Table 3.
Odds ratios (OR) for endometrial cancer associated with the highest quintile vs the lowest quintile (Q5 vs Q1) of circulating androgen/androgen metabolites: modification by age at blood draw and body mass index (BMI)*
| Androgen/Metabolite | Age |
P † | BMI, kg/m2 |
P † | |||
|---|---|---|---|---|---|---|---|
| <60 years (n = 192) | ≥60 years (n = 475) | <25 (n = 235) | 25–29.9 (n = 194) | ≥30 (n = 236) | |||
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |||
| Parent androgens | |||||||
| DHEA | 15.14 (1.73 to 132.36) | 1.61 (0.82 to 3.15) | 5.52 (1.65 to 18.46) | 1.51 (0.52 to 4.44) | 1.02 (0.37 to 2.78) | ||
| Ptrend‡ | 0.04 | 0.30 | .29 | 0.01 | 0.79 | 0.84 | .001 |
| DHEAS | 4.33 (0.99 to 18.87) | 1.26 (0.65 to 2.44) | 3.39 (1.20 to 9.59) | 1.01 (0.36 to 2.82) | 0.51 (0.18 to 1.48) | ||
| Ptrend | 0.17 | 0.72 | .41 | 0.03 | 0.90 | 0.53 | .07 |
| Androstenedione | 4.20 (0.75 to 23.67) | 2.16 (1.14 to 4.08) | 3.01 (1.05 to 8.63) | 2.18 (0.77 to 6.21) | 2.19 (0.78 to 6.13) | ||
| Ptrend | 0.29 | 0.03 | .93 | 0.04 | 0.28 | 0.08 | .56 |
| Testosterone | 0.76 (0.24 to 2.34) | 2.37 (1.25 to 4.46) | 4.87 (1.67 to 14.24) | 0.97 (0.37 to 2.54) | 1.15 (0.42 to 3.19) | ||
| Ptrend | 0.36 | 0.001 | .17 | 0.005 | 0.87 | 0.28 | .09 |
| 5α pathway | |||||||
| 5α-androstanedione | 0.92 (0.34 to 2.50) | 1.15 (0.60 to 2.20) | 1.90 (0.67 to 5.39) | 1.31 (0.51 to 3.38) | 0.98 (0.34 to 2.83) | ||
| Ptrend | 0.72 | 0.30 | .998 | 0.27 | 0.42 | 0.28 | .03 |
| DHT | 1.39 (0.45 to 4.25) | 1.03 (0.54 to 1.95) | 3.36 (1.05 to 10.75) | 0.78 (0.31 to 1.92) | 0.56 (0.21 to 1.46) | ||
| Ptrend | 0.78 | 0.62 | .94 | 0.07 | 0.87 | 0.31 | .04 |
| DHTS | 1.27 (0.44 to 3.69) | 1.15 (0.61 to 2.16) | 2.87 (0.99 to 8.31) | 0.65 (0.24 to 1.73) | 0.93 (0.37 to 2.37) | ||
| Ptrend | 0.30 | 0.95 | .31 | 0.09 | 0.42 | 0.43 | .34 |
| ADT | 1.20 (0.43 to 3.35) | 0.77 (0.41 to 1.46) | 0.62 (0.23 to 1.63) | 0.83(0.31 to 2.17) | 0.83(0.31 to 2.19) | ||
| Ptrend | 0.66 | 0.92 | .71 | 0.51 | 0.62 | 0.88 | .73 |
| ADT-G | 3.21 (0.73 to 14.09) | 1.26 (0.64 to 2.49) | 2.06 (0.65 to 6.56) | 1.40 (0.49 to 4.01) | 0.99 (0.36 to 2.71) | ||
| Ptrend | 0.52 | 0.95 | .48 | 0.19 | 0.87 | 0.46 | .73 |
| 3α-diol-3G | 10.76 (2.01 to 57.57) | 1.29 (0.65 to 2.54) | 2.26 (0.78 to 6.62) | 0.86 (0.28 to 2.59) | 2.37 (0.78 to 7.24) | ||
| Ptrend | 0.11 | 0.69 | .40 | 0.50 | 0.81 | 0.91 | .56 |
| 3α-diol-17G | 1.55 (0.46 to 5.21) | 0.99 (0.51 to 1.93) | 1.46 (0.52 to 4.07) | 0.81 (0.29 to 2.23) | 0.63 (0.18 to 2.17) | ||
| Ptrend | 0.94 | 0.74 | .96 | 0.73 | 0.31 | 0.82 | .55 |
