Department of Obstetrics and Gynecology, Shantou Central Hospital, Shantou, 515000, China.
Department of Anesthesiology, Shantou Central Hospital, Shantou, 515000, China.
BMC Womens Health. 2022 Oct 5;22(1):404. doi: 10.1186/s12905-022-01993-7.
Evidence regarding the relationship between serum vitamin C levels and human papillomavirus (HPV) infection is limited. Therefore, this study aimed to investigate whether serum vitamin C levels are independently associated with HPV infection.
Data for this cross-sectional study were obtained from the National Health and Nutrition Examination Survey 2003-2006. A total of 2174 women, 18-59 years of age, were enrolled in this study. The associations between serum vitamin C levels (continuous and categorical forms) and cervicovaginal HPV infection were estimated using weighted logistic regression.
The adjusted binary logistic regression showed that serum vitamin C was not associated with the risk of HPV infection after adjusting for age, race, poverty income ratio, alcohol consumption, smoking, body mass index, education, and health condition (odds ratio [OR] 0.998, 95% confidence interval [CI] 0.994-1.001). Serum vitamin C levels were converted from a continuous variable to a categorical variable for the analysis. Compared with the vitamin C deficiency and hypovitaminosis groups, there was a negative correlation between vitamin C and HPV infection when vitamin C was adequate (OR 0.7, 95% CI: 0.52-0.94); however, when the serum vitamin C level was inadequate and saturated, this negative correlation was weaker or nonexistent (OR 0.76, 95% CI 0.56-1.03 and OR 0.76, 95% CI 0.55-1.04, respectively). A nonlinear relationship was detected between vitamin C level and HPV infection. Furthermore, we performed subgroup analysis of different models and found that serum vitamin C concentration was negatively associated with HPV infection in women ≥ 25 years of age; however, in women < 25 years of age, serum vitamin C levels were not associated with HPV infection.
The results from this United States nationally representative sample supported the hypothesis that there was a U-shaped relationship between serum vitamin C levels and HPV infection. Future studies are warranted to assess the association between vitamin C and HPV persistence and clarify the underlying mechanisms of these associations.
有关血清维生素 C 水平与人类乳头瘤病毒（HPV）感染之间关系的证据有限。因此，本研究旨在探讨血清维生素 C 水平是否与 HPV 感染独立相关。
本横断面研究的数据来自 2003-2006 年全国健康和营养调查。共纳入 2174 名年龄在 18-59 岁的女性。使用加权逻辑回归估计血清维生素 C 水平（连续和分类形式）与宫颈阴道 HPV 感染之间的关联。
调整年龄、种族、贫困收入比、饮酒、吸烟、体重指数、教育和健康状况后，二元逻辑回归显示血清维生素 C 与 HPV 感染风险无关（比值比 [OR] 0.998，95%置信区间 [CI] 0.994-1.001）。将血清维生素 C 水平从连续变量转换为分类变量进行分析。与维生素 C 缺乏和维生素不足组相比，当维生素 C 充足时，维生素 C 与 HPV 感染呈负相关（OR 0.7，95%CI：0.52-0.94）；然而，当血清维生素 C 水平不足和饱和时，这种负相关较弱或不存在（OR 0.76，95%CI 0.56-1.03 和 OR 0.76，95%CI 0.55-1.04）。检测到维生素 C 水平与 HPV 感染之间存在非线性关系。此外，我们对不同模型进行了亚组分析，发现血清维生素 C 浓度与≥25 岁女性的 HPV 感染呈负相关；然而，在<25 岁的女性中，血清维生素 C 水平与 HPV 感染无关。
来自美国具有代表性的样本的结果支持了血清维生素 C 水平与 HPV 感染之间存在 U 型关系的假设。需要进一步的研究来评估维生素 C 与 HPV 持续感染之间的关联，并阐明这些关联的潜在机制。
