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

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.

SUBMITTER: Cook MB

PROVIDER: S-EPMC4339666 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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

Cook Michael B MB Wood Shannon N SN Cash Brooks D BD Young Patrick P Acosta Ruben D RD Falk Roni T RT Pfeiffer Ruth M RM Hu Nan N Su Hua H Wang Lemin L Wang Chaoyu C Gherman Barbara B Giffen Carol C Dykes Cathy C Turcotte Veronique V Caron Patrick P Guillemette Chantal C Dawsey Sanford M SM Abnet Christian C CC Hyland Paula L PL Taylor Philip R PR

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20140824 4

<h4>Background & aims</h4>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.<h4>Methods</h4>We a ...[more]

PMID: 25158929

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Project description:Background & aimsObesity is associated with Barrett's esophagus (BE) and with changes in circulating levels of adipokines (leptin and adiponectin) and cytokines. Although studies have reported that adipokines and inflammatory cytokines are necessary for the development of BE, their role is controversial.MethodsWe performed a case-control study; cases (n = 141) were patients who underwent esophagogastroduodenoscopy and were found to have BE, which was based on endoscopy and histology, and controls (n = 139) were primary care patients eligible for screening colonoscopies who agreed to undergo esophagogastroduodenoscopy. We examined the association between BE and circulating levels of adipokines and cytokines (interleukin [IL]-1?, IL-6, IL-8, IL-10, and IL-12p70; tumor necrosis factor-?; and interferon-?). Cases and controls were compared by calculating odds ratios (ORs) and 95% confidence intervals (CIs) and using unadjusted and multiple logistic regression, adjusting for age, sex, race, waist-hip ratio, use of proton pump inhibitors and nonsteroidal anti-inflammatory drugs, and Helicobacter pylori infection.ResultsThe adjusted ORs for BE were 2.62 (95% CI, 1.0-6.8), 5.18 (95% CI, 1.7-15.7), and 8.02 (95% CI, 2.79-23.07) for the highest quintile vs the lowest quintile of levels of IL-12p70, IL-8, and leptin, respectively, but the OR was not significant for IL-6 (2.39; 95% CI, 0.84-6.79). The adjusted OR for BE was 0.14 for highest quintile of IL-10 compared with lowest quintile (95% CI, 0.05-0.35) and 0.03 for IL-1? ? median vs none detected (95% CI, 0.006-0.13). Higher levels of IL-8 and leptin and lower levels of IL-10 and IL-1? were associated with the presence of long-segment (?3 cm) and short-segment BE. There were no differences between cases and controls in levels of interferon-?, tumor necrosis factor-?, adiponectin, or insulin.ConclusionsBE is associated with circulating inflammatory cytokines and leptin and low levels of anti-inflammatory cytokines. These findings could partly explain the effect of obesity on BE.

Dataset Information

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

Publications

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

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