Association of antioxidant nutrients and human papillomavirus persistence, clearance and viral load among women in the Ludwig-McGill Cohort Study

Persistent Link:
http://hdl.handle.net/10150/280535
Title:
Association of antioxidant nutrients and human papillomavirus persistence, clearance and viral load among women in the Ludwig-McGill Cohort Study
Author:
Siegel, Erin Michelle
Issue Date:
2004
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Although an oncogenic human papillomavirus (HPV) infection has been established as the necessary cause of cervical cancer, most HPV infections are transient and rarely progress to significant cervical lesions. Current research has focused on identifying factors associated with viral persistence and clearance. Low nutritional status might influence a woman's risk of having a persistent HPV infection and progression of that infection to cervical dysplasia, or at higher levels increase the probability of clearing infections. The overall goal of this research was to determine the associations between serum carotenoid, tocopherol, and retinoic acid levels and cervical carcinogenesis among the Ludwig-McGill Cohort Study. A sub-cohort of 846 women, all of whom had HPV results available from four consecutive study visits in the first year of follow-up, had serum samples analyzed for circulating nutrients. We determined the variability of circulating retinoic acid levels over the four months in a sample of 502 women and identified lifestyle, demographic and nutritional factors that were associated with these levels. The relative abundance of retinoic acid isomers was similar for each visit and the within person-variability of total retinoic acid and individual isomers was low. Using multivariate logistic regression models that serum nutrient levels (retinol, β-carotene, and β-cryptoxanthin), age, race, oral contraceptive use, total number of pregnancies, and season of initial blood draw were significantly associated with endogenous retinoic acid isomer levels. Among the 407 HPV positive women, endogenous levels of all-trans retinoic acid were positively associated with an increased probability of clearing oncogenic and nononcogenic type-specific HPV infections. Furthermore, among the carotenoids and tocopherols examined, we found that higher circulating zeaxanthin concentrations were associated with increased probability of clearing type-specific oncogenic HPV infections. Inverse associations were found between serum tocopherol levels (α-, δ- and γ-tocopherol) and type-specific nononcogenic HPV persistence. Overall, the findings of this study suggest that women with the highest levels of serum all-trans retinoic acid, zeaxanthin, and tocopherol are at a decreased risk for a persistent, type-specific HPV infection of long duration. As both classes of nutrients are modifiable by diet, alterations in diet may be a safe approach to cervical cancer prevention.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Biology, Biostatistics.; Health Sciences, Public Health.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Public Health
Degree Grantor:
University of Arizona
Advisor:
Giuliano, Anna R.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titleAssociation of antioxidant nutrients and human papillomavirus persistence, clearance and viral load among women in the Ludwig-McGill Cohort Studyen_US
dc.creatorSiegel, Erin Michelleen_US
dc.contributor.authorSiegel, Erin Michelleen_US
dc.date.issued2004en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractAlthough an oncogenic human papillomavirus (HPV) infection has been established as the necessary cause of cervical cancer, most HPV infections are transient and rarely progress to significant cervical lesions. Current research has focused on identifying factors associated with viral persistence and clearance. Low nutritional status might influence a woman's risk of having a persistent HPV infection and progression of that infection to cervical dysplasia, or at higher levels increase the probability of clearing infections. The overall goal of this research was to determine the associations between serum carotenoid, tocopherol, and retinoic acid levels and cervical carcinogenesis among the Ludwig-McGill Cohort Study. A sub-cohort of 846 women, all of whom had HPV results available from four consecutive study visits in the first year of follow-up, had serum samples analyzed for circulating nutrients. We determined the variability of circulating retinoic acid levels over the four months in a sample of 502 women and identified lifestyle, demographic and nutritional factors that were associated with these levels. The relative abundance of retinoic acid isomers was similar for each visit and the within person-variability of total retinoic acid and individual isomers was low. Using multivariate logistic regression models that serum nutrient levels (retinol, β-carotene, and β-cryptoxanthin), age, race, oral contraceptive use, total number of pregnancies, and season of initial blood draw were significantly associated with endogenous retinoic acid isomer levels. Among the 407 HPV positive women, endogenous levels of all-trans retinoic acid were positively associated with an increased probability of clearing oncogenic and nononcogenic type-specific HPV infections. Furthermore, among the carotenoids and tocopherols examined, we found that higher circulating zeaxanthin concentrations were associated with increased probability of clearing type-specific oncogenic HPV infections. Inverse associations were found between serum tocopherol levels (α-, δ- and γ-tocopherol) and type-specific nononcogenic HPV persistence. Overall, the findings of this study suggest that women with the highest levels of serum all-trans retinoic acid, zeaxanthin, and tocopherol are at a decreased risk for a persistent, type-specific HPV infection of long duration. As both classes of nutrients are modifiable by diet, alterations in diet may be a safe approach to cervical cancer prevention.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectBiology, Biostatistics.en_US
dc.subjectHealth Sciences, Public Health.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePublic Healthen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorGiuliano, Anna R.en_US
dc.identifier.proquest3131641en_US
dc.identifier.bibrecord.b46711788en_US
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