Combination of HPV and metabolic syndrome is associated with increased risk of death in women

In a recent study published in the journal pro swanResearchers investigated the association between human papillomavirus (HPV) and metabolic syndrome (MetS) and the impact of these comorbidities on the risk of all-cause mortality in men and women with clinically diagnosed HPV and MetS. Researchers used data from seven consecutive data collection cycles of the U.S. National Health and Nutrition Examination Survey (NHANES), which included more than 5,100 individuals aged 18 to 65 years. On average, follow-up was prolonged. Nine years after initial HPV and MetS diagnosis.

study: Association between human papillomavirus, metabolic syndrome, and all-cause mortality.US NHANES 2003-2004 to 2015-2016 Analysis. Image credit: Kateryna Kon / Shutterstock

Although data analysis shows that HPV (of any type) does not show a direct association with increased all-cause mortality, co-infection with both HPV (especially high-risk subvariants) and MetS is particularly It was found to significantly increase the risk of all-cause mortality. There was a higher proportion of women when compared to the no-HPV/no-MetS sample cohort. This study forms the basis for future research aimed at elucidating the temporal, vaccination status, age, and sexual effects of HPV, thereby paving the way for new interventions against this increasingly prevalent disease. Prepare.

HPV, MetS, and their potential association

Human papillomavirus (HPV) is a collective term for more than 200 closely related strains of viruses, which together cause the world’s most prevalent sexually transmitted infections (STIs). Alarmingly, some HPVs have been found to act as carcinogens in many malignancies, and the lack of treatments for these conditions and the global spread of this disease further heightens the concern. . In the United States alone, it is estimated that 20 million people are living with the disease, and an additional 5.5 million are diagnosed each year.

Of the more than 200 HPVs that have been identified to date, approximately 40 subvariants are known to infect the human reproductive tract. These subvariants are “risk-classified” into “no-risk,” “low-risk,” “intermediate-risk,” and “high-risk” HPV based on whether or not they are carcinogenic. Aside from its carcinogenic potential, science has so far been unable to establish any direct severe clinical outcomes from HPV infection. However, previous studies suggest that HPV is associated with many comorbidities and co-infections, which may even worsen outcomes. Although not formally verified, some studies show that HPV comorbidities may affect his HPV and worsen his cancer risk.

One of the most frequently cited HPV co-infections is metabolic syndrome (MetS), a commonly observed group of cardiovascular diseases including obesity, hypertension, dyslipidemia, and insulin resistance. MetS, an often asymptomatic condition that can remain undiagnosed throughout life, has previously been independently associated with an increased risk of cardiovascular disease (CVD), including heart attack and stroke. It has been. MetS has been reported to increase the prevalence and persistence of HPV. However, the cumulative effects of HPV and MetS, as well as their interrelationships and effects, remain unclear.

About research

This study aims to assess the combined impact of HVP and MetS on all-cause mortality risk in both men and women. Data for this study were obtained from the U.S. National Health and Nutrition Examination Survey (NHANES), a publicly available, long-term, large-cohort population-based study of adult Americans of all ages and ethnicities. . Participants in the current study were selected so that their ages ranged from 18 to 64 years and they had completed data sheets. Data collection included sociodemographic and medical history of participants, a uniform dietary questionnaire, and clinical examination of participants (physical and biological specimens).

The variables examined were age, ethnicity, gender, education, smoking status (nicotine), and health insurance status. Height and weight data were used to calculate body mass index (BMI) for each participant. All HPV and MetS diagnoses were clinically verified. The former used vaginal, penile, and oral swabs, and the latter used measurements of waist circumference, blood pressure (BP), blood sugar, blood triglycerides, or high-density lipoprotein (HDL) cholesterol. . At the same time, both conditions were stratified in terms of cancer risk (HPV) and severity of the condition (MetS).

Descriptive statistics were used to classify HPV subtypes. Multivariate statistics both with and without adjustment for sociodemographic factors were used to assess the influence of clinical and demographic data. Cox proportional hazard ratios were calculated to assess the joint impact of HPV and MetS on all-cause mortality.

research result

Of the 71,058 participants enrolled in the NHANES cohort, 5,101 met study inclusion criteria and were included in the final analysis. Women comprised 64% of the sample cohort, and women aged 18 to 24 years accounted for half of the total number of ‘high-risk HPV’ patients identified. Surprisingly, men in the same age group, particularly those with higher education and non-smokers, were the most ‘HPV-free’ cohort.

“Overall, the majority of the sample exhibited high-risk HPV (35% men, 31% women) or no HPV (34% men, 34% women). All-cause disease with an average follow-up of 9.4 years. There were 240 deaths. Number of deaths (no HPV: n = 46 deaths; low risk: n = 60 deaths; likely: n = 37 deaths, and; high risk: n = 97 deaths). Visual inspection of the survival probability curves suggests a decreased survival rate (p<0.05) between the high-risk HPV group and the high-risk HPV group probability (p<0.05) for men, but no clear relationship was observed for women. (p = 0.97).

Although multivariate statistics show no direct association between HPV (regardless of subtype) and all-cause mortality (no statistical difference between HPV-free and HPV cohorts), either It was revealed that co-infection with MetS factor was found to increase the adverse outcome of cervical cancer. This is especially noticeable in women.

“In the pooled NHANES sample, HPV types 16 and 18 accounted for approximately 22% and 10% of high-risk HPV, respectively, consistent with previous literature. [30, 31], HPV type 16 was the most common high-risk HPV subtype in both men and women. In this sample, high-risk HPV was highest in women between the ages of 18 and 24 and then decreased with age. In contrast, high-risk HPV tended to increase with age in men. ”

Caveats and limitations exist when interpreting these results. The sample is representative of the American population. Differences in health behaviors (particularly diet) in other parts of the world may alter outcomes for those populations. More importantly, significant differences exist in the coverage of sex-specific HPV screening. While all adult American women (and many other nationalities around the world) are encouraged to undergo regular HPV screening and vaccination, men rarely have access to screening. America’s record highlights this contradiction. Sixty percent of American women were tested, compared to only 42% of men. This could lead to an underestimation of men’s mortality risk and bias the study results. Nevertheless, this study lays the foundation for future studies that expand on geographic and demographic factors that can alter HPV cancer risk.

“Future efforts focused on harmonizing HPV-specific datasets and subsequent pooling of NHANES cycles to examine specific HPV subtypes, highly prevalent high-risk HPV subtypes, and HPV-associated cancers. In studies that include a more detailed history of HPV infection and persistence, the temporal, age, vaccination, and gender effects of HPV diagnosis on these relationships may be possible. Further prospective analysis is needed to understand the impact on