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Published in: Medical Oncology 9/2020

01-09-2020 | Obesity | Original Paper

What is the damage? Testicular germ cell tumour survivors deficient in testosterone at risk of metabolic syndrome and a need for medical intervention

Authors: Grazyna Poniatowska, Wojciech Michalski, Jakub Kucharz, Joanna Jonska-Gmyrek, Paulina Wieszczy, Karol Nietupski, Tomasz Demkow, Marek Dedecjus, Malgorzata Sadowska, Tomasz Kalinowski, Beata Grochulska-Nalazek, Ada Nowatorska, Pawel Stelmasiak, Pawel J. Wiechno

Published in: Medical Oncology | Issue 9/2020

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Abstract

Testicular germ cell tumours (TGCT) survivors are coping with late treatment sequelae. Testosterone deficiency may contribute to earlier onset of metabolic syndrome. The study aimed to assess connections between serum testosterone concentrations and metabolic disorders as well as body composition in TGCT survivors. 336 TGCT patients with over two years of complete post-treatment remission were divided into three groups: definite testosterone deficiency (< 8 nmol/L), ‘grey zone’ (8–12 nmol/L) and normal testosterone (> 12 nmol/L; control group) to assess differences in metabolism. Univariate and multivariate analyses were performed. The multivariate analysis assessed the risk of metabolic disorders and changes in body composition with regard to testosterone concentrations adjusted for age, smoking history, clinical stage, type of treatment and follow-up period. 14% of patients presented with definite testosterone deficiency; 46% were in the ‘grey zone’. On multivariate analysis, low testosterone levels were related to hyperglycemia, hypercholesterolemia, hypertriglyceridemia, inflammatory processes, procoagulant state and obesity. The odds ratio (OR) for the onset of metabolic syndrome was 2.87 (95% CI 1.74–4.73, p < 0.001) for the ‘grey zone’ patients and 7.92 (95% CI 3.76–16.70, p < 0.001) for those with definite testosterone deficiency. Testosterone concentrations were independently associated with metabolic disorders in TGCT survivors. Testicular cancer survivors often have lower testosterone and metabolic disorders. Apart from recurrence, follow-up should focus on promoting a healthy lifestyle, preventing and managing late effects.
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Metadata
Title
What is the damage? Testicular germ cell tumour survivors deficient in testosterone at risk of metabolic syndrome and a need for medical intervention
Authors
Grazyna Poniatowska
Wojciech Michalski
Jakub Kucharz
Joanna Jonska-Gmyrek
Paulina Wieszczy
Karol Nietupski
Tomasz Demkow
Marek Dedecjus
Malgorzata Sadowska
Tomasz Kalinowski
Beata Grochulska-Nalazek
Ada Nowatorska
Pawel Stelmasiak
Pawel J. Wiechno
Publication date
01-09-2020
Publisher
Springer US
Published in
Medical Oncology / Issue 9/2020
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-020-01407-4

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