Serum micronutrients and cervical dysplasia in Southwestern American Indian women.
We carried out a clinic-based case-control study to assess serum micronutrients as risk factors for cervical dysplasia among Southwestern American Indian women, a group with high rates of cervical preinvasive lesions. Cases were American Indian women with biopsy-proven cervical intraepithelial neoplasia (CIN I or CIN II/III). Controls were from the same Indian Health Service clinics with normal cervical epithelium. We interviewed women about histories of sexually transmitted diseases, sexual behavior, diet, hygienic practices, cigarette smoking, and reproductive factors. Laboratory assays included serum for retinol (vitamin A), ascorbic acid (vitamin C), alpha-tocopherol (vitamin E), and red blood cell folate levels, DNA for human papillomavirus (HPV) typing, and tests for other sexually transmitted diseases. The strongest risks for cervical dysplasia were associated with cervical HPV infection [odds ratio (OR) = 3.2, 95% confidence interval (CI) = 2.2-4.6 and OR = 7.9, 95% CI = 4.8-13.1 for CIN I and CIN II/III, respectively]. With adjustments made for HPV infection and other relevant confounders, subjects in the lowest serum retinol quartile were at increased risk of CIN I compared with women in the highest quartile (OR = 2.3, 95% CI = 1.3-4.1). The data suggest that low serum alpha-tocopherol was associated with CIN I/III, although the adjusted OR was not statistically significant (OR = 2.0, 95% CI = 0.9-4.8). Low serum ascorbic acid and red blood cell folate were not associated with cervical dysplasia.
Yeo
A S
AS
Department of Public Health and Preventive Medicine, Oregon Health Sciences University, Portland 92701-3098, USA.
Schiff
M A
MA
Montoya
G
G
Masuk
M
M
van Asselt-King
L
L
Becker
T M
TM
D000293:Adolescent; D000328:Adult; D001205:Ascorbic Acid / Q000097:blood; D016022:Case-Control Studies; D004848:Epithelium / Q000473:pathology; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D007198:Indians, North American; D018977:Micronutrients / Q000097:blood*; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D009752:Nutritional Status; D016017:Odds Ratio; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000097:blood / Q000150:complications / Q000208:ethnology; D017584:Reproductive History; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000208:ethnology; D014412:Tumor Virus Infections / Q000097:blood / Q000150:complications / Q000208:ethnology; D002578:Uterine Cervical Dysplasia / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D014801:Vitamin A / Q000097:blood; D014810:Vitamin E / Q000097:blood
D018977:Micronutrients; D014801:Vitamin A; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid