Metabolic alterations in men with coronary artery disease and concomitant prostate cancer and possibilities of their correction in statin-intolerant patients

Numerous studies suggest an increased frequency of dyslipidemia and metabolic disorders in patients with prostate adenocarcinoma. The aim was to evaluate lipid profile, insulin resistance level in men with coronary artery disease and concomitant prostate cancer and impact of ursodeoxycholic acid on these indicators in complex therapy. Study included 48 men with coronary artery disease and prostate adenocarcinoma. The lipid profile, insulin resistance, testosterone level were determined in all of patients. The level of insulin, C-reactive protein were determined by immune-enzyme analysis. 1st group (n=22) was made up by statin-intolerant patients treated with ursodeoxycholic acid during 60 days in addition to standard therapy; 2nd group (n=26) – by statin-intolerant patients treated with standard regimen. The levels of triglycerides, low density lipoprotein-cholesterol and apolipoprotein-B in men with coronary artery disease and prostate adenocarcinoma were significantly higher than those in control group (p<0.001). The complex therapy with ursodeoxycholic acid resulted in significant decrease in the level of total cholesterol by 17.6% (p<0.001), triglycerides by 21.6% (p<0.001), low density lipoprotein-cholesterol by 25.2% (p<0.001), apolipoprotein-B by 12.9% (p<0.001), HOMA index level by 19.4% (p=0.001), median insulin level by 22.9% (p=0.002). Men with coronary artery disease and concomitant prostate cancer are characterized by increased levels of triglycerides, low density lipoprotein-cholesterol, insulin resistance and decreased apolipoprotein-B associated with low testosterone level. Complex treatment with ursodeoxycholic acid in these patients contributed to significant lipid level improvement and additional decrease of insulin resistance.