title: Early development of the metabolic syndrome after chemotherapy for testicular cancer.
abstract: BACKGROUND
  The metabolic syndrome (MS) might increase the risk of cardiovascular disease in testicular cancer (TC) survivors. We investigated its prevalence, development, vascular implications, and the role of gonadal function.
  
  
  METHODS
  TC survivors treated with chemotherapy and follow-up ≥3 years (N = 370, study I) were retrospectively evaluated for the development of cardiovascular risk factors. A subgroup followed 3-20 years (N = 173, study II) was compared with controls (N = 1085) for MS prevalence and evaluated for vascular function.
  
  
  RESULTS
  In TC survivors (study I), 24% developed overweight, 24% hypercholesterolemia, and 30% hypertension, after median follow-up of 1.7, 0.9, and 5.1 years, respectively. At the median follow-up of 5 years (study II), 25% of survivors have the MS {odds ratio (OR) 2.2, [95% confidence interval (CI) 1.5-3.3] compared with controls}. Survivors with MS have features of inflammation and prothrombotic state, increased carotid artery intima-media thickness. Survivors with testosterone levels <15 nmol/l (22%) have an increased risk of the MS (OR 4.1, 95% CI 1.8-9.3).
  
  
  CONCLUSIONS
  The current data suggest that the MS occurs at earlier age in TC survivors treated with chemotherapy compared with controls and is accompanied by early signs of atherosclerosis. As low testosterone may have a causal role, it is a target for interventions.
authors.affiliation: Departments of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands..
authors.forename: E C
authors.initials: EC
authors.lastname: de Haas
authors.forename: R
authors.initials: R
authors.lastname: Altena
authors.forename: H M
authors.initials: HM
authors.lastname: Boezen
authors.forename: N
authors.initials: N
authors.lastname: Zwart
authors.forename: A J
authors.initials: AJ
authors.lastname: Smit
authors.forename: S J L
authors.initials: SJ
authors.lastname: Bakker
authors.forename: A M
authors.initials: AM
authors.lastname: van Roon
authors.forename: A
authors.initials: A
authors.lastname: Postma
authors.forename: B H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: F E
authors.initials: FE
authors.lastname: van Leeuwen
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: J A
authors.initials: JA
authors.lastname: Gietema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D002945:Cisplatin / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D050177:Overweight / Q000139:chemically induced / Q000453:epidemiology; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D002945:Cisplatin