). Body weight (p<0.0001) and whole-body fat mass (p<0.01) were reduced, while lean body mass (p=0.99) was unchanged. Additionally, reductions were noted in abdominal (p<0.01), subcutaneous (p<0.05) and visceral fat mass (p<0.01). Plasma markers of systemic inflammation were unchanged in response to the training. No group×time interactions were found, except for thigh intermuscular adipose tissue (IMAT) (p=0.01), reflecting a significant reduction in IMAT in controls (p<0.05) not observed in patients (p=0.64). In response to endurance training, ADT-treated prostate cancer patients improved insulin sensitivity and body composition to a similar degree as eugonadal men.