Longitudinal Changes in FIB-4 Score During Androgen Deprivation Therapy in Patients with Prostate Cancer

Objective: Androgen deprivation therapy (ADT) is associated with adverse metabolic effects; however, its impact on noninvasive markers of liver fibrosis remains unclear. This study aimed to evaluate longitudinal changes in the FIB-4 score in patients with prostate cancer receiving luteinizing hormone– releasing hormone (LHRH) agonist therapy.

Methods: This retrospective study included 74 patients with prostate cancer treated with LHRH agonists. FIB-4 scores were assessed at baseline, 6 months, and 12 months. Longitudinal comparisons were performed among patients with complete data at all 3 time points (n = 42) using a Friedman test with Bonferroni pairwise comparisons.

Results: A total of 74 patients were included. Total prostate-specific antigen (PSA) and total testosterone levels decreased significantly after treatment (P < .001). Metabolic parameters, including HbA1c, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), remained unchanged after 6 months of ADT (P > .05). Among the 42 patients with complete follow-up, no significant change in FIB-4 score was observed at 6 months (adjusted P = .243); however, a significant increase was observed at 12 months (adjusted P = .036), with a median absolute change of 0.25 (Q1–Q3: −0.11 to 0.49; 95% CI: 0.07–0.62), indicating a time-dependent pattern.

Conclusion: FIB-4 scores remained stable during the early phase of LHRH agonist therapy but increased significantly at 12 months, indicating a delayed effect of ADT on liver fibrosis markers. These findings underscore the need for longitudinal monitoring of liver-related parameters in patients undergoing long-term ADT.

Cite this article as: Barlas IS, Barlas T, Tunc L. Longitudinal changes in FIB-4 score during androgen deprivation therapy in patients with prostate cancer. Endocrinol Res Pract. . Published online August 1, 2026. doi: 10.5152/erp.2026.261001.