Punchoo Rivak, Dreyer Greta, Pillay Tahir S
Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
Division of Chemical Pathology, Department of Pathology, University of Cape Town, Cape Town 7701, South Africa.
J Clin Med. 2025 May 29;14(11):3817. doi: 10.3390/jcm14113817.
Cervical dysplasia is a pre-malignant condition of the uterine cervix and is highly prevalent in Sub-Saharan Africa; especially affecting HIV-infected Black women. The anti-dysplastic effect of vitamin D hormones in cervical dysplasia is poorly understood. Therefore, we conducted a cross-sectional case-control observational study to assess the relationship between serum 25-hydroxycholecalciferol (25(OH)D) and cervical dysplasia, amongst Black women with and without HIV infection. The study participants attended a gynaecologic oncology clinic at an academic hospital in Pretoria, South Africa ( = 109). Patient clinical data were obtained during consultation. Cervical dysplasia was identified by cytology (PAP smear) which classified the case group as high-grade squamous epithelial lesions (HSILs), and the control group as <HSIL. Serum biochemistry measured 25(OH)D and its covariate biochemical variables. The data were statistically modelled to adjust for clinical and biochemical covariates, identify a significant relationship ( ≤ 0.05) between 25(OH)D and cervical dysplasia, and analyse subgroup interaction between HIV status and cervical dysplasia. The data showed high levels of vitamin D insufficiency and deficiency in Black women with and without HIV infection. After covariate adjustment, 25(OH)D demonstrated an inverse relationship with HSIL in HIV-uninfected Black women. Furthermore, an interaction effect between women with and without HIV infection was observed. The role of 25(OH)D in the primary prevention of cervical dysplasia in Black women without HIV infection is promising, and dosing strategies require investigation. Also, future studies exploring the immunomodulatory role of 25(OH)D in cervical dysplasia in HIV-infected women is warranted.
宫颈发育异常是子宫颈的一种癌前病变，在撒哈拉以南非洲地区非常普遍；尤其影响感染艾滋病毒的黑人女性。维生素D激素在宫颈发育异常中的抗发育异常作用尚不清楚。因此，我们进行了一项横断面病例对照观察研究，以评估血清25-羟基胆钙化醇（25(OH)D）与宫颈发育异常之间的关系，研究对象为感染和未感染艾滋病毒的黑人女性。研究参与者在南非比勒陀利亚一家学术医院的妇科肿瘤诊所就诊（n = 109）。在咨询过程中获取患者临床数据。通过细胞学检查（巴氏涂片）确定宫颈发育异常，将病例组分类为高级别鳞状上皮病变（HSILs），对照组为<HSIL。血清生化检测25(OH)D及其协变量生化变量。对数据进行统计建模，以调整临床和生化协变量，确定25(OH)D与宫颈发育异常之间的显著关系（P≤0.05），并分析艾滋病毒感染状态与宫颈发育异常之间的亚组相互作用。数据显示，感染和未感染艾滋病毒的黑人女性维生素D不足和缺乏水平都很高。在进行协变量调整后，25(OH)D在未感染艾滋病毒的黑人女性中与HSIL呈负相关。此外，观察到感染和未感染艾滋病毒女性之间存在相互作用效应。25(OH)D在未感染艾滋病毒的黑人女性宫颈发育异常一级预防中的作用很有前景，给药策略需要研究。此外，有必要开展未来研究，探索25(OH)D在感染艾滋病毒女性宫颈发育异常中的免疫调节作用。
