Prevalence of the metabolic syndrome and cardiovascular disease risk in chemotherapy-treated testicular germ cell tumour survivors

Abstract

Background:Testicular cancer patients have an increased risk for cardiovascular disease (CVD), which might be related to the increased prevalence of the metabolic syndrome (MetS) in this group of patients.Methods:We assessed the prevalence of MetS and calculated the 10-year CVD risk in a cohort of 255 testicular germ cell tumour survivors (median age, 38.7 years; interquartile range, 31–48) at a mean of 7.8 years after anti-cancer treatment, and compared these with data obtained from 360 healthy men.Results:Survivors had an age-adjusted increased risk for MetS of 1.9 compared with that of healthy controls. The risk for MetS was highest in survivors treated with combination chemotherapy (CT) 2.3 (Adult Treatment Panel of the National Cholesterol Education Program classification) and 2.2 (International Diabetes Federation classification). The risk of MetS was especially increased in survivors with testosterone levels in the lowest quartile (OR, 2.5). Ten-year cardiovascular risk as assessed by the Framingham Risk Score (3.0%) and Systemic Coronary Risk Evaluation (1.7%) algorithms was low, independent of treatment, and was comparable to controls.Conclusion:Testicular germ cell tumour survivors have an increased prevalence of MetS, with hypogonadism and CT treatment being clear risk factors for the development of the syndrome. The increased prevalence of MetS was not associated with an increased 10-year cardiovascular risk.

Pulmonary and cardiovascular toxicity in long-term testicular cancer survivors

“…The prevalence of the metabolic syndrome is higher among patients treated with cisplatin-based chemotherapy than among controls or other treatment groups [55,56,58], with prevalence rates ranging between 17% and 34% several years after cisplatin-based chemotherapy [51,55,58].…”

“…Furthermore, diabetes is more frequent after infradiaphragmatic RT when comparison with healthy controls and patients treated with surgery only [51,53], with a reported prevalence rate of 10% after 20 years of follow-up. Several studies have also reported an increased risk for hypercholesterolemia after cisplatin-based chemotherapy [10,35,55,56], with reported rates of 67% to 84%.…”

“…Furthermore, low testosterone levels are associated with increased risk of metabolic syndrome and CVD [51,55,56,58] as well as decreased pulmonary function in TCSs [31]. It should be noted that low testosterone levels are also associated with increased prevalence of the metabolic syndrome and an increased risk of CVD mortality [71,72], reduction of spirometry variables [73], and increased risk of respiratory disease mortality [74] in epidemiological studies.…”

Treatment-related cardiovascular late effects and exercise training countermeasures in testicular germ cell cancer survivorship

“…For example, Nuver et al found the prevalence of MetS was approximately 4-fold increased among orchiectomized GCC patients compared with healthy controls [14], while a recent study found no difference in MetS prevalence between these GCC survivors and their healthy counterparts [15]. The diversity of these findings may be due to differences in diagnostic definitions of MetS and potential suboptimal dataset with national/regional differences in clinical follow-up proceedings.…”

Metabolic syndrome and common urological conditions: looking beyond the obvious

“…35 DIABETES AND METABOLIC SYNDROME 31 TESTICULAR CANCER Testicular cancer patients have an increased risk for CVD, which might be related to the increased prevalence of the metabolic syndrome in this group of patients. 36 A recent study assessed the prevalence of metabolic syndrome and the 10-year CVD risk in a cohort of 255 testicular germ cell tumour survivors (median age, 38.7 years; interquartile range, 31-48) at a mean of 7.8 years after anticancer treatment, and compared these with data obtained from 360 healthy men. The survivors had an age-adjusted increased risk for metabolic syndrome of 1.9 compared with that of healthy controls.…”