Serum dioxin, testosterone, and subsequent risk of benign prostatic hyperplasia: A prospective cohort study of Air Force Veterans

Amit Gupta, Norma Ketchum, Claus G. Roehrborn, Arnold Schecter, Corinne C. Aragaki, Joel E Michalek

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Operation Ranch Hand veterans were involved in spraying herbicides, including Agent Orange, during the Vietnam War in 1962-1971; Agent Orange was contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). It has been hypothesized that dioxins may be partially responsible for an increase of male reproductive tract disorders such as testicular cancer, cryptorchidism, and hypospadias. Objectives: In this study, our objective was to assess the effect of serum TCDD concentration on the risk of development of benign prostatic hyperplasia (BPH) and on serum testosterone levels. Methods: This study was a longitudinal, prospective cohort study made up of U.S. Air Force veterans involved in Operation Ranch Hand. Other Air Force veterans who did not spray herbicides were included as comparisons. BPH was determined by medical record review and by medical examinations conducted during the study. Data were available for 971 Ranch Hand and 1,266 comparison veterans. We investigated the relationship between BPH and serum TCDD level using the Cox proportional hazards models adjusted for testosterone levels, body mass index (BMI), and the percentage change in BMI per year. Results: In univariate and multivariate analyses, the risk of BPH decreased with increasing serum TCDD in the comparison group. The multivariate risk ratio for BPH in the comparison group was 0.84 (95% confidence interval, 0.73-0.98). Excluding men with prostate cancer, inflammatory or other prostatic diseases did not substantially alter the association. Serum testosterone levels were inversely associated with serum TCDD levels in both Ranch Hand and comparison groups. Conclusions: TCDD exposure at general population levels is associated with a decreasing risk of BPH with higher exposure levels. TCDD exposure is also negatively associated with serum testosterone levels.

Original languageEnglish (US)
Pages (from-to)1649-1654
Number of pages6
JournalEnvironmental Health Perspectives
Volume114
Issue number11
DOIs
StatePublished - Nov 2006

Fingerprint

Dioxins
Prostatic Hyperplasia
testosterone
Veterans
dioxin
Testosterone
serum
Cohort Studies
Air
Prospective Studies
Serum
Hand
Herbicides
body mass
Body Mass Index
herbicide
cancer
Prostatic Diseases
Hypospadias
Cryptorchidism

Keywords

  • Benign prostatic hyperplasia
  • BPH
  • Dioxins
  • Endocrine disruptors
  • Persistent organic pollutants
  • Ranch Hand
  • TCDD
  • Testosterone
  • Vietnam veterans

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

Serum dioxin, testosterone, and subsequent risk of benign prostatic hyperplasia : A prospective cohort study of Air Force Veterans. / Gupta, Amit; Ketchum, Norma; Roehrborn, Claus G.; Schecter, Arnold; Aragaki, Corinne C.; Michalek, Joel E.

In: Environmental Health Perspectives, Vol. 114, No. 11, 11.2006, p. 1649-1654.

Research output: Contribution to journalArticle

Gupta, Amit ; Ketchum, Norma ; Roehrborn, Claus G. ; Schecter, Arnold ; Aragaki, Corinne C. ; Michalek, Joel E. / Serum dioxin, testosterone, and subsequent risk of benign prostatic hyperplasia : A prospective cohort study of Air Force Veterans. In: Environmental Health Perspectives. 2006 ; Vol. 114, No. 11. pp. 1649-1654.
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abstract = "Background: Operation Ranch Hand veterans were involved in spraying herbicides, including Agent Orange, during the Vietnam War in 1962-1971; Agent Orange was contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). It has been hypothesized that dioxins may be partially responsible for an increase of male reproductive tract disorders such as testicular cancer, cryptorchidism, and hypospadias. Objectives: In this study, our objective was to assess the effect of serum TCDD concentration on the risk of development of benign prostatic hyperplasia (BPH) and on serum testosterone levels. Methods: This study was a longitudinal, prospective cohort study made up of U.S. Air Force veterans involved in Operation Ranch Hand. Other Air Force veterans who did not spray herbicides were included as comparisons. BPH was determined by medical record review and by medical examinations conducted during the study. Data were available for 971 Ranch Hand and 1,266 comparison veterans. We investigated the relationship between BPH and serum TCDD level using the Cox proportional hazards models adjusted for testosterone levels, body mass index (BMI), and the percentage change in BMI per year. Results: In univariate and multivariate analyses, the risk of BPH decreased with increasing serum TCDD in the comparison group. The multivariate risk ratio for BPH in the comparison group was 0.84 (95{\%} confidence interval, 0.73-0.98). Excluding men with prostate cancer, inflammatory or other prostatic diseases did not substantially alter the association. Serum testosterone levels were inversely associated with serum TCDD levels in both Ranch Hand and comparison groups. Conclusions: TCDD exposure at general population levels is associated with a decreasing risk of BPH with higher exposure levels. TCDD exposure is also negatively associated with serum testosterone levels.",
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