TY - JOUR
T1 - Association Between Circulating Levels of Sex Steroid Hormones and Barrett's Esophagus in Men
T2 - A Case-Control Analysis
AU - Cook, Michael B.
AU - Wood, Shannon N.
AU - Cash, Brooks D.
AU - Young, Patrick
AU - Acosta, Ruben D.
AU - Falk, Roni T.
AU - Pfeiffer, Ruth M.
AU - Hu, Nan
AU - Su, Hua
AU - Wang, Lemin
AU - Wang, Chaoyu
AU - Gherman, Barbara
AU - Giffen, Carol
AU - Dykes, Cathy
AU - Turcotte, Veronique
AU - Caron, Patrick
AU - Guillemette, Chantal
AU - Dawsey, Sanford M.
AU - Abnet, Christian C.
AU - Hyland, Paula L.
AU - Taylor, Philip R.
N1 - Publisher Copyright:
© 2015 AGA Institute.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background and Aims: Esophageal adenocarcinoma is believed to result from the progression of gastroesophageal reflux disease to erosive esophagitis and re-epithelialization of the esophagus with a columnar cell population termed Barrett's esophagus (BE). Men develop BE and esophageal adenocarcinoma more frequently than women, yet little is known about the mechanisms of this difference. We assessed whether sex steroid hormones were associated with BE in a male population. Methods: We analyzed data from the Barrett's Esophagus Early Detection Case Control Study, based at the Walter Reed National Military Medical Center. Blood samples were collected from 174 men with BE and 213 men without BE (controls, based on endoscopic analysis); 13 sex steroid hormones were measured by mass spectrometry and sex hormone binding globulin was measured by enzyme-linked immunosorbent assay. We also calculated free estradiol, free testosterone, and free dihydrotestosterone (DHT). We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, race, smoking status, alcohol consumption, body mass index, heartburn, regurgitation, and gastroesophageal symptom score (excluding heartburn and regurgitation). Results: Levels of free testosterone and free DHT were associated positively with BE risk; patients in the highest quartile for these hormones were most likely to have BE (free testosterone: OR, 5.36; 95% CI, 2.21-13.03; P= .0002; free DHT: OR, 4.25; 95% CI, 1.87-9.66; P= .001). Level of estrone sulfate was associated inversely with BE risk (P for trend= .02). No other hormone was associated with BE risk. Relationships were not modified by age or BMI. Conclusions: In an analysis of men, levels of free testosterone and free DHT were significantly associated withBE.
AB - Background and Aims: Esophageal adenocarcinoma is believed to result from the progression of gastroesophageal reflux disease to erosive esophagitis and re-epithelialization of the esophagus with a columnar cell population termed Barrett's esophagus (BE). Men develop BE and esophageal adenocarcinoma more frequently than women, yet little is known about the mechanisms of this difference. We assessed whether sex steroid hormones were associated with BE in a male population. Methods: We analyzed data from the Barrett's Esophagus Early Detection Case Control Study, based at the Walter Reed National Military Medical Center. Blood samples were collected from 174 men with BE and 213 men without BE (controls, based on endoscopic analysis); 13 sex steroid hormones were measured by mass spectrometry and sex hormone binding globulin was measured by enzyme-linked immunosorbent assay. We also calculated free estradiol, free testosterone, and free dihydrotestosterone (DHT). We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, race, smoking status, alcohol consumption, body mass index, heartburn, regurgitation, and gastroesophageal symptom score (excluding heartburn and regurgitation). Results: Levels of free testosterone and free DHT were associated positively with BE risk; patients in the highest quartile for these hormones were most likely to have BE (free testosterone: OR, 5.36; 95% CI, 2.21-13.03; P= .0002; free DHT: OR, 4.25; 95% CI, 1.87-9.66; P= .001). Level of estrone sulfate was associated inversely with BE risk (P for trend= .02). No other hormone was associated with BE risk. Relationships were not modified by age or BMI. Conclusions: In an analysis of men, levels of free testosterone and free DHT were significantly associated withBE.
KW - BEEDS
KW - Cancer Risk
KW - Esophageal Neoplasms
KW - Gonadal Steroid Hormones
KW - SHBG
UR - http://www.scopus.com/inward/record.url?scp=84925039008&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2014.08.027
DO - 10.1016/j.cgh.2014.08.027
M3 - Article
C2 - 25158929
AN - SCOPUS:84925039008
SN - 1542-3565
VL - 13
SP - 673
EP - 682
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 4
ER -