Abstract
The purpose was to elucidate the interplay between current smoking, anthropometric measurements, and endogenous hormone levels in women ≤ 40 years. Questionnaires on lifestyle and reproductive factors were completed by 269 healthy women from high-risk breast cancer families between 1996 and 2006 in Sweden. Blood samples for analyses of plasma testosterone, estradiol, androstenedione, sex hormone-binding globulin, and body measurements were obtained 5–10 days before predicted onset of the next menstrual period. Women without smoking status, who were currently breastfeeding, or using hormonal contraception other than combined oral contraceptives (OCs) were excluded (n = 27). Current smokers (n = 57) had larger waist circumference (adjp = 0.004) and waist-to-hip ratio (WHR) (adjp = 0.007) than non-smokers (n = 185). In non-OC users, adjusted mean androstenedione levels were higher in current smokers compared with non-smokers (10.3 vs. 8.6 nmol/L; adjp = 0.0002). While in current OC users estradiol levels were higher in smokers compared with non-smokers (22.5 vs. 17.4 pg/mL; adjp = 0.012). In multivariable models, WHR was associated with both current smoking (adjp ≤ 0.016) and higher levels of androstenedione (adjp = 0.05) or bioavailable testosterone (adjp = 0.001). Among non-OC users, a more androgenic profile was observed in current smokers compared with non-smokers, but not in current OC users. Irrespective of OC use, current smoking was associated with increased waist circumference.
Highlights
Cigarette smoke is considered a carcinogen, which causes lung cancer as well as several other types of cancer, including pancreatic, liver, ovarian, cervical, and uterine cancers [1]
Because breast cancer develops long before the tumor is clinically detectable, the purpose of this study was to elucidate the interplay between current smoking and anthropometric measurements, as well as their relationship with endogenous hormone levels in young healthy women, with or without current oral contraceptives (OCs) use, at a time point when breast cancer might be initiated
The main finding of this study was that current smoking was associated with a more androgenic profile in non-OC users, and larger waist circumference and larger waist-to-hip ratio (WHR) irrespective of current OC status
Summary
Cigarette smoke is considered a carcinogen, which causes lung cancer as well as several other types of cancer, including pancreatic, liver, ovarian, cervical, and uterine cancers [1]. Whether cigarette smoke causes breast cancer has been heavily debated [2, 3]. An animal study in female baboons showed that administering nicotine at doses equivalent to that of an average smoker inhibited aromatase function by close to 50% [7, 8]. Studies in postmenopausal women have indicated increased testosterone levels in current smokers compared with non-smokers [9]. Estradiol, testosterone, and sex hormone-binding globulin (SHBG) levels increased with increasing cigarette smoke exposure [9, 10].
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