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Review
. 2022 Oct 13;12(10):969.
doi: 10.3390/metabo12100969.

The Beneficial Effect of a Healthy Dietary Pattern on Androgen Deprivation Therapy-Related Metabolic Abnormalities in Patients with Prostate Cancer: A Meta-Analysis Based on Randomized Controlled Trials and Systematic Review

Lili Wang  1 , Lifen Wu  1 , Chunya Qian  1 , Yang Ju  2 , Ting Liu  3 , Yushan Chen  4 , Xiaohua Wang  5
Affiliations
Review

The Beneficial Effect of a Healthy Dietary Pattern on Androgen Deprivation Therapy-Related Metabolic Abnormalities in Patients with Prostate Cancer: A Meta-Analysis Based on Randomized Controlled Trials and Systematic Review

Lili Wang et al. Metabolites. .

Abstract

Metabolic abnormalities as side effects of androgen-deprivation therapy (ADT) can accelerate progression of prostate cancer (PCa) and increase risks of cardiovascular diseases. A healthy dietary pattern (DP) plays an important role in regulating glycolipid metabolism, while evidence about DP on ADT-related metabolic abnormalities is still controversial. To explore the effect of DP on metabolic outcomes in PCa patients with ADT, PubMed, Embase, Cochrane, and CINAHL were searched from inception to 10 September 2022. Risk of biases was evaluated through Cochrane Collaboration’s Tool. If heterogeneity was low, the fixed-effects model was carried out; otherwise, the random-effects model was used. Data were determined by calculating mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CIs). Nine studies involving 421 patients were included. The results showed that healthy DP significantly improved glycated hemoglobin (MD: −0.13; 95% CI: −0.24, −0.02; p = 0.020), body mass index (MD: −1.02; 95% CI: −1.29, −0.75; p < 0.001), body fat mass (MD: −1.78; 95% CI: −2.58, −0.97; p < 0.001), triglyceride (MD: −0.28; 95% CI: −0.51, −0.04; p = 0.020), systolic blood pressure (MD: −6.30; 95% CI: −11.15, −1.44; p = 0.010), and diastolic blood pressure (MD: −2.94; 95% CI: −5.63, −0.25; p = 0.030), although its beneficial effects on other glycolipid metabolic indicators were not found. Additionally, a healthy DP also lowered the level of PSA (MD: −1.79; 95% CI: −2.25, −1.33; p < 0.001). The meta-analysis demonstrated that a healthy DP could improve ADT-related metabolic abnormalities and be worthy of being recommended for PCa patients with ADT.

Keywords: androgen-deprivation therapy; dietary patterns; metabolic abnormalities; prostate cancer; prostate-specific antigen.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart showing the selection of articles.
Figure 2
Figure 2
Risk of bias assessment results for included studies. “+”: low risk of bias; “?”: unclear risk of bias; “−”: high risk of bias [10,11,12,13,14,15,19,20,21].
Figure 3
Figure 3
Forest plot of effect of healthy DP on glucose metabolism. DP, dietary pattern; HbAlc, glycated hemoglobin; HOMA-IR, homeostasis model assessment of insulin resistance; the diamond, effect size and 95%CIs; green color, weight. (A) HbA1c and (B) HOMA-IR [10,14].
Figure 4
Figure 4
(A) forest plot of effect of healthy DP on BMI. DP, dietary pattern; BMI, body mass index. (A) BMI, (A1) BMI subgroup, and (B) forest plot of effect of healthy DP on BFM. DP, dietary pattern; BFM, body fat mass. (B) BFM, (B1) BFM subgroup, and (C) forest plot of effect of healthy DP on BLM. DP, dietary pattern; BLM, body lean mass. (C) BLM, (C1) BLM subgroup, and (D–G) forest plot of effect of healthy DP on serum lipid profile. DP, dietary pattern; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol. (D) TG, (E) TC, (F) LDL-C, and (G) HDL-C. The diamond, effect size and 95%CIs; green color, weight [10,11,12,13,14,15,19,20,21].
Figure 4
Figure 4
(A) forest plot of effect of healthy DP on BMI. DP, dietary pattern; BMI, body mass index. (A) BMI, (A1) BMI subgroup, and (B) forest plot of effect of healthy DP on BFM. DP, dietary pattern; BFM, body fat mass. (B) BFM, (B1) BFM subgroup, and (C) forest plot of effect of healthy DP on BLM. DP, dietary pattern; BLM, body lean mass. (C) BLM, (C1) BLM subgroup, and (D–G) forest plot of effect of healthy DP on serum lipid profile. DP, dietary pattern; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol. (D) TG, (E) TC, (F) LDL-C, and (G) HDL-C. The diamond, effect size and 95%CIs; green color, weight [10,11,12,13,14,15,19,20,21].
Figure 4
Figure 4
(A) forest plot of effect of healthy DP on BMI. DP, dietary pattern; BMI, body mass index. (A) BMI, (A1) BMI subgroup, and (B) forest plot of effect of healthy DP on BFM. DP, dietary pattern; BFM, body fat mass. (B) BFM, (B1) BFM subgroup, and (C) forest plot of effect of healthy DP on BLM. DP, dietary pattern; BLM, body lean mass. (C) BLM, (C1) BLM subgroup, and (D–G) forest plot of effect of healthy DP on serum lipid profile. DP, dietary pattern; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol. (D) TG, (E) TC, (F) LDL-C, and (G) HDL-C. The diamond, effect size and 95%CIs; green color, weight [10,11,12,13,14,15,19,20,21].
Figure 5
Figure 5
Forest plot of effect of healthy DP on BP. DP, dietary pattern; SBP, systolic blood pressure; DBP, diastolic blood pressure; BP, blood pressure; the diamond, effect size and 95%CIs; green color, weight. (A) SBP and (B) DBP [10,11,15].
Figure 6
Figure 6
Fatigue: forest plot of effect of healthy DP on fatigue. DP, dietary pattern; the diamond, effect size and 95%CIs; green color, weight [11,13,19,21].
Figure 7
Figure 7
PSA: forest plot of effect of healthy DP on PSA. DP, dietary pattern and PSA, prostate specific antigen; the diamond, effect size and 95%CIs; green color, weight [11,14,15].
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