ارتباط ویتامین D با ویروس پاپیلومای انسانی: یک مطالعه مقایسه‌ای

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 مربی گروه مامایی، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه زنان و مامایی، مرکز تحقیقات پیشگیری از بیماری‌های زنان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استادیار گروه آمار زیستی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات سلامت مردان و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: سرطان دهانه رحم، چهارمین سرطان شایع در زنان و ویروس پاپیلومای انسانی، شایع‌ترین عامل خطر آن می­ باشد. مطالعه حاضر با هدف تعیین ارتباط بین سطح سرمی ویتامین D و ویروس پاپیلومای انسانی در زنان مراجعه کننده به بیمارستان­ های دانشگاه علوم پزشکی شهید بهشتی انجام شد.
روش‌کار: این مطالعه مقایسه‌ای در سال 1399 بر روی 140 زن مراجعه کننده به بیمارستان ­های وابسته دانشگاه علوم پزشکی شهید بهشتی تهران انجام گرفت. گروه مورد زنان مبتلا به ویروس پاپیلومای انسانی بودند و گروه شاهد در همان مراکز، زنان غیرمبتلا به این ویروس بر اساس گزارش پاپ‌اسمیر بر پایه مایع بودند. جمع‌آوری اطلاعات پرسشنامه از طریق مصاحبه و تکمیل پرسشنامه گزارش پاپ‌اسمیر و تعیین سطح سرمی ویتامین D انجام شد. تجزیه و تحلیل داده­ ها با استفاده از نرم‌افزار آماری SPSS (نسخه 26) و آزمون­ های من‌ویتنی، تی مستقل، کای دو، دقیق فیشر و رگرسیون لوجستیک انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: بر اساس نتایج رگرسیون لوجستیک با کنترل متغیر­های مداخله‌گر تحصیلات و مصرف قلیان، در گروه شاهد 64 نفر (43/91%) و گروه مورد 70 نفر (100%) سطح ویتامین D کمتر از 20 نانوگرم بر میلی‌لیتر و 6 نفر (57/8%) از گروه شاهد سطح 29-21 نانوگرم بر میلی‌لیتر داشتند. بین سطح ویتامین D و ابتلاء به ویروس پاپیلومای انسانی ارتباط آماری معنی‌داری مشاهده شد (03/4-69/0، 001/0>p، 95% CI، 3/0:OR). با هر 1 نانوگرم بر میلی‌لیتر کاهش سطح ویتامین D، شانس ابتلاء به ویروس پاپیلومای انسانی 3/0 افزایش می ­یافت (001/0>p).
نتیجه­ گیری: در این مطالعه سطح سرمی ویتامین D در زنان مبتلا به ویروس پاپیلومای انسانی پایین‌تر بود، اما به‌دلیل محدودیت­ های پژوهش حاضر، تحقیقات وسیع‌تری در این زمینه نیاز می‌باشد. سطح مطلوب ویتامین D می­ تواند به حفظ و ارتقاء سلامت زنان کمک کند.

کلیدواژه‌ها

عنوان مقاله [English]

Relationship between Vitamin D and Human Papillomavirus Infection: A Comparative Study

نویسندگان [English]

  • Sara Ehsanzade 1
  • Zohre Sheikhan 2
  • Farah Farzaneh 3
  • Malihe Nasiri 4
  • Nahid Khodakarami 5
1 M.Sc. student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Instructor, Department of Midwifery, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Assistant Professor, Department of Biostatics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Assistant Professor, Department of Midwifery and Reproductive Health, Men’s Health & Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Cervical cancer is the fourth common cancer in women and human papillomavirus is the most common risk factor of it. The present study was performed aimed to determine the relationship between Vitamin D and human papillomavirus in women referring to the hospitals of Shahid Beheshti University of Medical Sciences.
Methods: This comparative study was conducted on 140 women referring to the hospitals of Shahid Beheshti University of Medical Sciences of Tehran in 2020. The case group were women with HPV infection and the control group in the same centers were the women with no HPV infection based on liquid based pap smear. Data was collected by interview and completing the questionnaire of Pap smear and measuring serum level of vitamin D. Data were analyzed by SPSS software (version 26) and Mann-Whitney test, independent t, chi-square, Fisher's exact and logistic regression. P<0.05 was considered statistically significant.
Results: Logistic regression results and control of confounding variables of education and hookah consumption showed that 64 women (91.43%) in control group and 70 women (100%) in case group had vitamin D level less than 20 ng/ml and 6 women (8.57%) in control group had vitamin D level of 21-29 ng/ml. There was significant relationship between vitamin D and HPV infection (OR: 0.3, CI: 95%, P<0.001, 0.69-4.03). The risk of HPV infection increased as 0.3 by each 1 ng/ml reduction of vitamin D level.
Conclusion: In the present study, serum level of vitamin D was lower in women with HPV, but due to the limitations of the present study, more extensive research is needed in this regard.  Sufficient vitamin D level can help maintain and promote women's health.

