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Dear Editor, Prostate cancer (PCa) is the most frequently diagnosed male cancer in Western countries, and the number of PCa patients is also rapidly increasing in Japan.1,2 Simultaneously, androgen deprivation therapy (ADT) has also been increasingly used in PCa patients in recent years.3–5 However, the long-term use of ADT is associated with a variety of pivotal adverse events, including diabetes, anemia, osteoporosis, serum lipid profile changes, and cardiovascular disease (CVD).1,2 Higher low-density lipoprotein cholesterol (LDL-C) and/or lower high-density lipoprotein cholesterol (HDL-C) are well-established risk factors for CVD, and control of their levels has been an important goal in the treatment and prevention of CVD.6,7 Recently, another alternative parameter, the LDL-C to HDL-C (L/H) ratio, has been reported to be strongly associated with CVD and is thought to be a better predictor of future CVD than LDL-C alone. Closely monitoring serum lipid profile, including the L/H ratio changes affected by ADT, is a key to preventing CVD in PCa patients. Moreover, we previously suggested that a higher L/H ratio might have an impact on the development of arterial stiffness after ADT administration.7 Although some cutoff points of the L/H ratio have been reported in clinical use, it has been suggested that thrombosis can occur when the L/H ratio increases to around 2.5 or more in East Asian populations.6 The aim of the present study was to investigate the changes in serum lipid profile and to identify the clinical factors associated with an increased L/H ratio in PCa patients who received ADT. This was a retrospective study approved by the institutional review board of Toho University Sakura Medical Center (No. 2012-008). All patients enrolled in the study gave their written informed consent. One hundred patients with pathologically confirmed PCa scheduled to receive ADT for more than 6 months between March 2012 and August 2015 were analyzed. Patients and the statistical analysis methods are minutely described in the LETTER TO THE EDITOR

asian journal of andrology/asian journal of andrology

Worsening of the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in patients with prostate cancer after androgen deprivation therapy