Gonadotrophic hormones hold clue to Barrett’s oesophagus, oesophageal adenocarcinoma risk

Elevated predicted levels of follicle-stimulating and luteinizing hormones are associated with a lower risk of Barrett’s oesophagus (BE), oesophageal adenocarcinoma (EAC), according to the results of a Mendelian randomization analysis.

The analysis used data from an international consortia of genome-wide association studies in Australia, Europe, and North America and included 2,488 EAC patients (mean age, 65.1 years), 3,247 BE patients (mean age, 63.1 years), and 2,127 healthy controls (mean age, 61.7 years).

There were more men than women across all groups. Compared with control participants, patients with EAC and BE were more likely to have recurrent reflux symptoms, higher body mass index, and were ever smokers.

According to estimates, higher genetically predicted levels of follicle-stimulating hormones conferred increased likelihood of EAC and/or BE in men (per allele increase: odds ratio [OR], 1.14, 95 percent confidence interval [CI], 1.01–1.27) and in women (OR, 1.28, 95 percent CI, 1.03–1.59).

Results were the same for luteinizing hormone, where elevated predicted levels were linked to a reduced risk of EAC in men (per SD increase: OR, 0.92, 95 percent CI, 0.87–0.99) and in women (OR, 0.93, 95 percent CI, 0.79–1.09), and to lower odds of BE (OR, 0.88, 95 percent CI, 0.77–0.99) and EAC and/or BE (OR, 0.89, 95 percent CI, 0.79–1.00) in women.

There were no clear associations for other hormones examined, including sex hormone–binding globulin, dehydroepiandrosterone sulfate, testosterone, dihydrotestosterone, oestradiol, progesterone, or free androgen index.