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Of all 28 metabolites that were significantly different between +ADT and −ADT groups, only androsterone sulfate levels significantly correlated with PROMIS-SRI sleep impairment T -scores (Figure 6C, r = −0.19, p = 0.020), which serves as a metabolic endpoint indicator of the effectiveness of ADT in reducing circulating androgens ( FIGURE 6 Discussion Our goal in this study was to focus on mechanisms of a subcategory of cancer-related fatigue specifically related to ADT in patients with non-metastatic localized prostate adenocarcinoma