Associations of Body Fat Distribution and Cardiometabolic Risk of Testicular Cancer Survivors After Cisplatin-Based Chemotherapy
dc.contributor.author | Wibmer, Andreas G. | |
dc.contributor.author | Dinh, Paul C., Jr. | |
dc.contributor.author | Travis, Lois B. | |
dc.contributor.author | Chen, Carol | |
dc.contributor.author | Bromberg, Maria | |
dc.contributor.author | Zheng, Junting | |
dc.contributor.author | Capanu, Marinela | |
dc.contributor.author | Sesso, Howard D. | |
dc.contributor.author | Feldman, Darren R. | |
dc.contributor.author | Vargas, Hebert Alberto | |
dc.contributor.department | Medicine, School of Medicine | |
dc.date.accessioned | 2023-07-31T10:44:30Z | |
dc.date.available | 2023-07-31T10:44:30Z | |
dc.date.issued | 2022 | |
dc.description.abstract | Background: It is unknown how body fat distribution modulates the cardiometabolic risk of testicular cancer survivors after cisplatin-based chemotherapy. Methods: For 455 patients enrolled in the Platinum Study at Memorial Sloan Kettering Cancer Center, visceral (VAT) and subcutaneous (SAT) adipose tissue was quantified on prechemotherapy computed tomography. The VAT-to-SAT ratio was calculated as a quantitative measure of central adiposity. Endpoints were incidence of new posthemotherapy cardiometabolic disease (new antihypertensive, lipid-lowering, or diabetes medication), and postchemotherapy Framingham risk scores. Cox models and linear regression with interaction terms were applied. Postchemotherapy body fat distribution was analyzed in 108 patients. All statistical tests were 2-sided. Results: The baseline median age was 31 years (interquartile range [IQR] = 26-39 years), body mass index (BMI) was 26 kg/m2 (IQR = 24-29 kg/m2), and the VAT-to-SAT ratio was 0.49 (IQR = 0.31-0.75). The median follow-up was 26 months (IQR = 16-59 months). Higher prechemotherapy VAT-to-SAT ratios inferred a higher likelihood of new cardiometabolic disease among patients with a BMI of 30 kg/m2 or greater (age-adjusted hazard ratio = 3.14, 95% confidence interval = 1.02 to 9.71, P = .047), but not other BMI groups. The prechemotherapy VAT-to-SAT ratio was associated with postchemotherapy Framingham risk scores in univariate regression analysis (exp(β)-estimate: 2.10, 95% confidence interval = 1.84 to 2.39, P < .001); in a multivariable model, this association was stronger in younger vs older individuals. BMI increased in most patients after chemotherapy and correlated with increases in the VAT-to-SAT ratio (Spearman r = 0.39, P < .001). Conclusions: In testicular cancer survivors, central adiposity is associated with increased cardiometabolic risk after cisplatin-based chemotherapy, particularly in obese or young men. Weight gain after chemotherapy occurs preferentially in the visceral compartment, providing insight into the pathogenesis of cardiovascular disease in this population. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Wibmer AG, Dinh PC, Travis LB, et al. Associations of Body Fat Distribution and Cardiometabolic Risk of Testicular Cancer Survivors After Cisplatin-Based Chemotherapy. JNCI Cancer Spectr. 2022;6(4):pkac030. doi:10.1093/jncics/pkac030 | |
dc.identifier.uri | https://hdl.handle.net/1805/34596 | |
dc.language.iso | en_US | |
dc.publisher | Oxford University Press | |
dc.relation.isversionof | 10.1093/jncics/pkac030 | |
dc.relation.journal | JNCI Cancer Spectrum | |
dc.rights | Attribution 4.0 International | en |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | PMC | |
dc.subject | Body fat distribution | |
dc.subject | Cardiovascular diseases | |
dc.subject | Cisplatin | |
dc.subject | Intra-abdominal fat | |
dc.subject | Obesity | |
dc.subject | Subcutaneous fat | |
dc.subject | Testicular neoplasms | |
dc.title | Associations of Body Fat Distribution and Cardiometabolic Risk of Testicular Cancer Survivors After Cisplatin-Based Chemotherapy | |
dc.type | Article |