What is the damage? Testicular germ cell tumour survivors deficient in testosterone at risk of metabolic syndrome and a
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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 Grazyna Poniatowska1 · Wojciech Michalski1 · Jakub Kucharz1 · Joanna Jonska‑Gmyrek1 · Paulina Wieszczy2,3 · Karol Nietupski1 · Tomasz Demkow1 · Marek Dedecjus4 · Malgorzata Sadowska1 · Tomasz Kalinowski1 · Beata Grochulska‑Nalazek1 · Ada Nowatorska1 · Pawel Stelmasiak1 · Pawel J. Wiechno1 Received: 26 March 2020 / Accepted: 30 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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 ( 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
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