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, design and methods: We evaluated novel and traditional cardiometabolic risk factors in young male cancer survivors in a cross-sectional study of male cancer survivors aged 2545 years compared with age-matched non-cancer 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 BMI, adipocytokines, insulin resistance, total cholesterol and triglyceride levels and lower free androgen index (FAI). Handgrip strength, smoking, alcohol consumption, free estrogen 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 multi-variable logistic regression, and this showed that high leptin:adiponectin ratio (odds ratio=2.63; 95% CI 1.345.15; P=0.005), hypercholesterolaemia (odds ratio=1.85; 95% CI 1.083.17; P=0.025) and low FAI (odds ratio=2.01; 95% CI 1.073.79; 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% CI 3.3013.12; 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.