Metabolic syndrome and persistent cervical human papillomavirus infection

Objective: Few studies have been conducted on the relationship between metabolic syndrome (MetS) and persistent human papillomavirus (HPV) infection. We investigated whether MetS and associated factors can predict the persistence of HPV infection. Patients and methods: We performed a retrospective cohort study of 80,993 female cases undergoing general medical screenings at Samsung Medical Center and 51,140 cases were included in final analysis. MetS and associated factors were used to develop a model predicting the persistence of HPV infection which was defined as HPV positivity for at least one year. The performance of the model was internally validated using bootstrapping and externally validated by testing the risk score against the test set. Results: Of the 51,140 cases, there were 5833 (11.4%) cases diagnosed with MetS and 7682 (15.0%) cases diagnosed with HPV infection at baseline. The 12- to 24-month persistence rates of HPV were 50.0% (2846/5691). MetS (OR 1.34, 95% CI 1.04–1.71), globulin (by quintile; OR 1.70, 95% CI 1.25–2.30), fibrinogen (x100 value by quintile; OR 1.07, 95% CI 1.02–1.14), total protein (by quintile; OR 0.91, 95% CI 0.84–0.99) and prothrombin time (by quintile; OR 0.94, 95% CI 0.89–0.99) were significantly associated with the persistence of HPV in multivariate analysis. For validation, a prediction model showed good performance for a range of risk scores and categorized cases into low-, intermediate- and high-risk, which were also correlated with HPV persistence (45.8%, 51.9%, and 60.2% respectively, P < 0.001). Conclusion: MetS and associated factors were associated with an increased risk of persistent HPV infection.