摘要
目的:探讨血清25-羟-维生素D[25-(OH)D]与持续性高危型人乳头状瘤病毒(HR-HPV)感染的相关性。方法:选取2016年6月-2019年5月HR-HPV感染女性900例,均检测血清25-(OH)D。随访2年,统计持续性HR-HPV感染发生率。通过电子病历系统收集入选患者资料,根据最邻近匹配法对持续性HR-HPV感染患者和无持续性HR-HPV感染患者进行1:1匹配,logistic回归模型计算评分值。分析血清25-(OH)D与持续性HR-HPV感染的关系,绘制受试者工作特征曲线(ROC)分析25-(OH)D对持续性HR-HPV感染的评估价值。应用限制性立方样条模型(RCS)分析血清25-(OH)D与持续性HR-HPV感染是否存在非线性相关。结果:900例患者随访2年,有效随访685例,随访率76.1%,出现持续性HR-HPV感染103例,发生率为15.0%。倾向性评分匹配后,持续性HR-HPV感染者宫颈炎、性伴侣数、宫颈癌家族史、HPV分型、血清25-(OH)D水平与无持续性HR-HPV感染患者比较,差异有统计学意义(P<0.05)。经logsitic回归模型分析发现,调整混杂因素后血清25-(OH)D水平仍是持续性HR-HPV感染独立危险因素(P<0.05)。血清25-(OH)D评估持续性HR-HPV感染的AUC值为0.823,对应敏感度为70.6%,特异度为82.4%。血清25-(OH)D与持续性HR-HPV感染率呈非线性剂量-反应关系(P=0.039),曲线拐点位于50 ng/ml处,当25-(OH)D≤50 ng/ml时,25-(OH)D与持续性HR-HPV感染率呈负相关(β=-2.226,95%CI 0.218~0.681,P=0.008)。结论:血清25-(OH)D是持续性HR-HPV感染的独立保护因素,与持续性HR-HPV感染率呈非线性剂量-反应关系,可作为判断持续性HR-HPV感染风险的参考指标。
Objective:To analyze the correlation between the serum 25-hydroxyvitamin D[25-(OH)D]level of women and their persistent high-risk human papilloma virus(HR-HPV)infection.Methods:A total of 900 women with HR-HPV infection were selected in this study from June 2016 to May 2019.The serum 25-(OH)D level of these women was detected.The incidence of persistent HR-HPV infection of the women within 2 years of follow-up was counted.The data of these women were collected by the electronic medical record system,and 1:1 matching was performed between the women with persistent HR-HPV infection and the women without persistent HR-HPV infection according to the nearest matching method.The score of the women was calculated by logistic regression model.The correlation between the serum 25-(OH)D level of the women and their persistent HR-HPV infection was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the value of 25-(OH)D level of the women for evaluating their persistent HR-HPV infection.Restricted cubic splines(RCS)model was used to analyze the nonlinear correlation between the serum 25-(OH)D level of the women and their persistent HR-HPV infection.Results:900 women with HR-HPV infection were followed up for two years,and 685women had been effectively followed up,with the followup rate of 76.1%.There were 103 women with persistent HR-HPV infection,with an incidence of 15.0%.After propensity score matching,there were significant differences in the cervicitis rate,the number of sexual partners,the family history of cervical cancer,the HPV typing,and the serum 25-(OH)D level between the women with persistent HR-HPV infection and the women without persistent HR-HPV infection(P<0.05).Logistic regression analysis showed that the serum 25-(OH)D level of the women was still an independent risk factor for their persistent HR-HPV infection after adjusting the confounding factors(P<0.05).The AUC value,the sensitivity,and the specificity of the serum 25-(OH)D level of the women for evaluating their persistent HR-H
作者
毛惠娟
黄国琴
杨棹霞
叶火红
MAO Huijuan;HUANG Guoqin;YANG Zhaoxia;YE Huohong(Nantong Second People's Hospital,Nantong,Jiangsu Province,226002;Nantong Maternal and Child Health Hospital;Xianfeng Street Health Service Center,Tongzhou District,Nantong,Jiangsu Province)
出处
《中国计划生育学杂志》
2023年第11期2758-2764,共7页
Chinese Journal of Family Planning
基金
江苏省南通市基础科学研究和社会民生科技计划项目(MSZ21070)
江苏省南通市基础科学研究和社会民生科技计划项目(MSZ2022008)。
