Revised manuscript R2, clean version are serum levels of 25-hydroxy vitamin D reduced following orchiectomy in testicular cancer patients?

Abstract

Background The testis represents one place where the progenitor of vitamin D is converted into its active form. Loss of one testis was suggested to result in reduced vitamin D serum levels. Vitamin D deficiency would represent a significant health problem in the long-term course of patients with testicular germ cell tumors (GCTs) since most of them survive. The purpose of this study was to look to the serum 25(OH)-Vitamin D (25OHD) levels in patients with GCTs before and after orchiectomy. A total of 177 GCT patients underwent measurements of serum 25OHD levels, thereof 83 with preoperative measurements and 94 with measurements at six particular time-points from immediate postoperatively to >24 months. Longitudinal assessments of 25OHD serum levels were performed in individual patients with repeated measurements. A second analysis involved patient cohorts with measurements at six postoperative time-points. Serum levels of patients were also compared with 2 control groups, one consisting of 84 patients with non-neoplastic testicular diseases and another with 237 patients with non-neoplastic urologic diseases. We also looked to associations of 25OHD levels with levels of testosterone, follicle stimulating hormone (FSH), age, histology of GCT and season. Descriptive statistical methods were employed to compare groups and to analyze changes over time. Results Normal serum levels of 25OHD were found in 21.7%, 23.1%, 20.2%, 21.9% in GCT patients preoperatively, after >2 years, in control group 1 and control group 2, respectively. Levels were significantly higher in spring and summer, but no association was found with other parameters. We found a significant transient decrease of 25OHD levels with a nadir at 6-12 months after orchiectomy and a recovery thereafter. Conclusion Contrasting with previous studies we found no permanent reduction of serum 25OHD levels after orchiectomy but transient postoperative drop of 25OHD levels. There were no associations of 25OHD levels with age, and levels of testosterone or FSH. Our results may point to a particular role of the testis in vitamin D metabolism and may thus enhance the understanding of the diverse physiological roles of the testis.

Prognostic role of plasma vitamin D and its association with disease characteristics in germ cell tumours

“…There is evidence that GCT survivors are associated with an insufficient level of vitamin D after treatment of primary cancer ( 47 – 50 ), with a significant difference compared to healthy donors ( 48 , 49 ). An interesting study, which encompassed healthy donors as well as GCT patients, was outdone, where measurements of vitamin D values in GCT patients were assessed in longitudinal follow-up (>24 months) ( 51 ). In this study, decrement of vitamin D in GCT patients after orchiectomy was only transient, with a nadir at 6 months (mean), and thereafter, values comparable to healthy donors were observed ( 51 ).…”

“…An interesting study, which encompassed healthy donors as well as GCT patients, was outdone, where measurements of vitamin D values in GCT patients were assessed in longitudinal follow-up (>24 months) ( 51 ). In this study, decrement of vitamin D in GCT patients after orchiectomy was only transient, with a nadir at 6 months (mean), and thereafter, values comparable to healthy donors were observed ( 51 ). To sum it up, the mentioned studies proposed conflicting results: that vitamin D level in GCT patients and/or survivors is associated with hypovitaminosis, which could be transient, however, whether the potential explanation of hypovitaminosis might arise from its high prevalence in the general population is up for debate.…”

Isochromosome 12p Formation Regulates Vitamin D Metabolism in Testicular Cancer

“…Interestingly, a high prevalence of Vitamin D 3 deficiency was confirmed in TGCT up to 83% [ 55 ]. In contrast, no permanent reduction in serum 25(OH)D 3 levels after orchiectomy but a transient post-operative drop of 25(OH)D levels were found in 177 TGCT patients [ 56 ]. Nevertheless, a recent study by Lesko et al demonstrated that low-plasma Vitamin D was associated with an unfavorable response to therapy and disease recurrence in TGCT [ 57 ].…”

The Impact of Cholecalciferol on the Reproductive System Function in Rats Males With Experimental Gonadopathy

“…D-deficiency statuses may be occurred under the condition of hypofertility of different genesis. Thus, Klaus Peter Dikmann et al ( 2021) have reported significant transitional declining of cholecalciferol level after orchiectomy [5]. Nowadays, it is proved, that testicle is one of the sites when the precursor of vitamin D transforms into its active form [4].…”