Health Promotion Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Gynecol Oncol. 2021 May;161(2):559-564. doi: 10.1016/j.ygyno.2021.02.009. Epub 2021 Mar 4.
Few studies have been conducted on the relationship between metabolic syndrome (MetS) and persistent human papillomavirus (HPV) infection. We investigated whether MetS and associated factors can predict the persistence of HPV infection.
We performed a retrospective cohort study of 80,993 female cases undergoing general medical screenings at Samsung Medical Center and 51,140 cases were included in final analysis. MetS and associated factors were used to develop a model predicting the persistence of HPV infection which was defined as HPV positivity for at least one year. The performance of the model was internally validated using bootstrapping and externally validated by testing the risk score against the test set.
Of the 51,140 cases, there were 5833 (11.4%) cases diagnosed with MetS and 7682 (15.0%) cases diagnosed with HPV infection at baseline. The 12- to 24-month persistence rates of HPV were 50.0% (2846/5691). MetS (OR 1.34, 95% CI 1.04-1.71), globulin (by quintile; OR 1.70, 95% CI 1.25-2.30), fibrinogen (x100 value by quintile; OR 1.07, 95% CI 1.02-1.14), total protein (by quintile; OR 0.91, 95% CI 0.84-0.99) and prothrombin time (by quintile; OR 0.94, 95% CI 0.89-0.99) were significantly associated with the persistence of HPV in multivariate analysis. For validation, a prediction model showed good performance for a range of risk scores and categorized cases into low-, intermediate- and high-risk, which were also correlated with HPV persistence (45.8%, 51.9%, and 60.2% respectively, P < 0.001).
MetS and associated factors were associated with an increased risk of persistent HPV infection.
关于代谢综合征（MetS）与持续性人乳头瘤病毒（HPV）感染之间的关系，目前研究较少。本研究旨在探讨 MetS 及其相关因素是否可以预测 HPV 感染的持续性。
我们对在三星医疗中心接受常规体检的 80993 名女性病例进行了回顾性队列研究，最终有 51140 例病例纳入最终分析。采用 MetS 及其相关因素建立预测模型，用于预测 HPV 感染的持续性，HPV 感染持续性定义为 HPV 阳性至少 1 年。采用 Bootstrap 法对模型进行内部验证，并通过测试风险评分与测试集的关系对模型进行外部验证。
在 51140 例病例中，有 5833 例（11.4%）被诊断为 MetS，有 7682 例（15.0%）在基线时被诊断为 HPV 感染。HPV 的 12-24 个月持续性率为 50.0%（2846/5691）。多因素分析显示，MetS（OR 1.34，95%CI 1.04-1.71）、球蛋白（五分位组；OR 1.70，95%CI 1.25-2.30）、纤维蛋白原（五分位组；OR 1.07，95%CI 1.02-1.14）、总蛋白（五分位组；OR 0.91，95%CI 0.84-0.99）和凝血酶原时间（五分位组；OR 0.94，95%CI 0.89-0.99）与 HPV 持续性显著相关。验证结果显示，预测模型在不同风险评分范围内均具有良好的性能，并将病例分为低危、中危和高危，这与 HPV 持续性也有相关性（分别为 45.8%、51.9%和 60.2%，P<0.001）。
MetS 及其相关因素与持续性 HPV 感染风险增加相关。
