title: Urinary estrogen metabolites, prostate specific antigen, and body mass index among African-American men in South Carolina.
abstract: BACKGROUND
  Estrogen metabolites have been linked to risk of breast cancer, and we were interested in whether they are associated with prostate specific antigen (PSA) and other factors associated with prostate cancer. African-American (AA) men in South Carolina have among the highest prostate cancer rates in the world, and thus provide an ideal population in which to investigate this hypothesis.
  
  
  METHODS
  We recruited AA men attending prostate cancer screenings in and around Columbia, South Carolina. Because very few men had elevated PSAs, we restricted our study to the 77 men whose PSA was below the cutpoint used by the screening program to indicate need for diagnostic workup. These men provided spot urine samples and answered demographic and lifestyle questions including self-reported body weight, height, exercise, tobacco use, medications, cancer history and age. Levels of urinary 2-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1), and their ratio (2/16) and blood PSA levels were determined.
  
  
  RESULTS
  After adjusting for a statistically significant interaction between age and BMI, we found a reduction of 14.2% in 2-OHE1 for each 1.0 ng/ml increase in PSA (p=0.05). For obese AA men only (BMI> or =30 kg/m2), 2-OHE1 increased by 36% for each decade of age (p=0.009).
  
  
  CONCLUSIONS
  Estrogen metabolites may be related to PSA level in AA men. Older men with BMIs greater than 30 kg/m2 had an unexpected increase in 2-OHE1, suggesting a dysregulation of this estrogen metabolism pathway. Further studies of estrogen metabolites may provide insights into prostate cancer risk factors.
authors.affiliation: Arnold School of Public Health, University of South Carolina, 2221 Devine Street Room 230, Columbia, SC 29208, USA. jane.teas@sc.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Teas
authors.forename: Joan E
authors.initials: JE
authors.lastname: Cunningham
authors.forename: Jay H
authors.initials: JH
authors.lastname: Fowke
authors.forename: Daniela
authors.initials: D
authors.lastname: Nitcheva
authors.forename: C P
authors.initials: CP
authors.lastname: Kanwat
authors.forename: R J
authors.initials: RJ
authors.lastname: Boulware
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Sepkovic
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Hurley
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D004967:Estrogens / Q000378:metabolism / Q000652:urine*; D006801:Humans; D006894:Hydroxyestrones / Q000652:urine; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000652:urine*; D012307:Risk Factors; D013022:South Carolina
chemical_list: D004967:Estrogens; D006894:Hydroxyestrones; D017430:Prostate-Specific Antigen; C024980:2-hydroxyestrone