The association between cytomegalovirus (CMV) infection, obesity and metabolic syndrome in US adults: NHANES 1999-2004. Open Access

Abstract

Background : Metabolic syndrome (MetS) is a constellation of risk factors - including increased waist circumference, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and elevated fasting glucose - that usually manifest in the setting of obesity. However, the presence of chronic inflammation is believed to be a distinguishing factor for why some develop MetS, but others do not. The purpose of this analysis was to determine whether a common pathogen, cytomegalovirus (CMV), was associated with an increased prevalence of MetS, and whether this relationship was influenced by obesity.

Methods : Data from the National Health and Nutrition Examination Survey (NHANES) were pooled for the years 1999-2004 for this analysis. The study population was limited to adults between 20-49 years of age who participated in the fasting sub-study (n=2,532). Logistic regression was used to obtain prevalence odds ratios (OR) for assessing the association between CMV and MetS stratified by BMI category (normal weight, overweight, obesity and extreme obesity); Poisson regression was used for examining the association between CMV and count of individual MetS components.

Results : In unadjusted analyses, CMV was significantly associated with MetS in females (OR: 1.50; 95% CI: 1.1-2.1), but not in males (OR: 0.99; 95% CI: 0.9-1.1). After stratifying by BMI and poverty level and adjusting for age, race/ethnicity and smoking status, the odds of MetS was significantly higher in CMV+ normal weight females above or at the federal poverty level (aOR: 43.25; 95% CI: 4.1-452.3), as well as for those below the poverty level (aOR: 146.10; 95% CI: 10.8-1980.3), when both were compared to their CMV- counterparts. Interestingly, in extremely obese females at or above the poverty level, the odds of MetS was 84% lower in CMV+ vs. CMV- individuals (aOR: 0.16; 95% CI: 0.04-0.67).

Conclusions: CMV seropositivity was associated with a higher odds of MetS in normal weight females, but a lower odds of MetS in extremely obese females. These results suggest that the presence of alternative sources of inflammation may be influencing the burden of MetS in adult females.

Table of Contents

INTRODUCTION & HYPOTHESES BACKGROUND & LITERATURE REVIEW METHODS RESULTS DISCUSSION TABLE 1 TABLE 2 TABLE 3 TABLE 4 SUPPLEMENTARY TABLE 1 SUPPLEMENTARY TABLE 2 SUPPLEMENTARY TABLE 3 SUPPLEMENTARY TABLE 4 FIGURE 1 REFERENCES

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	obesity CMV metabolic syndrome
Committee Chair / Thesis Advisor	McClellan, William, Emory University
Committee Members	Wojcicki, Janet, University of California, San Francisco
Partnering Agencies	Does not apply (no collaborating organization)

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