Available online 4 December 2023

Obese testicular cancer patients already have shorter telomeres before treatment.

Telomere shortening is correlated with rising diastolic blood pressure and triglycerides.

Telomere length cannot predict development of the metabolic syndrome after 5 years.

Hypogonadal survivors 5 years after treatment had short telomeres at start or shortening after treatment.

Testicular cancer (TC) survivors cured with chemotherapy (CT) are prone to develop cardiovascular diseases, as part of an accelerated aging phenotype. A mechanism contributing to these events can be telomere shortening.

In a prospective cohort of patients with disseminated TC who received cisplatin-based CT, mean absolute leukocyte telomere length (TL) was measured before and 1 year after start of treatment. Cardiovascular risk factors, including development of the metabolic syndrome and hypogonadism, were assessed before and up to 5 years after CT.

For the whole group (n = 55), TL did not change 1 year after CT (5.7 (2.2–13.4) vs. 5.8 kb (1.6–19.2), P = 0.335). At baseline, patients with a BMI >30 kg/m2 (n = 12) had shorter TL (4.9 (2.2–13.4) vs. 6.3 kb (3.1–12.9), P = 0.045), while no age-dependent differences were measured. Patients with TL shortening after 1 year (n = 7) showed a significant increase in diastolic blood pressure (P = 0.007) and triglycerides (P = 0.003), compared to those with unchanged TL. There was no association between telomere shortening after 1 year or short TL at baseline (n = 7+11) and development of metabolic syndrome (25% vs. 21%; P = 0.777), or hypogonadism (38% vs. 17%; P = 0.120) after 5 years.

A small subset of TC patients treated with cisplatin-based CT showed telomere shortening 1 year after treatment. This shortening was associated to a rise in diastolic blood pressure and triglycerides, but not to newly developed metabolic syndrome and hypogonadism after 5 years.

Cisplatin

Hypogonadism

Metabolic syndrome

Obesity

Survivorship

Telomere

Testicular neoplasms

© 2023 The Authors. Published by Elsevier Inc.