The effects of androgen deprivation therapy with weight management on serum aP2 and adiponectin levels in prostate cancer patients.

Androgen deprivation therapy (ADT) for the treatment of prostate cancer (PCa) causes an increase in total body fat, leading to a net gain in body weight. Moreover, the use of the luteinizing hormone-releasing hormone agonists in ADT causes a decrease in serum androgen levels, leading to the development of metabolic syndrome (MetS). Androgen blockade significantly increases plasma adiponectin levels, which has some efficacy against MetS, whereas ADT increases fasting plasma insulin and decreases insulin sensitivity, suggesting that there are other mechanisms involved in the onset of MetS besides adiponectin activation. We investigated the effects of ADT on serum aP2 and adiponectin in PCa patients. Six months post-ADT, serum aP2 and adiponectin levels were significantly increased, although there were no changes in patient body weight and no correlation between the changes in serum aP2 and total adiponectin levels. The serum adiponectin and aP2 levels have independent implications in ADT for PCa; therefore, their combined measurement will clarify the impact on the development of obesity-related diseases during ADT. Contrary to adiponectin, high serum aP2 levels were correlated with the late development of MetS. Further studies are needed to investigate the future occurrence of metabolic diseases post-ADT.

Liraglutide is effective in type 2 diabetic patients with sustained endogenous insulin-secreting capacity.

UNLABELLED: Aims/Introduction: Recently, glucagon-like peptide-1 (GLP-1) receptor agonists of liraglutide have become available in Japan. It has not yet been clarified what clinical parameters could discriminate liraglutide-effective patients from liraglutide-ineffective patients. MATERIALS AND METHODS: We reviewed 23 consecutive patients with type 2 diabetes admitted to Osaka University Hospital for glycemic control. All of the patients were treated with diet plus insulin (or plus oral antidiabetic drugs) to improve fasting plasma glucose (FPG) and postprandial glucose below 150 and 200 mg/dL, respectively. After insulin secretion and insulin resistance were evaluated, insulin was replaced by liraglutide. The efficacy of liraglutide was determined according to whether glycemic control was maintained at the target levels. RESULTS: Liraglutide was effective in 13 of 23 patients. There were significant differences in the parameters of insulin secretion, including fasting C-peptide (F-CPR), C-peptide index (CPI), insulinogenic index (I.I.) and urine C-peptide (U-CPR), between liraglutide-effective and -ineffective patients. The duration of diabetes was significantly shorter in liraglutide-effective patients than in liraglutide-ineffective patients. In receiver operating characteristic analyses, the cut-off value for predicting the efficacy of liraglutide was 0.14 for I.I., 1.1 for CPI, 1.5 ng/mL for F-CPR, 33.3 µg/day for U-CPR and 19.5 years for duration of type 2 diabetes. CONCLUSIONS: Insulin secretion evaluated by F-CPR, CPI, I.I., U-CPR and the duration of type 2 diabetes were useful parameters for predicting the efficacy of liraglutide in patients with type 2 diabetes. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00168.x, 2011).