Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
School of Medicine, Lishui University, Lishui, China.
J Med Virol. 2024 Feb;96(2):e29444. doi: 10.1002/jmv.29444.
To examine the association between cytomegalovirus (CMV) seropositivity and all-cause mortality in a nationwide cohort of US adults. We obtained data from the National Health and Nutrition Examination Survey III (1988-1994), including 16,547 participants aged 18-90 years old with CMV serology assessments. Mortality status was ascertained until December 2019 using the National Death Index linkage data. The Cox proportional hazard model was applied to estimate the association between CMV seropositivity and mortality. During a median follow-up of 26.3 years, 6,930 deaths were recorded. CMV seropositivity was associated with a higher hazard of all-cause mortality after adjusting for attained age, sex, and ethnicity (HR: 1.22, 95% CI: 1.10, 1.36, p < 0.001). The magnitude of the association attenuated slightly after adjusting further for body mass index, family income, smoking status, diabetes, and self-reported cancer history (HR = 1.11, 95% CI: 1.00, 1.23, p = 0.04). While the association was observed for both men and women, it was only statistically significant among non-Hispanic white people (HR: 1.16, 95% CI: 1.06, 1.26, p = 0.001) but not among other ethnic populations. CMV seropositivity might be an independent risk factor for all-cause mortality among US adults. If the findings are validated in an independent population, further research is needed to unveil the biological mechanisms driving the increased mortality with CMV seropositivity.
为了研究巨细胞病毒（CMV）血清阳性与美国成年人全因死亡率之间的关系，我们从国家健康与营养调查 III 期（1988-1994 年）获得数据，该研究共纳入了 16547 名年龄在 18-90 岁之间、CMV 血清学检查结果为阳性的参与者。通过国家死亡索引链接数据确定截至 2019 年 12 月的死亡率。应用 Cox 比例风险模型估计 CMV 血清阳性与死亡率之间的关联。在中位随访 26.3 年后，记录了 6930 例死亡。在校正了实际年龄、性别和种族后，CMV 血清阳性与全因死亡率升高相关（HR：1.22，95%CI：1.10，1.36，p < 0.001）。进一步校正体重指数、家庭收入、吸烟状况、糖尿病和自我报告的癌症病史后，这种关联的幅度略有减弱（HR = 1.11，95%CI：1.00，1.23，p = 0.04）。虽然这种关联在男性和女性中都存在，但仅在非西班牙裔白人中具有统计学意义（HR：1.16，95%CI：1.06，1.26，p = 0.001），而在其他族裔人群中则无统计学意义。CMV 血清阳性可能是美国成年人全因死亡率的一个独立危险因素。如果这些发现能够在独立人群中得到验证，那么需要进一步研究来揭示导致 CMV 血清阳性与死亡率升高相关的生物学机制。
