Presence of the metabolic syndrome in testicular cancer patients and the relation with a SNP near IRS1

Koffeman, E. (Eva) (2013) Presence of the metabolic syndrome in testicular cancer patients and the relation with a SNP near IRS1. thesis, Medicine.

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Abstract

Background: Testicular cancer is the most common malignancy in men aged 20-40 years. The prognosis is relatively good; the current survival rate exceeds 90%. TC patients with disseminated disease receive chemotherapy. Due to the good survival a lot more cancer survivors are faced with the late effects of chemotherapy. A common late effect is the metabolic syndrome; in this study we want to investigate the prevalence, the relation with a single nucleotide polymorphism (SNP) near IRS1 (insulin receptor substrate 1) and body changes in relation to the metabolic syndrome. Methods and results: 246 patients were eligible for this study; follow-up data and IRS1 SNP data were collected from the genomic DNA of the patients. 1. For our first objective all 246 patients were analyzed and the metabolic syndrome was diagnosed in 30.9% of all patients with a median follow-up time of 6.3 years (range 1.4-20.2). 2. Our second primary objective was to test the relation between a SNP near IRS1 (rs2943650) and the presence of the metabolic syndrome during follow-up. All 246 patients were eligible for this part of the study. We found no significant relation between the presence of the metabolic syndrome and a SNP near IRS1 (rs2943650). The different genotypes were: TT (92/246), CT (117/246) and CC (37/246). 3. Our secondary objective was to detect changes in body composition and in relation with the development of the metabolic syndrome. For this analysis 141 patients were eligible because there were two follow-up visits available of these patients, so we could determine the presence of the metabolic syndrome at two moments. We studied three groups, the first group had no metabolic syndrome during follow-up, the second group developed it between the first and the second FU moment and the third group had the metabolic syndrome at both FU moments. Patients without the metabolic syndrome (N=95) had lower triglyceride and glucose levels in comparison with the groups who did develop metabolic syndrome during FU. Testosterone levels were also higher in the group without the metabolic syndrome. Another part of the study was to look at metabolic syndrome before chemotherapy. 104 patients were eligible for this part of the study because we presumed they did not have the metabolic syndrome before chemotherapy. We wanted to investigate predictors for the development of the metabolic syndrome by analyzing two groups who did not have metabolic syndrome at FU visit 1 but one group developed it at FU visit 2 and the other group did not. The data of the first follow-up visit were analyzed. We found that testosterone levels are significantly lower in the group that develops metabolic syndrome between FU 1 and 2. Insulin levels, BMI and waist circumference are increased in comparison with the group that does not develop the metabolic syndrome. Conclusion: Metabolic syndrome is a common late effect in patients with testicular cancer treated with chemotherapy. The prevalence is higher than in the general population and we investigated the relation between a known SNP near IRS1 and the presence of the metabolic syndrome, which we could not find. Body composition changes in patients developing the metabolic syndrome. Testosterone levels and insulin levels could be important predictors for the metabolic syndrome. Future research is needed to investigate the importance of these predictors and to investigate early treatment options.

Item Type:	Thesis (Thesis)
Supervisor name:	Gietema, prof. dr. J.A. and Boer, drs. Hink
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1039

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