Androgen deprivation therapy and risk of rheumatoid arthritis in patients with localized prostate cancer.

Background: Androgens are generally immunosuppressive, and men with untreated hypogonadism are at increased risk for autoimmune conditions. To date, there has been no evidence linking androgen deprivation therapy (ADT) to autoimmune diseases, including rheumatoid arthritis (RA). We investigated the association between ADT and RA in patients with prostate cancer. Patients and methods: We identified 105 303 men age 66 years or older who were diagnosed with stages I-III prostate cancer from 1992 through 2006 using the Surveillance, Epidemiology, and End Results-Medicare linked database, excluding patients with a history of RA. χ2 test was used to compare 5-year Kaplan-Meier rates of RA diagnoses. Competing risk Cox regression using inverse probability of treatment weighting was utilized to examine the association between pharmacologic ADT and diagnosis of RA. Results: The 43% of patients (N = 44 785) who received ADT experienced a higher 5-year rate of RA diagnoses compared with men who did not (5.4% versus 4.4%, P < 0.001). Receipt of any ADT was associated with a 23% increased risk of being diagnosed with RA (hazard ratio 1.23, 95% confidence interval 1.09-1.40, P = 0.001). The risk of being diagnosed with RA increased with a longer duration of ADT, from 19% with 1-6 months and 29% with 7-12 months to 33% with ≥13 months (Ptrend < 0.001). Conclusions: Consistent with the immunosuppressive properties of androgens, we demonstrated for the first time that ADT was associated with an elevated risk of being diagnosed with RA in this large cohort of elderly men with prostate cancer. The risk was higher with a longer duration of ADT. Linking ADT to an increased risk of being diagnosed with an autoimmune condition adds to mounting evidence of the adverse effects of ADT that should prompt physicians to thoughtfully weigh its risks and benefits.

[Interorgan metabolic correlations during muscular activity and fatigue]. / Mezhorgannye metabolicheskie korreliatsii pri myshechnoi deiatel'nosti i utomlenii.

Biochemical and mathematical analysis revealed that metabolic processes in muscles, blood, liver, and brain during both unfatiguing muscular activity and in fatigue change their correlative bonds not identealby. The experiments exposed as a common traits, as differences in metabolic structure of both rapidly and slowly developed fatigue.

[The relationship between pre-exertional biochemical changes metabolic features during muscular activity]. / Sviaz' mezhdu predrabochimi biokhimicheskimi izmeneniiami i osobennostiami metabolizma pri myshechnoi deiatel'nosti

Metabolic changes during intense muscular activity and the work efficiency depend on the prestart biochemical changes. Excessiveness of these changes or, particularly, their absence decrease the work capacity. Character of the prestart reaction depends on the grade of adaptation of the organism to muscular activity; favourable, moderate prestart biochemical changes are characteristic o highly trained sportsmen. Disturbed ATP balance in the working muscles was found not to be always a limiting factor for the work capacity.