Moore Kristen R, Smith Jennifer S, Cole Stephen R, Schoenbach Victor J, Schlusser Katherine, Gaydos Charlotte A, Baird Donna D
Am J Epidemiol. 2016 Jun 1;183(11):961-8. doi: 10.1093/aje/kwv313. Epub 2016 May 8.
For decades reproductive tract infections (RTIs) have been hypothesized to play a role in uterine fibroid development. The few previous studies conducted used self-reported history of RTIs and had inconsistent findings. We investigated this hypothesis further using serological analysis, an immunological measure of past exposure. We focused on herpes simplex virus type 2 (HSV-2) because prior published data have suggested a possible association with fibroids, and serology for HSV-2 is much more sensitive than self-report. We used cross-sectional enrollment data from African-American women enrolled in a prospective study of fibroid incidence and growth (recruited 2010-2012) in the Detroit, Michigan, area. The women were aged 23-34 years and were screened for fibroids using a standardized ultrasound examination at their enrollment. Age- and multivariable-adjusted logistic regression models were used to estimate odds ratios. Of 1,696 participants, 1,658 had blood samples and HSV-2 serology results; 22% of participants with serology results had fibroids. There was no significant association between HSV-2 seropositivity and the presence of fibroids (multivariable-adjusted odds ratio = 0.94, 95% confidence interval: 0.73, 1.20), nor were there any associations with size of the largest fibroid, number of fibroids, or total fibroid volume. Our data provide no evidence for an influence of HSV-2 exposure on fibroid risk in young African-American women. Further study of other serologically measured RTIs is warranted.
几十年来,一直有人提出生殖道感染(RTIs)在子宫肌瘤的发生发展中起作用。此前进行的少数研究使用了自我报告的生殖道感染病史,结果并不一致。我们使用血清学分析(一种过去接触情况的免疫测量方法)进一步研究了这一假设。我们重点关注2型单纯疱疹病毒(HSV - 2),因为先前发表的数据表明它可能与子宫肌瘤有关,而且HSV - 2的血清学检测比自我报告更敏感。我们使用了来自参与密歇根州底特律地区一项子宫肌瘤发病率和生长情况前瞻性研究(2010 - 2012年招募)的非裔美国女性的横断面登记数据。这些女性年龄在23 - 34岁之间,登记时通过标准化超声检查筛查子宫肌瘤。使用年龄和多变量调整的逻辑回归模型来估计比值比。在1696名参与者中,1658人有血样和HSV - 2血清学检测结果;有血清学检测结果的参与者中22%患有子宫肌瘤。HSV - 2血清阳性与子宫肌瘤的存在之间没有显著关联(多变量调整后的比值比 = 0.94,95%置信区间:0.73,1.20),与最大肌瘤的大小、肌瘤数量或肌瘤总体积也没有关联。我们的数据没有提供证据表明HSV - 2暴露对年轻非裔美国女性患子宫肌瘤的风险有影响。有必要进一步研究其他通过血清学检测的生殖道感染。