From the Department of Epidemiology.
University of Nairobi Institute of Tropical & Infectious Diseases (UNITID).
Sex Transm Dis. 2019 Jan;46(1):31-36. doi: 10.1097/OLQ.0000000000000905.
Some studies suggest that higher body mass index is associated with increased susceptibility to bacterial vaginosis (BV), but results are conflicting.
Female sex workers aged 16 to 45 years and participating in an open, prospective cohort study in Mombasa, Kenya between 2000 and 2014 were included in this analysis. Up to 2 years of follow-up were included per woman. Body mass index (BMI) was categorized as underweight (≤18.5), normal (18.5-24.9), overweight (25-29.9), and obese (≥30). Bacterial vaginosis was assessed using Nugent scores. Generalized estimating equations were used to estimate relative risks of the association between BMI and BV.
At baseline, 32.1% (n = 625) of 1946 women had BV. Half of women were overweight (31.1%, n = 606) or obese (20.1%, n = 391). Participants contributed 14,319 follow-up visits. Adjusting for age, compared to women with normal BMI, overweight (adjusted relative risk, 0.91; 95% confidence interval, 0.81-1.02) and obese (adjusted relative risk, 0.82; 95% confidence interval, 0.71-0.94) women were at lower risk for BV (joint P = 0.03).
Obese women had a nearly 20% lower risk of BV compared with women with normal BMI. Potential mechanisms for this effect, including possible effects of diet, obesity-associated changes in the gut microbiome, and systemic estrogen levels, should be explored.
一些研究表明，较高的体重指数与细菌性阴道病（BV）的易感性增加有关，但结果存在矛盾。
本分析纳入了 2000 年至 2014 年间在肯尼亚蒙巴萨参与一项开放、前瞻性队列研究的年龄在 16 至 45 岁的女性性工作者。每位女性最多随访 2 年。体重指数（BMI）分为消瘦（≤18.5）、正常（18.5-24.9）、超重（25-29.9）和肥胖（≥30）。使用 Nugent 评分评估细菌性阴道病。使用广义估计方程估计 BMI 与 BV 之间关联的相对风险。
在基线时，1946 名女性中有 32.1%（n=625）患有细菌性阴道病。一半的女性超重（31.1%，n=606）或肥胖（20.1%，n=391）。参与者共提供了 14319 次随访。调整年龄后，与 BMI 正常的女性相比，超重（调整后的相对风险，0.91；95%置信区间，0.81-1.02）和肥胖（调整后的相对风险，0.82；95%置信区间，0.71-0.94）女性患细菌性阴道病的风险较低（联合 P=0.03）。
与 BMI 正常的女性相比，肥胖女性患细菌性阴道病的风险低近 20%。应该探索这种影响的潜在机制，包括饮食的可能影响、肥胖相关的肠道微生物组变化和全身雌激素水平。
