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亚临床动脉硬化与睾丸癌长期幸存者的常见血管危险因素相关。

Subclinical Arteriosclerosis is Associated With Common Vascular Risk Factors in Long-Term Survivors of Testicular Cancer.

作者信息

Espíldora-Hernández Javier, Díaz-Antonio Tania, Baena-Espinar Javier, Alonso-Calderón Inmaculada, Rioja José, Alba-Conejo Emilio, Valdivielso Pedro, Sánchez-Chaparro Miguel-Ángel

机构信息

Internal Medicine Unit, Hospital Virgen de la Victoria, 29010 Málaga, Spain.

Radiology Unit, Hospital Virgen de la Victoria, 29010 Málaga, Spain.

出版信息

J Clin Med. 2020 Mar 31;9(4):971. doi: 10.3390/jcm9040971.

Abstract

Cardiovascular disease risk is increased in survivors of testicular cancer because of exposure to treatment (chemotherapy and radiotherapy), as well as modification in lifestyle. Our aim was to assess the presence of subclinical arteriosclerosis in survivors of testicular cancer in comparison with a control group. This was a cross-sectional, observational, case-control study including 50 survivors of Germ Cell Tumor (GCT) (14 years of follow-up) and 53 age-matched controls with no cancer. We registered clinical data, cardiovascular risk factors, physical and Mediterranean questionnaires, intima-media thickness and plaque at carotid and femoral arteries by ultrasound, calcium score at the abdominal aorta, and liver steatosis by computed tomography, and applied analytical tests to quantify metabolic risk factors and inflammation markers. Patients showed a trend toward greater intima-media thickness (IMT) and plaques than controls, as well as a higher calcium score in the abdominal aorta. Remarkably, patients had higher waist circumference, insulin resistance (HOMA-IR), and liver steatosis, but lower physical activity and high-density lipoprotein (HDL) cholesterol than controls (all < 0.05). In multivariate analyses, only common vascular risk factors were associated with subclinical arteriosclerosis. As a conclusion, in our study, a higher rate of subclinical arteriosclerosis in testicular cancer survivors was associated with classical metabolic risk factors and lifestyle, but not with exposure to chemotherapy.

摘要

由于接受治疗(化疗和放疗)以及生活方式的改变,睾丸癌幸存者患心血管疾病的风险增加。我们的目的是评估睾丸癌幸存者与对照组相比是否存在亚临床动脉硬化。这是一项横断面、观察性病例对照研究,包括50名生殖细胞肿瘤(GCT)幸存者(随访14年)和53名年龄匹配的无癌症对照者。我们记录了临床数据、心血管危险因素、身体状况和地中海饮食问卷,通过超声测量颈动脉和股动脉的内膜中层厚度和斑块、腹主动脉的钙化评分,通过计算机断层扫描测量肝脂肪变性,并应用分析测试来量化代谢危险因素和炎症标志物。患者的内膜中层厚度(IMT)和斑块趋势高于对照组,腹主动脉钙化评分也更高。值得注意的是,患者的腰围、胰岛素抵抗(HOMA-IR)和肝脂肪变性更高,但身体活动和高密度脂蛋白(HDL)胆固醇低于对照组(均P<0.05)。在多变量分析中,只有常见的血管危险因素与亚临床动脉硬化有关。总之,在我们的研究中,睾丸癌幸存者中亚临床动脉硬化的发生率较高与经典的代谢危险因素和生活方式有关,但与化疗暴露无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b8d/7231146/c162f6ffe1ae/jcm-09-00971-g001.jpg

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