Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 168, Issue 12, Pages 1416-1424Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwn272
Keywords
gonadal steroid hormones; prostatic hyperplasia
Categories
Funding
- National Institutes of Health [DK63303, CA37429, CA18964, CA108964]
- Korean Research Foundation [KRF-2006-214C00100]
- South Korean Ministry of Education
- Human Resources Development (Basic Research Promotion Fund)
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The authors conducted a nested case-control study of serum steroid concentrations and risk of benign prostatic hyperplasia (BPH), using data from the placebo arm of the Prostate Cancer Prevention Trial (1993-2003). Incident BPH over 7 years (n = 708) was defined as receipt of treatment, a report of 2 International Prostate Symptom Score (IPSS) values greater than 14, or 2 increases of 5 or more from baseline IPSS values with at least 1 value greater than or equal to 12. Controls (n = 709) were selected from men who reported no BPH treatment or any IPSS greater than 7. Baseline serum was analyzed for testosterone, estradiol, estrone, 5 alpha-androstane-3 alpha, 17 beta-diol-glucuronide, and sex hormone-binding globulin. Covariate-adjusted odds ratios contrasting the highest quartiles with the lowest quartiles of testosterone, estradiol, and testosterone:17 beta-diol-glucuronide ratio were 0.64 (95% confidence interval (CI): 0.43, 0.95; P-trend = 0.04), 0.72 (95% CI: 0.53, 0.98; P-trend = 0.09), and 0.64 (95% CI: 0.46, 0.89; P-trend = 0.004), respectively. Findings did not differ by age, body mass index, time to BPH endpoint, or type of BPH endpoint. High testosterone levels, estradiol levels, and testosterone:17 beta-diol-glucuronide ratio are associated with reduced BPH risk, which may reflect decreased activity of 5-alpha-reductase. Genetic or environmental factors that affect the activity of 5-alpha-reductase may be important in the development of symptomatic BPH.
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