کلیدواژه‌ها [English]

  • Human papillomavirus
  • Iran
  • Vitamin D

مراجع

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer 2015; 136(5):E359-86.
  2. Bruni LB, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, et al. Human papillomavirus and related diseases in the world. Summary report 2015; 20140822.
  3. Kohan S, Taeri K. Effect of educational intervention based on perceived benefits and barriers on human papillomavirus inoculation in vulnerable women: Application of health belief model. Iran J Obstet Gynecol Infertil 2020; 23(7):78-87.
  4. Pouide E, Arefian E, Deldar AA. Evaluation of Human Papilloma Virus (HPV) genotypes diversity in oral cancer lesions of patients in Imam Khomeini Hospital. Pathobiology Research 2016; 19(2):19-27.
  5. Salehifar D, Lotfi R, Akbari KM. Knowledge about cervical cancer, human papilloma virus and attitude towards acceptance of vaccination among female students. Payesh 2015; 14(2):217-26.
  6. Chen AA, Gheit T, Franceschi S, Tommasino M, Clifford GM. Human papillomavirus 18 genetic variation and cervical cancer risk worldwide. Journal of virology 2015; 89(20):10680-7.
  7. Hajibagheri K, Abaszade A, Afrasiabian S, Verdi F, Roshani D, Abdi F, et al. Frequency of human papilloma virus genotypes Among woman with genitalia lesion, Sanandaj, Iran. Scientific Journal of Kurdistan University of Medical Sciences 2018; 23(4):46-52.
  8. Frumovitz M, Goff B, Falk S. Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis. UpToDate [internet]; 2011.
  9. Hoshmndi K, Hoveizi E, Gooraninejad S, Tabandeh M. Comparison of the apoptotic effects of TPSF small molecule and hydroalcoholic extract of Ziziphus spina-christi on cervical cancer cells. KAUMS Journal (FEYZ) 2020; 24(1):21-30.
  10. Asgarlou Z, Tehrani S, Asghari E, Arzanlou M, Naghavi-Behzad M, Piri R, et al. Cervical cancer prevention knowledge and attitudes among female university students and hospital staff in Iran. Asian Pacific Journal of Cancer Prevention: APJCP 2016; 17(11):4921.
  11. Mobini Kesheh M, Kafashi A, Bagheri G, Shahkarami MK, Mohamadi M, Nadji SA. Identification of human papillomavirus type 16 among thinprep samples from 11 provinces of Iran. Iran J Obstet Gynecol Infertil 2013; 16(72):22-8.
  12. Didarloo A, Khalkhali HR, Ghorbani B. Relationship between health belief model and human papillomavirus vaccine intent among female students of Urmia university of medical sciences. Nursing And Midwifery Journal 2020; 17(11):897-906.
  13. Burd EM. Human papillomavirus and cervical cancer. Clinical microbiology reviews 2003;16(1):1-7.
  14. Peluso M, Munnia A, Risso GG, Catarzi S, Piro S, Ceppi M, Giese RW, Brancato B. Breast fine-needle aspiration malondialdehyde deoxyguanosine adduct in breast cancer. Free radical research 2011; 45(4):477-82.
  15. Nabatchian F, Ashteeani M, Noroozi A. The Effect of Combined Vitamin Supplements Compared with Single Vitamins D3, A, E in Reducing Oxidative Stress in Female Mice with Breast Cancer. Payavard-Salamat 2016; 10(2):119-32.
  16. Bochen F, Balensiefer B, Körner S, Bittenbring JT, Neumann F, Koch A, et al. Vitamin D deficiency in head and neck cancer patients–prevalence, prognostic value and impact on immune function. Oncoimmunology 2018; 7(9):e1476817.
  17. Ness RA, Miller DD, Wei LI. The role of vitamin D in cancer prevention. Chinese journal of natural medicines 2015; 13(7):481-97.
  18. Goodarzi A, Farshidzadeh M, Roohaninasab M, Atefi N, Behrangi E. Assessment of serum vitamin D level in patients with cutaneous warts: a case-control study. Iranian Journal of Dermatology 2020; 23(2):64-71.
  19. Shim J, Perez A, Symanski E, Nyitray AG. Association between serum 25-hydroxyvitamin D level and human papillomavirus cervicovaginal infection in women in the United States. The Journal of infectious diseases 2016; 213(12):1886-92.
  20. Özgü E, Yılmaz N, Başer E, Güngör T, Erkaya S, İbrahim Yakut H. Could 25-OH vitamin D deficiency be a reason for HPV infection persistence in cervical premalignant lesions?. Journal of experimental therapeutics & oncology 2016; 11(3).
  21. Malakouti J, Mirghafourvand M, Gorbani M, Salehi Poormehr H, Pourasad Shahrak S, Jafari Shabiri M. Incidence of Human Papilloma Virus (HPV) infection and its relevant factors among women referring to Alzahra Therapeutic-Educational Center of Tabriz, September 2013 to March 2014. Iran J Obstet Gynecol Infertil 2016; 18(185):16-22.
