Association of Vitamin D and Parathyroid Hormone With Barrett's Esophagus.
J Clin Gastroenterol 2019;
53:711-716. [PMID:
30180151 PMCID:
PMC6395569 DOI:
10.1097/mcg.0000000000001124]
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Abstract
BACKGROUND
Esophageal adenocarcinoma has been inversely associated with exposure to ultraviolet radiation. This could be because of vitamin D deficiency or hyperparathyroidism promoting gastroesophageal reflux disease (GERD) and Barrett's esophagus.
AIM
The aim of this study is to determine the association between parathyroid hormone (PTH) and vitamin D deficiency with GERD symptoms, erosive esophagitis, and Barrett's esophagus.
METHODS
We assayed banked serum for PTH and total 25-hydroxy vitamin D from a cross-sectional cohort. Logistic regression was performed to estimate the associations of vitamin D deficiency and hyperparathyroidism with GERD symptoms, erosive esophagitis, and Barrett's esophagus.
RESULTS
Sera from 605 men were assayed, including 150 with GERD, 216 with erosive esophagitis, 145 with Barrett's esophagus, and 174 normal subjects. Contrary to our hypothesis, we found a strong inverse association between Barrett's esophagus and hyperparathyroidism (odds ratio=0.516; 95% confidence interval=0.265, 1.01), and a trend toward an inverse association with vitamin D deficiency. We found no association between vitamin D deficiency or hyperparathyroidism with GERD symptoms or erosive esophagitis.
CONCLUSIONS
Contrary to our hypothesis, we found an inverse association between serum PTH and Barrett's esophagus. Validation of the finding and the mechanism of that association deserves further study.
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