title: Associations between excessive adiposity and seroprevalence of herpes simplex virus type 1 and type 2 among US adults: a population-based age-period-cohort analysis.
abstract: Evidence on the association between herpes simplex virus (HSV) and excessive adiposity, such as obesity (body mass index ≥30 kg/m2) and abdominal obesity (waist circumference (WC) >102 or 88 cm), has been inconsistent. We sought to examine whether age-period-cohort (APC) effects could explain for the observed heterogeneities.
  
  
  
  Population-based cross-sectional study.
  
  
  
  Adults aged 20-49 years with available serological data in the National Health and Nutrition Examination Survey (NHANES) in 1999-2012.
  
  
  
  Obesity and abdominal obesity.
  
  
  
  In men, excessive adiposity was generally not associated with HSV1 or HSV2 (all p>0.05); however, there were positive correlations between HSV seroprevalence and excessive adiposity in certain age and birth cohort groups. Based on APC analysis, abdominally obese men aged 30-40 years showed a nearly 20% increase in risk for HSV1 seropositivity (adjusted prevalence ratio (aPR)=1.18; 95% CI 1.10 to 1.27) as compared with abdominally non-obese men of the same age; there was no such association in men of other age groups. Also, men of a large WC who were born before 1962 or after 1979 had a 28% higher risk for HSV2 seropositivity than those of a normal WC in the same birth cohorts (aPR=1.28, 95% CI 1.17 to 1.54); yet the association did not hold for men in other cohorts (aPR=0.86, 95% CI 0.64 to 1.17). In women, a large WC was correlated with a minimally increased HSV1 seroprevalence (aPR=1.07, 95% CI 1.01 to 1.13) but not with HSV2 seropositivity (aPR=1.13; 95% CI 0.99 to 1.28). Likewise, there were strong associations between abdominal obesity and HSV2 seropositivity in subgroups of women participating in the earliest survey cycle (aPR=1.41, 95% CI 1.12 to 1.78) but not in other survey periods (aPR=0.94, 95% CI 0.85 to 1.03).
  
  
  
  There was no consistent evidence for strong associations between HSV seropositivity and excessive adiposity in adults. APC analysis results further cautioned the generalisability of previous reports based on 1 or 2 cycles of survey data.
authors: College of Medicine, Chang Gung University, Taoyuan City, Taiwan.|Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
authors: Su-Hsun
authors: 0000-0002-1151-7983
authors: SH
authors: Liu
authors: Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.|Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
authors: I-Shiang
authors: IS
authors: Tzeng
authors: Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.|Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
authors: Tsung-Han
authors: TH
authors: Hsieh
authors: College of Medicine, Chang Gung University, Taoyuan City, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
authors: Yhu-Chering
authors: YC
authors: Huang
mesh_terms: D050154:Adiposity / Q000276:immunology*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D056128:Obesity, Abdominal / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference
keywords: Adiposity; Herpes simplex virus; NHANES; age-period-cohort analysis; subgroup analysis