  22. Troja C, Hoofnagle AN, Szpiro A, Stern JE, Lin J, Winer RL. Serum concentrations of emerging vitamin D biomarkers and detection of prevalent high-risk HPV infection in mid-adult women. Cancer Epidemiology, Biomarkers & Prevention 2020; 29(7):1468-74.
  23. Hosono S, Matsuo K, Kajiyama H, Hirose K, Suzuki T, Kawase T, et al. Association between dietary calcium and vitamin D intake and cervical carcinogenesis among Japanese women. European journal of clinical nutrition 2010; 64(4):400-9.
  24. Kumar S, Biswas M, Jose T. HPV vaccine: Current status and future directions. medical journal armed forces india 2015; 71(2):171-7.
  25. Vahedpoor Z, Jamilian M, Bahmani F, Aghadavod E, Karamali M, Kashanian M, et al. Effects of long-term vitamin D supplementation on regression and metabolic status of cervical intraepithelial neoplasia: a randomized, double-blind, placebo-controlled trial. Hormones and Cancer 2017; 8(1):58-67.
  26. Schulte-Uebbing C, Schlett S, Craiut ID, Antal L, Olah H. Chronical cervical infections and dysplasia (CIN I, CIN II): Vaginal vitamin D (high dose) treatment: A new effective method?. Dermato-endocrinology 2014; 6(1):e983684.
  27. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006; 311(5768):1770-3.
  28. Barlow PG, Svoboda P, Mackellar A, Nash AA, York IA, Pohl J, et al. Antiviral activity and increased host defense against influenza infection elicited by the human cathelicidin LL-37. PloS one 2011; 6(10):e25333.
  29. Liu PT, Stenger S, Tang DH, Modlin RL. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. The journal of immunology 2007; 179(4):2060-3.
  30. Nseir W, Taha M, Nemarny H, Mograbi J. The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. International Journal of Infectious Diseases 2013; 17(12):e1121-4.
  31. Frew L, Makieva S, McKinlay AT, McHugh BJ, Doust A, Norman JE, et al. Human cathelicidin production by the cervix. PloS one 2014; 9(8):e103434.
  32. Horne AW, Stock SJ, King AE. Innate immunity and disorders of the female reproductive tract. Reproduction 2008; 135(6):739-49.
  33. Iwasaki A. Antiviral immune responses in the genital tract: clues for vaccines. Nature Reviews Immunology 2010; 10(10):699-711.
  34. Buck CB, Day PM, Thompson CD, Lubkowski J, Lu W, Lowy DR, et al. Human α-defensins block papillomavirus infection. Proceedings of the National Academy of Sciences 2006; 103(5):1516-21.
  35. Stanley MA. Immune responses to human papilloma viruses. Indian Journal of Medical Research 2009; 130(3):266-76.
  36. Hewison M, Zehnder D, Chakraverty R, Adams JS. Vitamin D and barrier function: a novel role for extra-renal 1α-hydroxylase. Molecular and cellular endocrinology 2004; 215(1-2):31-8.
  37. Herfs M, Hubert P, Moutschen M, Delvenne P. Mucosal junctions: open doors to HPV and HIV infections?. Trends in microbiology 2011; 19(3):114-20.
  38. Díaz L, Díaz-Muñoz M, García-Gaytán AC, Méndez I. Mechanistic effects of calcitriol in cancer biology. Nutrients 2015; 7(6):5020-50.
  39. Campbell MJ, Gombart AF, Kwok SH, Park S, Koeffler HP. The anti-proliferative effects of 1α, 25 (OH) 2D3 on breast and prostate cancer cells are associated with induction of BRCA1 gene expression. Oncogene 2000; 19(44):5091-7.
  40. Kizildag S, Ates H, Kizildag S. Treatment of K562 cells with 1, 25-dihydroxyvitamin D3 induces distinct alterations in the expression of apoptosis-related genes BCL2, BAX, BCLXL, and p21. Annals of hematology 2010; 89(1):1-7.
  41. Pruitt SL, Shim MJ, Mullen PD, Vernon SW, Amick III BC. Association of area socioeconomic status and breast, cervical, and colorectal cancer screening: a systematic review. Cancer epidemiology, biomarkers & prevention 2009; 18(10):2579-99.
  42. Singh GK, Azuine RE, Siahpush M. Global inequalities in cervical cancer incidence and mortality are linked to deprivation, low socioeconomic status, and human development. International Journal of MCH and AIDS 2012; 1(1):17-30.
  43. Peterson LA, Urban AM, Hecht SS. Carcinogenic effects of cigarette smoke on the respiratory tract. Comprehensive Toxicology 2010; 8:351-77.
مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 9
آذر 1401
صفحه 79-86

فایل ها

هم رسانی

ارجاع به این مقاله

آمار