title: Evaluation of adipocytokines and traditional cardiometabolic risk factors in young male cancer survivors: an age-matched control study.
abstract: BACKGROUND
  Life expectancy of cancer survivors has doubled in the past four decades; however, death due to cardiovascular disease is more prevalent in survivors than the general population.
  
  
  OBJECTIVE
  We evaluated novel and traditional cardiometabolic risk factors in young male cancer survivors in a cross-sectional study of male cancer survivors aged 25-45 years compared with age-matched noncancer controls. Demographic and anthropometric data were recorded and biochemical and hormonal parameters assayed from fasting blood samples in 176 survivors and 213 controls (lipids were measured in all survivors and 97 controls).
  
  
  RESULTS
  Compared with controls, survivors had significantly higher body mass index, adipocytokines, insulin resistance, total cholesterol and triglyceride levels and lower free androgen index (FAI). Handgrip strength, smoking, alcohol consumption, free oestrogen index, insulin-like growth factor 1 and high-density lipoprotein cholesterol levels did not differ between cancer survivors and controls. Risk factors were analysed simultaneously using stepwise multivariable logistic regression, and this showed that high leptin: adiponectin ratio (odds ratio = 2·63; 95% confidence interval: 1·34-5·15; P = 0·005), hypercholesterolaemia (odds ratio = 1·85; 95%CI: 1·08-3·17; P = 0·025) and low FAI (odds ratio = 2·01; 95% confidence interval: 1·07-3·79; P = 0·030) were independently more common in survivors. The odds ratio in survivors for having at least two of these three risk factors rose to 6·58 (95% confidence interval: 3·30-13·12; P < 0·001). Among survivors, risk factors were not different between cancer therapies but worse in survivors who had radiotherapy involving the testes (hyperleptinaemia and insulin resistance) or age at diagnosis above group median (hypertriglyceridaemia and hypercholesterolaemia).
  
  
  CONCLUSIONS
  A high leptin: adiponectin ratio, hypercholesterolaemia and low FAI are observed in young male cancer survivors, especially those who received radiotherapy involving the testes or were diagnosed at a later age. In view of their youth and known increased risk of cardiovascular death, treatment strategies are required to address this cardiovascular risk.
authors.affiliation: Specialised Cancer, Medicine & Rehabilitation, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, UK.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Greenfield
authors.affiliation: Academic Units of Clinical Oncology, University of Sheffield, Sheffield, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Blewitt
authors.affiliation: Academic Units of Clinical Oncology, University of Sheffield, Sheffield, UK.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Coleman
authors.affiliation: Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Walsh
authors.affiliation: Specialised Cancer, Medicine & Rehabilitation, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Snowden
authors.affiliation: Department of Human Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Richard J M
authors.initials: RJM
authors.lastname: Ross
authors.affiliation: Department of Endocrinology, Ashford and St Peter's National Hospital Service Foundation Trust, Surrey, UK.
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han