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Blood glucose levels and the risk of HPV multiple infections in high-grade squamous intraepithelial lesions: A retrospective cross-sectional study of Chinese patients
Authors:Jie Zhou  Xiang Cai Wei  Hong Yan Xu  Hong Bo Hu  Fan Xiang Li  Wei Juan Zhou  Ye Chen  Zhen Liu
Affiliation:a Jinan University, Guangzhou, Guangdong, China;b Department of gynecology, Yuebei People’s Hospital, Shaoguan, Guangdong, China;c Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Abstract:Besides the controversy of the association of high glycemic index and glycemic load with precancerous cervical lesions, only a few studies have examined the impact of fasting blood glucose levels on human papillomavirus (HPV) multiple infections. In the present study, we appraised the relationship between blood glucose levels and multiple HPV infections in a population of HPV-positive women with cervical high-grade squamous intraepithelial lesions (HSIL). The present study was designed as a cross-sectional correlative analysis. A total of 560 participants with a pathologically confirmed HSIL with HPV infection were included from a hospital in China during January 1, 2018, and December 31, 2019. The target variables and the outcome variables were the glucose levels at the baseline and HPV multiplicity, respectively. The odds ratio and 95% confidence intervals were calculated to estimate the risk of multiple infections via logistic regression analysis. The average age of the 560 participants was 44.63 ± 10.61 years; the nonlinear relationship was detected between the glucose levels and multiplicity of HPV, with an inflection point at 5.4. After adjusting for the full range of variables, the effect sizes and confidence intervals for the left and right sides of the inflection points were found to be 0.379 (0.196–0.732) and 5.083 (1.592–16.229), respectively. In this cross-sectional study, both high and low blood glucose levels increased the risk of multiple HPV infections, demonstrating a U-shaped relationship between the blood glucose levels and multiple HPV infections.
Keywords:association   generalized additive model   glucose   HPV multiple infections
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