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Abstract：
Serum concentration of folate was inversely associated with cervical intraepithelial neoplasia and cervical cancer in some studies. The association between folate and human papillomavirus (HPV) infection, a necessary cause of cervical cancer, has not been well elucidated.
We evaluated whether serum folate concentrations were associated with high-risk HPV (hrHPV) infection.
The study population was 11,801 females, aged 18-59 y, enrolled in the National Health and Nutrition Examination Survey (NHANES), from 2003 to 2016, in the United States. In this cross-sectional study, prevalence ratios (PRs) of vaginal hrHPV were calculated using logistic regression models, by quintiles of serum folate.
Females in the lowest quintile had <21.3 nmol/L of folate. Approximately 23% of the females (2733/11,801) were hrHPV positive. In age-adjusted models, folate was significantly associated with hrHPV infection. The PRs and 95% confidence intervals (CIs) were (PR: 1.52; 95% CI: 1.37, 1.70) for the first, (PR: 1.29; 95% CI: 1.15, 1.44) for the second, (PR: 1.19; 95% CI: 1.06, 1.34) for the third, and (PR: 1.09; 95% CI: 0.96, 1.23) for the fourth quintiles, compared with the females in the highest quintile, with a significant P value for trend, <0.0001. The association remained statistically significant after the models were further adjusted for lifestyle and sexual risk factors for hrHPV infection; the females in the lowest quintile were more likely to have hrHPV infection than those in the highest quintile (PR: 1.40; 95% CI: 1.11, 1.53).
Results from this sample of females in the United States suggest that serum folate concentration is inversely associated with hrHPV infection.
We evaluated whether serum folate concentrations were associated with high-risk HPV (hrHPV) infection.
The study population was 11,801 females, aged 18-59 y, enrolled in the National Health and Nutrition Examination Survey (NHANES), from 2003 to 2016, in the United States. In this cross-sectional study, prevalence ratios (PRs) of vaginal hrHPV were calculated using logistic regression models, by quintiles of serum folate.
Females in the lowest quintile had <21.3 nmol/L of folate. Approximately 23% of the females (2733/11,801) were hrHPV positive. In age-adjusted models, folate was significantly associated with hrHPV infection. The PRs and 95% confidence intervals (CIs) were (PR: 1.52; 95% CI: 1.37, 1.70) for the first, (PR: 1.29; 95% CI: 1.15, 1.44) for the second, (PR: 1.19; 95% CI: 1.06, 1.34) for the third, and (PR: 1.09; 95% CI: 0.96, 1.23) for the fourth quintiles, compared with the females in the highest quintile, with a significant P value for trend, <0.0001. The association remained statistically significant after the models were further adjusted for lifestyle and sexual risk factors for hrHPV infection; the females in the lowest quintile were more likely to have hrHPV infection than those in the highest quintile (PR: 1.40; 95% CI: 1.11, 1.53).
Results from this sample of females in the United States suggest that serum folate concentration is inversely associated with hrHPV infection.
摘要：
背景：在一些研究中，血清叶酸浓度与宫颈上皮内瘤变和宫颈癌呈负相关。叶酸与人乳头瘤病毒（HPV）感染之间的关系，宫颈癌的必要原因，还没有很好地阐明。
目的：我们评估了血清叶酸水平是否与高危型HPV（hrHPV）感染相关。
方法：研究人群为11,801名女性，18-59岁,参加了国家健康和营养检查调查（NHANES），从2003年到2016年，在美国。在这项横断面研究中，使用logistic回归模型计算阴道hrHPV的患病率（PRs），血清叶酸的五分之一。
结果：处于最低五分之一的女性的叶酸含量低于21.3nmol/L。约23%的女性（2,733/11,801），hrHPV阳性。在年龄调整模型中，叶酸与hrHPV感染显著相关。PR和95%置信区间(CI)为(PR:1.52;95%CI:1.37-1.70)（PR：1.29；95%CI：1.15-1.44）第二，（PR：1.19；95%CI：1.06-1.34）第三和（PR：1.09；95%CI：0.96-1.23）第四五分之一，与最高五分之一的女性相比，趋势有显著的p值，<0.0001.在进一步调整hrHPV感染的生活方式和性危险因素后，该关联仍然具有统计学意义；与最高五分之一的女性相比，最低五分之一的女性更可能感染hrHPV（PR：1.40;95％CI：1.11-1.53）。
结论：来自美国女性样本的结果表明，血清叶酸水平与hrHPV感染呈负相关。
目的：我们评估了血清叶酸水平是否与高危型HPV（hrHPV）感染相关。
方法：研究人群为11,801名女性，18-59岁,参加了国家健康和营养检查调查（NHANES），从2003年到2016年，在美国。在这项横断面研究中，使用logistic回归模型计算阴道hrHPV的患病率（PRs），血清叶酸的五分之一。
结果：处于最低五分之一的女性的叶酸含量低于21.3nmol/L。约23%的女性（2,733/11,801），hrHPV阳性。在年龄调整模型中，叶酸与hrHPV感染显著相关。PR和95%置信区间(CI)为(PR:1.52;95%CI:1.37-1.70)（PR：1.29；95%CI：1.15-1.44）第二，（PR：1.19；95%CI：1.06-1.34）第三和（PR：1.09；95%CI：0.96-1.23）第四五分之一，与最高五分之一的女性相比，趋势有显著的p值，<0.0001.在进一步调整hrHPV感染的生活方式和性危险因素后，该关联仍然具有统计学意义；与最高五分之一的女性相比，最低五分之一的女性更可能感染hrHPV（PR：1.40;95％CI：1.11-1.53）。
结论：来自美国女性样本的结果表明，血清叶酸水平与hrHPV感染呈负相关。
