GNRH1 and bone metastasis: In patients without bone metastases, 2 studies showed that BMD decreases at 12M post-ADT with GnRH agonist were 3.9% and 4.8% of total BMD of L-spine, which represents a lower degree of BMD decrease than patients with bone metastasis19, 22, similar to the degree of BMD decrease in our previous results including cases without bone metastasis8, because the subjects with bone metastasis in our study constituted <20% of the entire study population.