PDF(Pubmed)
Abstract：
Metabolic disturbances and immune alterations caused by diabetes are not just bystanders of HPV infection, but the conclusion that diabetes increases the risk of HPV infection requires more clinical epidemiological evidence to confirm. Our aim was to evaluate the association of diabetes with HPV infection risk in female patients aged over 50 years in the cervical clinic.
We conducted a cross-sectional study of 6402 women aged over 50 years in the cervical clinic between May 2019 and March 2022 from China\'s largest academic woman\'s hospital. The quantitative-effect relationship between diabetes and HPV infection was observed by dose-response graph. Segmented multivariate logistic regression analysis was conducted to estimate the relative risk of HPV infection in diabetes patients. Multivariable predicted marginal proportions from logistic regression models were used to compute adjusted risk ratios.
There is a nonlinear relationship between HbA1c and the risk of HPV infection. When the HbA1c exceeds 5.7%, there is a saturation effect. After adjustment for confounders, the risk ratio for HPV infection in women with prediabetes was 1.09 (95% CI: 1.00-1.18) compared with women with HbA1c <5.7%, and the risk ratio for HPV infection in women with diabetes was 1.18 (95%). CI: 1.04-1.33). Sensitivity analysis showed that the risk ratio for HPV infection was 1.47 (95% CL: 1.07-1.91) when diabetes was associated with vaginitis. E-value analysis suggested robustness to unmeasured confounding.
Diabetes and prediabetes are at increased risk of coinfection with HPV in female patients aged over 50 years in the cervical clinic.
We conducted a cross-sectional study of 6402 women aged over 50 years in the cervical clinic between May 2019 and March 2022 from China\'s largest academic woman\'s hospital. The quantitative-effect relationship between diabetes and HPV infection was observed by dose-response graph. Segmented multivariate logistic regression analysis was conducted to estimate the relative risk of HPV infection in diabetes patients. Multivariable predicted marginal proportions from logistic regression models were used to compute adjusted risk ratios.
There is a nonlinear relationship between HbA1c and the risk of HPV infection. When the HbA1c exceeds 5.7%, there is a saturation effect. After adjustment for confounders, the risk ratio for HPV infection in women with prediabetes was 1.09 (95% CI: 1.00-1.18) compared with women with HbA1c <5.7%, and the risk ratio for HPV infection in women with diabetes was 1.18 (95%). CI: 1.04-1.33). Sensitivity analysis showed that the risk ratio for HPV infection was 1.47 (95% CL: 1.07-1.91) when diabetes was associated with vaginitis. E-value analysis suggested robustness to unmeasured confounding.
Diabetes and prediabetes are at increased risk of coinfection with HPV in female patients aged over 50 years in the cervical clinic.
摘要：
糖尿病引起的代谢紊乱和免疫改变不仅仅是HPV感染的旁观者，但糖尿病增加HPV感染风险的结论需要更多的临床流行病学证据来证实.我们的目的是评估宫颈诊所50岁以上女性患者糖尿病与HPV感染风险的关系。
我们在2019年5月至2022年3月期间，对中国最大的学术女性医院的6402名50岁以上的女性进行了横断面研究。通过剂量-反应图观察糖尿病与HPV感染之间的定量-效应关系。采用分段多因素logistic回归分析评估糖尿病患者HPV感染的相对风险。使用逻辑回归模型的多变量预测边际比例来计算调整后的风险比。
HbA1c与HPV感染风险之间存在非线性关系。当HbA1c超过5.7%时，有饱和效应。在对混杂因素进行调整后，与HbA1c<5.7%的女性相比，糖尿病前期女性HPV感染的风险比为1.09(95%CI:1.00-1.18)，女性糖尿病患者HPV感染的风险比为1.18(95%).CI：1.04-1.33）。敏感性分析表明，当糖尿病与阴道炎相关时，HPV感染的风险比为1.47（95％CL：1.07-1.91）。E值分析表明对不可测量的混杂因素具有鲁棒性。
在宫颈诊所，50岁以上的女性患者中，糖尿病和前驱糖尿病与HPV共感染的风险增加。
我们在2019年5月至2022年3月期间，对中国最大的学术女性医院的6402名50岁以上的女性进行了横断面研究。通过剂量-反应图观察糖尿病与HPV感染之间的定量-效应关系。采用分段多因素logistic回归分析评估糖尿病患者HPV感染的相对风险。使用逻辑回归模型的多变量预测边际比例来计算调整后的风险比。
HbA1c与HPV感染风险之间存在非线性关系。当HbA1c超过5.7%时，有饱和效应。在对混杂因素进行调整后，与HbA1c<5.7%的女性相比，糖尿病前期女性HPV感染的风险比为1.09(95%CI:1.00-1.18)，女性糖尿病患者HPV感染的风险比为1.18(95%).CI：1.04-1.33）。敏感性分析表明，当糖尿病与阴道炎相关时，HPV感染的风险比为1.47（95％CL：1.07-1.91）。E值分析表明对不可测量的混杂因素具有鲁棒性。
在宫颈诊所，50岁以上的女性患者中，糖尿病和前驱糖尿病与HPV共感染的风险增加。
