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Clin Gastroenterol Hepatol. 2015 Apr;13(4):673-82. doi: 10.1016/j.cgh.2014.08.027. Epub 2014 Aug 24.

Association between circulating levels of sex steroid hormones and Barrett's esophagus in men: a case-control analysis.

Author information

1
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. Electronic address: michael.cook@nih.gov.
2
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
3
Walter Reed National Military Medical Center, Bethesda, Maryland.
4
Westat, Inc, Rockville, Maryland.
5
IMS, Inc, Calverton, Maryland.
6
Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec Research Center and Faculty of Pharmacy, Laval University, Québec, Canada.

Abstract

BACKGROUND & 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 with BE.

KEYWORDS:

BEEDS; Cancer Risk; Esophageal Neoplasms; Gonadal Steroid Hormones; SHBG

PMID:
25158929
PMCID:
PMC4339666
DOI:
10.1016/j.cgh.2014.08.027
[Indexed for MEDLINE]
Free PMC Article

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