Prevalence and consequences of androgen deficiency in young male cancer survivors in a controlled cross-sectional study.
J Clin Endocrinol Metab
; 92(9): 3476-82, 2007 Sep.
Article
em En
| MEDLINE
| ID: mdl-17579201
ABSTRACT
BACKGROUND:
Testosterone replacement in hypogonadal males improves body composition, sexual function, and health-related quality of life. Male cancer survivors are at risk of androgen deficiency; however, when and in whom testosterone should be replaced remain unanswered questions.OBJECTIVE:
The aim of our study was to define the prevalence of androgen deficiency in this patient group through assessment of testosterone levels and related measures.DESIGN:
This was a cross-sectional, observational study of cases and controls. We recruited 176 cancer survivors and 213 controls, aged 25-45 yr.RESULTS:
Of cancer survivors, 97% had received chemotherapy and 40% radiotherapy. Cancer survivors had lower total testosterone (tT) levels than controls (mean difference 2.67 nmol/liter; 95% confidence interval 1.58-3.76; P = 0.003), and 24 of 176 (13.6%; 95% confidence interval 9.3-19.5) had a tT less than 10 nmol/liter, which was less than 2.5% centile for controls. Cancer survivors had a greater fat mass, higher fasting insulin and glucose levels, increased fatigue, and reduced sexual function and health-related quality of life. In both cohorts, the tT correlated negatively with insulin levels and negatively with body fat mass; however, the difference in tT between them was independent of fat mass. We measured tT and SHBG and calculated bioavailable testosterone. The changes in calculated bioavailable testosterone were similar to tT.CONCLUSIONS:
A significant proportion of young male cancer survivors had a frankly low tT associated with an increased fat mass and insulin level compared with controls. These factors would be predicted to improve in response to testosterone replacement therapy and provide a powerful argument for an interventional study of testosterone therapy in young male cancer survivors.
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Base de dados:
MEDLINE
Assunto principal:
Sobreviventes
/
Hipogonadismo
/
Androgênios
/
Neoplasias
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article