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Association of Vitamin D and Parathyroid Hormone With Barrett's Esophagus
Joel H Rubenstein1,2,3, Daniel McConnell4, David G Beer5
1Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center.
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.