Obesity is associated with lower bacterial vaginosis prevalence in menopausal but not pre-menopausal women in a retrospective analysis of the Women’s Interagency HIV Study

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  • Daubert, E.
    • Other Affiliation: Cook County Health/Hektoen Institute of Medicine
  • Weber, K.M.
    • Other Affiliation: Cook County Health/Hektoen Institute of Medicine
  • French, A.L.
    • Other Affiliation: Stroger Hospital of Cook County
  • Seidman, D.
    • Other Affiliation: University of California, San Francisco
  • Michel, K.
    • Other Affiliation: Georgetown University
  • Gustafson, D.
    • Other Affiliation: State University of New York, Downstate Health Sciences University
  • Murphy, K.
    • Other Affiliation: Albert Einstein College of Medicine
  • Muzny, C.A.
    • Other Affiliation: University of Alabama, Birmingham
  • Alcaide, M.
    • Other Affiliation: University of Miami
  • Sheth, A.
    • Other Affiliation: Emory University
  • Adimora, A.A.
    • Affiliation: School of Medicine, Department of Medicine
  • Spear, G.T.
    • Other Affiliation: Hektoen Institute of Medicine
Abstract
  • The vaginal microbiota is known to impact women’s health, but the biological factors that influence the composition of the microbiota are not fully understood. We previously observed that levels of glycogen in the lumen of the vagina were higher in women that had a high body mass index (BMI). Vaginal glycogen is thought to impact the composition of the vaginal microbiota. We therefore sought to determine if BMI was associated having or not having bacterial vaginosis (BV), as determined by the Amsel criteria. We also hypothesized that increased blood glucose levels could lead to the previously-observed higher vaginal glycogen levels and therefore investigated if hemoglobin A1c levels were associated with BV. We analyzed data from the Women’s Interagency HIV Study using multiple multivariable (GEE) logistic regression models to assess the relationship between BMI, BV and blood glucose. Women with a BMI >30 kg/m2 (obese) had a lower rate (multivariable adjusted OR 0.87 (0.79–0.97), p = 0.009) of BV compared to the reference group (BMI 18.5–24.9 kg/m2). There was a significantly lower rate of BV in post-menopausal obese women compared to the post-menopausal reference group, but not in pre-menopausal women. HIV- post-menopausal obese women had a significantly lower rate of BV, but this was not seen in HIV+ post-menopausal obese women. Pre-menopausal women with a higher hemoglobin A1c (≥6.5%) had a significantly lower rate (multivariable adjusted OR 0.66 (0.49–0.91), p = 0.010) of BV compared to pre-menopausal women with normal hemoglobin A1c levels (<5.7%), but there was no difference in post-menopausal women. This study shows an inverse association of BMI with BV in post-menopausal women and hemoglobin A1c with BV in pre-menopausal women. Further studies are needed to confirm these relationships in other cohorts across different reproductive stages and to identify underlying mechanisms for these observed associations.
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  • Article
Rights statement
  • In Copyright
License
  • Attribution 4.0 International
Journal title
  • PLoS ONE
Journal volume
  • 16
Journal issue
  • 3-Mar
Language
  • English
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  • Publisher
Funder
  • National Heart, Lung, and Blood Institute, NHLBI: U01HL146194, U01HL146202, U01HL146204
  • National Center for Advancing Translational Sciences, NCATS: KL2TR001432
ISSN
  • 1932-6203
Publisher
  • Public Library of Science

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