Low bone mineral density in hormone-naive men with prostate carcinoma

BACKGROUND. The objective of this study was to determine the prevalence of low bone mineral density in men with prostate carcinoma and no history of a ndrogen-deprivation therapy. METHODS. The authors conducted a cross-sectional study in 41 hormone-naive men with locally advanced, lymph node positive, or recurrent prostate carci noma and no radiographic evidence of bone metastases. Bone mineral density of the total hip, posterior-anterior (PA) lumbar spine, and lateral lumbar spine was determined by dual-energy X-ray absorptiometry (DXA) using a dens itometer. Trabecular bone mineral density of the lumbar spine was determine d by quantitative computed tomography (QCT). Bone mineral density results w ere expressed in standard deviation units relative to young adult men (T sc ore) and relative to age-matched men (Z score). RESULTS. Fourteen of 41 men [34%; 95%] confidence interval [95% CI], 20-51% ) had T scores < -1.0 at one or more skeletal sites by DXA, 12 of 41 men (2 9%; 95% CI, 16-42%) had T scores between -1.0 and -2.5, and 12 of 41 men (5 %; 95% CI, 1-17%) had T scores < -2.5. Thirty-nine of 41 men (95%; 95% CI, 83-99%) had T scores < -1.0 by QCT, 13 of 41 men (31%; 95% CI 18-48%) had T scores between -1.0 and -2.5, and 26 of 41 men (63%; 95% CI, 47-78%) had T scores < -2.5. T scores for trabecular bone mineral density of the lumbar spine were significantly lower than T scores for either the total hip (P < 0.001) or the PA lumbar spine (P ( 0.001). The mean Z score for trabecular bone mineral density of the lumbar spine was -0.7 +/- 0.9. Hypogonadism, hy povitaminosis D, and dietary calcium intakes below the Recommended Daily Al lowance were observed in 20%, and 17%, and 59% of study participants, respe ctively. CONCLUSIONS. Many hormone-naive men with prostate carcinoma have low bone m ineral density. QCT is a more sensitive method than DXA for diagnosing low bone mineral density in this patient population. Trabecular bone mineral de nsity is lower than expected for age and risk factors for osteoporosis are common. (C) 2001 American Cancer Society.