| Marker of androgenic activity | 3.00 (0.67 to 13.36) | 1.40 (0.71 to 2.80) | 1.70 (0.52 to 5.55) | 1.35 (0.47 to 3.90) | 1.28 (0.45 to 3.62) | ||
| Ptrend | 0.65 | 0.94 | .55 | 0.37 | 1.00 | 0.61 | .63 |
| 5β pathway | |||||||
| Etio-G | 2.70 (0.87 to 8.42) | 1.27 (0.67 to 2.40) | 2.06 (0.73 to 5.82) | 3.41 (1.14 to 10.20) | 0.59 (0.24 to 1.46) | ||
| Ptrend | 0.23 | 0.34 | .44 | 0.25 | 0.02 | 0.38 | .20 |
| Parent estrogens | |||||||
| Unconjugated estrone | 1.84 (0.57 to 5.92) | 3.02 (1.55 to 5.88) | 3.34 (1.22 to 9.16) | 1.30 (0.47 to 3.60) | 4.45 (1.17 to 16.95) | ||
| Ptrend | 0.32 | 0.0002 | .58 | 0.01 | 0.38 | 0.03 | .50 |
| Unconjugated estradiol | 4.82 (1.05 to 22.04) | 5.87 (2.67 to 12.87) | 7.26 (2.17 to 24.30) | 2.56 (0.73 to 9.05) | 5.08 (0.81 to 31.96) | ||
| Ptrend | 0.32 | <.0001 | .60 | 0.01 | 0.08 | 0.07 | .98 |
| Ratios | |||||||
| 5α-androstanedione: Androstenedione | 0.60 (0.19 to 1.90) | 0.80 (0.42 to 1.51) | 0.82 (0.30 to 2.29) | 0.86 (0.31 to 2.41) | 0.66 (0.26 to 1.66) | ||
| Ptrend | 0.42 | 0.49 | .96 | 0.41 | 0.96 | 0.68 | .07 |
| Unconjugated estrone: Androstenedione | 1.26 (0.42 to 3.77) | 3.13 (1.49 to 6.58) | 2.20 (0.77 to 6.26) | 1.25 (0.40 to 3.87) | 2.73 (0.81 to 9.23) | ||
| Ptrend | 0.80 | 0.02 | .05 | 0.19 | 0.94 | 0.35 | .99 |
| DHT: Testosterone | 1.05 (0.36 to 3.12) | 0.53 (0.29 to 0.98) | 0.53 (0.19 to 1.46) | 0.83 (0.32 to 2.20) | 0.48 (0.20 to 1.18) | ||
| Ptrend | 0.65 | 0.03 | .39 | 0.15 | 0.98 | 0.14 | .63 |
| Unconjugated estradiol: Testosterone | 3.49 (0.81 to 15.05) | 2.80 (1.39 to 5.63) | 1.41 (0.46 to 4.29) | 2.29 (0.71 to 7.37) | 1.16 (0.19 to 6.97) | ||
| Ptrend | 0.12 | 0.003 | .64 | 0.33 | 0.13 | 0.01 | .23 |
*Unconditional logistic regression models for each androgen/metabolite were used and adjusted for gravidity, smoking status, body mass index, duration of oral contraceptive use, and age at menarche and additionally adjusted for matching factors: age at baseline, year of blood draw, race/ethnicity, time since last menopausal hormone therapy use. Full results for all quintiles are available as Supplementary Material (available online). Comparisons are made to the controls within each model/stratum of the modifiers. ADT = androsterone; ADT-G = ADT-glucuronide; CI = confidence interval; DHEA = dehydroepiandrosterone; DHEAS = dehydroepiandrosterone sulfate; DHT = dihydrotestosterone; DHTS = dihydrotestosterone sulfate; etio-G = etiocholanolone-glucuronide.
χ2P values from the cross-product interaction terms between the modifiers of interest and hormone exposures.
P trend for trend across quintiles of a given hormone/metabolite.