前立腺肥大症のアンチアンドロゲン療法における脂質代謝への影響

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前立腺肥大症80例に4種のアンチアンドロゲン剤を1年間投与し,血中脂肪値の変動を3ヵ月毎に測定した。各脂質値に有意な変化は認められなかった。4種のアンチアンドロゲン剤は冠動脈疾患の危険因子をもたない症例では長期投与が可能な安全な薬剤であると思われる。しかし,すでに肝機能異常や高脂血症を有する症例に対しては二次的な合併症を引き起こす可能性もあり,注意を払う必要があるAntiandrogen therapy has an important role in the treatment of patients with benign prostatic hypertrophy who lack indication for surgery. Herein, the effects on lipid metabolism of administration of antiandrogen agents for benign prostatic hypertrophy are reported. Eighty patients with benign prostatic hypertrophy were each treated with the antiandrogen agents, chlormadinone acetate, allylestrenol, gestonolone caproate and oxendolone for 12 months. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), alpha-lipoprotein, apoprotein, and maronediardehyde (MDA) were measured every 4 weeks after initiation of antiandrogen treatment. In the chlormadinone acetate group, the TG level was significantly decreased between 3 and 6 months after treatment (p < 0.05). In the oxendolone group, the alpha-lipoprotein level was also elevated between 3 and 6 months and between 6 to 12 months after treatment (p < 0.05). The MDA level was also significantly elevated 6 and 12 months after treatment. However, the levels of the other lipids were within the normal range. In conclusion, the changes in the levels of plasma lipoprotein, apoprotein and MDA resulting from antiandrogen therapy were unlikely to be a cause of ischemic coronary disease.

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井口宏
中央林間病院泌尿器科

前立腺肥大症のアンチアンドロゲン療法における脂質代謝への影響

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