Abstract

Alcohol intake may influence breast cancer risk in women through hormonal changes, but the evidence to date is inconclusive. We investigated cross-sectional associations between habitual alcohol intake and serum concentrations of testosterone, sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IGF-1), and estradiol (premenopausal women only) in UK Biobank. We included 30,557 premenopausal and 134,029 postmenopausal women aged between 40 and 69 years when recruited between 2006 and 2010. At their initial assessment visit, habitual alcohol intake was assessed using a touchscreen questionnaire, and serum hormone concentrations were assayed. Multivariable linear regression analysis was performed. Per 10 g/day increment in alcohol intake, testosterone concentration was 3.9% [95% confidence intervals (CI): 3.3%-4.5%] higher in premenopausal women and 2.3% (1.8%-2.7%) higher in postmenopausal women (P heterogeneity < 0.0001); SHBG concentration was 0.7% (0.2%-1.1%) higher in premenopausal women and 2.4% (2.2%-2.6%) lower in postmenopausal women (P heterogeneity < 0.0001); and IGF-1 concentration was 1.9% (1.7%-2.1%) lower in premenopausal women and 0.8% (0.6%-0.9%) lower in postmenopausal women (P heterogeneity < 0.0001). In premenopausal women, there was no significant overall association of alcohol with estradiol but a positive association was observed in the early and mid-luteal phases: 1.9% (95% CI: 0.2%-3.6%) and 2.4% (95% CI: 0.7%-4.2%) higher, respectively. This study confirms significant but modest associations between alcohol intake and hormones, with evidence of heterogeneity by menopausal status. The findings facilitate better understanding of whether alcohol intake influences hormone concentrations, but further work is necessary to fully understand the mechanisms linking alcohol with cancer risk.

Highlights

  • Alcohol use is prevalent in many countries globally [1] and is a leading risk factor for several diseases including cancer [2]

  • Total and calculated free testosterone In both pre- and postmenopausal women, habitual alcohol intake was positively associated with testosterone concentrations (Table 2; Fig. 1; Supplementary Table S2)

  • The association of alcohol intake with total testosterone was significantly greater in premenopausal than in postmenopausal women (Pheterogeneity < 0.0001)

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Summary

Introduction

Alcohol use is prevalent in many countries globally [1] and is a leading risk factor for several diseases including cancer [2]. Circulating estrogens, androgens, and insulin-like growth factor 1 (IGF-1) have been associated with an increased risk of breast cancer in women, whereas sex hormone-binding globulin (SHBG) is inversely associated with the risk [7,8,9,10]. Breast cancer is related to alcohol intake [11, 12], suggesting that hormones, if influenced by the latter, may at least in part explain this effect. Alcohol intake may influence breast cancer risk in women through hormonal changes, but the evidence to date is inconclusive. We investigated cross-sectional associations between habitual alcohol intake and serum concentrations of testosterone, sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IGF-1), and estradiol (premenopausal women only) in UK Biobank

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