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Hypogonadism in testicular cancer patients is associated with risk factors of cardiovascular disease and the metabolic syndrome
Author(s) -
Bogefors C.,
Isaksson S.,
Bobjer J.,
Kitlinski M.,
Leijonhufvud I.,
Link K.,
Giwercman A.
Publication year - 2017
Publication title -
andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.947
H-Index - 43
eISSN - 2047-2927
pISSN - 2047-2919
DOI - 10.1111/andr.12354
Subject(s) - medicine , metabolic syndrome , testicular cancer , testosterone (patch) , insulin resistance , endocrinology , luteinizing hormone , cancer , prostate cancer , disease , androgen , gynecology , insulin , diabetes mellitus , hormone
Summary More than 95% of testicular cancer are cured but they are at increased long‐term risk of cardiovascular disease. The risk of cardiovascular disease and treatment intensity was reported, but it is unknown whether this effect of cancer therapy is direct or indirect, mediated through androgen deficiency. Our aim was, therefore, to evaluate whether testicular cancer patients have increased the prevalence of risk factors of cardiovascular disease and if these risk factors are associated with hypogonadism and/or the cancer treatment given. In 92 testicular cancer patients (mean 9.2 years follow‐up) and age‐matched controls, blood samples were analysed for lipids, total testosterone, luteinizing hormone (LH), glucose and insulin. An estimate of insulin resistance, HOMA ir was calculated. Hypogonadism was defined as total testosterone < 10 nmol/L and/or LH > 10 IU/L and/or androgen replacement. In testicular cancer men with hypogonadism, compared with eugonadal patients, higher insulin (mean difference: 3.10 mIU/L; p = 0.002) and HOMA ir (mean difference: 0.792; p = 0.007) were detected. Hypogonadism group presented with increased risk ( OR = 4.4; p = 0.01) of metabolic syndrome. Most associations between the treatment given and the metabolic parameters became statistically non‐significant after adjustment for hypogonadism. In conclusion, testicular cancer patients with signs of hypogonadism presented with significantly increased risk of metabolic syndrome and investigation of endocrine and metabolic parameters is warranted in these patients.