title: Association between circulating levels of sex steroid hormones and Barrett's esophagus in men: a case-control analysis.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Cook
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Wood
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Brooks D
authors.initials: BD
authors.lastname: Cash
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Young
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Ruben D
authors.initials: RD
authors.lastname: Acosta
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Roni T
authors.initials: RT
authors.lastname: Falk
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Nan
authors.initials: N
authors.lastname: Hu
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Hua
authors.initials: H
authors.lastname: Su
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Lemin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Chaoyu
authors.initials: C
authors.lastname: Wang
authors.affiliation: Westat, Inc, Rockville, Maryland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gherman
authors.affiliation: IMS, Inc, Calverton, Maryland.
authors.forename: Carol
authors.initials: C
authors.lastname: Giffen
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Cathy
authors.initials: C
authors.lastname: Dykes
authors.affiliation: Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec Research Center and Faculty of Pharmacy, Laval University, Québec, Canada.
authors.forename: Veronique
authors.initials: V
authors.lastname: Turcotte
authors.affiliation: Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec Research Center and Faculty of Pharmacy, Laval University, Québec, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Caron
authors.affiliation: Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec Research Center and Faculty of Pharmacy, Laval University, Québec, Canada.
authors.forename: Chantal
authors.initials: C
authors.lastname: Guillemette
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Hyland
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin
keywords: BEEDS; Cancer Risk; Esophageal Neoplasms; Gonadal Steroid Hormones; SHBG