{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:03:36Z","timestamp":1791475416432,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004861","name":"Mackay Memorial Hospital","doi-asserted-by":"publisher","award":["MMH\u2010114\u201022"],"award-info":[{"award-number":["MMH\u2010114\u201022"]}],"id":[{"id":"10.13039\/501100004861","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Androgen deprivation therapy (ADT) increases the risk of adverse cardiovascular events in patients with prostate cancer. ADT can induce body composition change; however, the association between body composition change and cardiovascular outcomes remains unclear. This study aimed to determine the association between ADT\u2010induced body composition change and cardiovascular outcomes in patients with prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 681 patients with prostate cancer (410 in the derivation cohort and 271 in the external validation cohort) who underwent radiotherapy and ADT between 2008 and 2021. Computed tomography (CT) scans at baseline and 6\u2009months post\u2010ADT were used to assess the changes in skeletal muscle index (\u0394SMI), subcutaneous adipose tissue index (\u0394SATI) and visceral adipose tissue index (\u0394VATI) at the L3 vertebral level. The primary outcome was major adverse cardiovascular events (MACEs), defined as a composite of myocardial infarction, stroke, heart failure, arterial revascularization and cardiovascular death. The association between body composition changes and MACE was analysed using the SHapley Additive ExPlanations (SHAP) method and validated using the Cox proportional hazards model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 72\u2009years (interquartile range: 66\u201377). With a median follow\u2010up of 6.0\u2009years (derivation cohort) and 6.6\u2009years (validation cohort), 62 (15.1%) and 39 (14.4%) patients experienced MACE, respectively. Six months post\u2010ADT, there was a reduction in SMI, whereas SATI and VATI had increased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The \u0394SMI and \u0394SATI were the most important features for predicting MACE in both cohorts, whereas \u0394VATI and baseline body composition parameters were less influential. SMI loss was inversely correlated with MACE risk, whereas increases in SATI and VATI were positively correlated. The identified thresholds for MACE prediction were SMI loss \u2265\u20094.7% and SATI gain \u2265\u20098.2%. On multivariable Cox regression analysis, \u0394SMI (hazard ratio: 1.27 per 1% decrease,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and \u0394SATI (hazard ratio: 1.07 per 1% increase,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with MACE risk; however, \u0394VATI was not (hazard ratio: 0.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.23). Stratification based on thresholds confirmed that SMI loss \u2265\u20094.7% (hazard ratio: 10.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and SATI gain \u2265\u20098.2% (hazard ratio: 3.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with increased MACE risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ADT\u2010induced muscle loss and increased subcutaneous adipose tissue were associated with an increased MACE risk in patients with prostate cancer. These findings highlight the need to monitor and address body composition changes in patients undergoing ADT to reduce cardiovascular risk. Future research should explore interventions to mitigate these metabolic effects and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13844","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:04:45Z","timestamp":1749726285000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Androgen Deprivation Therapy\u2013Induced Muscle Loss and Fat Gain Predict Cardiovascular Events in Prostate Cancer Patients"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1445-2393","authenticated-orcid":false,"given":"Jie","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology MacKay Memorial Hospital  Taipei Taiwan"},{"name":"Department of Medicine MacKay Medical College  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Hsuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Informatics National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pai\u2010Kai","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Medicine MacKay Medical College  New Taipei City Taiwan"},{"name":"Department of Urology MacKay Memorial Hospital  Taipei Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhen\u2010Bin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Changhua Christian Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Ting","family":"Jan","sequence":"additional","affiliation":[{"name":"Department of Radiology MacKay Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Kung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Medicine MacKay Medical College  New Taipei City Taiwan"},{"name":"Department of Urology MacKay Memorial Hospital  Taipei Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MacKay Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun\u2010Pin","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Informatics National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"PhD Program of Interdisciplinary Medicine National Yang Ming Chiao Tung University  Taipei 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