血清叶酸和维生素 B12 浓度较高的印度女性，感染致癌或高危（HR）型人乳头瘤病毒（HPV）的风险显著降低。
Indian women with higher serum concentrations of folate and vitamin B12 are significantly less likely to be infected with carcinogenic or high-risk (HR) types of human papillomaviruses (HPVs).
机构信息
Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA;
出版信息
Int J Womens Health. 2010 Aug 9;2:7-12. doi: 10.2147/ijwh.s6522.
BACKGROUND
Studies conducted in the USA have demonstrated that micronutrients such as folate and vitamin B12 play a significant role in modifying the natural history of high-risk human papillomaviruses (HR-HPVs), the causative agent for developing invasive cervical cancer (CC) and its precursor lesions.
OBJECTIVE
The purpose of the current study was to investigate whether these micronutrients have similar effects on HR-HPV infections in Indian women.
METHODS
The associations between serum concentrations of folate and vitamin B12 and HR-HPV infections were evaluated in 724 women who participated in a CC screening study in the southern state of Andhra Pradesh, India. Serum folate and vitamin B12 concentrations were measured by using a competitive radio-binding assay. Digene hybrid capture 2 (HC2) assay results were used to categorize women into two groups, positive or negative for HR-HPVs. Unconditional logistic regression models specified a binary indicator of HC2 (positive/negative) as the dependent variable and serum folate concentrations combined with serum vitamin B12 concentrations as the independent predictor of primary interest. Models were fitted, adjusting for age, education, marital status, parity, type of fuel used for cooking and smoking status.
RESULTS
Women with higher concentrations of serum folate (>6 ng/mL) and vitamin B12 (>356 pg/mL) were at lower risk of being positive for HR-HPVs compared to those with serum folate ≤6 ng/mL and serum vitamin B12 ≤ 356 pg/mL (odds ratio = 0.26; 95% confidence interval: 0.08-0.89; P = 0.03).
CONCLUSIONS
These results demonstrated that improving folate and vitamin B12 status in Indian women may have a beneficial impact on the prevention of CC. Micronutrient based interventions for control of HR-HPV infections may represent feasible alternatives to vaccine based approaches to HPV disease prevention, which are currently unaffordable for use in resource limited areas in rural India.
背景
美国的研究表明，叶酸和维生素 B12 等微量营养素在改变高危型人乳头瘤病毒（HR-HPV）的自然史方面发挥着重要作用，HR-HPV 是导致浸润性宫颈癌（CC）及其前体病变的病原体。
目的
本研究旨在探讨这些微量营养素是否对印度女性的 HR-HPV 感染有类似的影响。
方法
在印度安得拉邦南部进行的 CC 筛查研究中，对 724 名女性进行了血清叶酸和维生素 B12 浓度与 HR-HPV 感染之间关系的研究。采用竞争性放射结合测定法测定血清叶酸和维生素 B12 浓度。使用 Digene 杂交捕获 2（HC2）检测结果将女性分为 HR-HPV 阳性或阴性两组。条件逻辑回归模型将 HC2（阳性/阴性）的二进制指标指定为因变量，血清叶酸浓度和血清维生素 B12 浓度的组合作为主要感兴趣的独立预测因子。模型调整了年龄、教育程度、婚姻状况、生育次数、烹饪燃料类型和吸烟状况。
结果
与血清叶酸浓度≤6ng/ml 和血清维生素 B12 浓度≤356pg/ml 的女性相比，血清叶酸浓度较高（>6ng/ml）和维生素 B12 浓度较高（>356pg/ml）的女性 HR-HPV 阳性的风险较低（比值比=0.26；95%置信区间：0.08-0.89；P=0.03）。
结论
这些结果表明，改善印度女性的叶酸和维生素 B12 状况可能对预防 CC 有有益的影响。基于微量营养素的干预措施可能是控制 HR-HPV 感染的可行替代方案，而基于疫苗的 HPV 疾病预防方法目前在印度农村资源有限的地区无法负担。
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