Huang Xin, Zhao Qun, Yang Pingting, Li Ying, Yuan Hong, Wu Liuxin, Chen Zhiheng
From the Department of Preventive Medicine, School of Medicine, Hunan Normal University (XH); Department of Health Management (XH, QZ, PY, LW, ZC); Department of Health Management (XH, QZ, PY, LW, ZC); Department of Clinical Pharmacology Center (YL, YH); the Third Xiangya Hospital, Central South University, Changsha, Hunan; and Institute of Aviation Medicine (LW), Beijing, China.
Medicine (Baltimore). 2016 Mar;95(9):e2905. doi: 10.1097/MD.0000000000002905.
Few studies have been conducted on the relationship between metabolic syndrome (MetS) and cervical human papillomavirus (HPV) incidence and persistent infection. We performed a prospective cohort study including 8598 female employees in Hunan, China. First, the subjects were stratified into HPV-negative (N = 7282) and HPV-positive (N = 1316) subgroups, according to the results of an HPV DNA test at baseline. Second, comparisons of the risks of HPV incident and persistent infection between MetS-positive (exposed) and MetS-negative (unexposed) groups were conducted among the HPV-negative and -positive subgroups, respectively. There were 976 (11.39%) subjects diagnosed with MetS and 1316 subjects diagnosed with HPV infection at baseline. The 12-month cumulative incidence of any type of HPV and high-risk type HPV were 7.28% (530/7282) and 6.26% (456/7282), respectively. Obesity was a modifier of the association between MetS and HPV incident infection. As long as obesity presented, MetS and hypertriglyceridemia were significantly associated with an increased risk of HPV incident infection (any-type or high-risk type) (adjusted risk ratios (RR) were 2.88 (95% confidence interval (CI): 1.16, 7.19) and 3.29 (95% CI: 1.47, 7.38), respectively). Among those infected with HPV at baseline, the 12-month type-specific persistence rates were 51.67% and 53.38% for any-type and high-risk type HPV, respectively. No interaction was found between obesity and MetS with regard to the risk of HPV persistence. After adjustment for confounding factors, MetS was still associated with increased risk of any-type HPV persistence (RRadj = 1.21, 95% CI: 1.05, 1.41) and high-risk type HPV persistence (RRadj = 1.25, 95% CI: 1.09, 1.46). No single metabolic component was associated with the risk of HPV persistence. The prevalence of MetS was 11.39% among the Hunan female occupational population. MetS was associated with an increased risk of persistent cervical HPV infection and also with an increased risk of HPV incident infection when obesity presented as well.
关于代谢综合征（MetS）与宫颈人乳头瘤病毒（HPV）感染率及持续感染之间的关系，相关研究较少。我们开展了一项前瞻性队列研究，纳入了中国湖南的8598名女性雇员。首先，根据基线时HPV DNA检测结果，将研究对象分为HPV阴性（N = 7282）和HPV阳性（N = 1316）亚组。其次，分别在HPV阴性和阳性亚组中，比较MetS阳性（暴露组）和MetS阴性（非暴露组）人群发生HPV感染及持续感染的风险。基线时，有976名（11.39%）受试者被诊断为MetS，1316名受试者被诊断为HPV感染。任何类型HPV和高危型HPV的12个月累积感染率分别为7.28%（530/7282）和6.26%（456/7282）。肥胖是MetS与HPV新发感染之间关联关系的一个修饰因素。只要存在肥胖，MetS和高甘油三酯血症就与HPV新发感染（任何类型或高危型）风险增加显著相关（调整风险比（RR）分别为2.88（95%置信区间（CI）：1.16，7.19）和3.29（95%CI：1.47，7.38））。在基线时感染HPV的人群中，任何类型HPV和高危型HPV的12个月型特异性持续感染率分别为51.67%和53.38%。在HPV持续感染风险方面，未发现肥胖与MetS之间存在交互作用。在对混杂因素进行调整后，MetS仍与任何类型HPV持续感染风险增加相关（调整后RR = 1.21，95%CI：1.05，1.41）以及高危型HPV持续感染风险增加相关（调整后RR = 1.25，95%CI：1.09，1.46）。没有单一的代谢组分与HPV持续感染风险相关。在湖南女性职业人群中，MetS的患病率为11.39%。MetS不仅与宫颈HPV持续感染风险增加相关，在存在肥胖的情况下还与HPV新发感染风险增加相关。
