The Association between Cytomegalovirus Infection, Obesity, and Metabolic Syndrome in US Adult Females

Objective: The purpose of this analysis was to determine whether cytomegalovirus (CMV) infection is associated with the prevalence of metabolic syndrome (MetS) and whether this relationship differs by BMI. Methods: Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were pooled (N=2,532). Logistic regression was used for assessing the association between CMV and MetS, stratified by gender and BMI, categorized as normal weight, overweight, obesity, and extreme obesity, and adjusted for age, race/ethnicity, and poverty level. Results: In unadjusted analyses, CMV infection was significantly associated with MetS in females (OR: 1.50; 95% CI: 1.1- 2.1) but not males. After adjusting for confounders, the odds of MetS were higher in CMV1 normal-weight females (aOR: 65.31; 95% CI: 6.8- 625.6) but lower in CMV1 females with extreme obesity (aOR: 0.25; 95% CI: 0.1- 0.9). CMV infection was associated with higher high- density lipoprotein cholesterol (HDL-C) and lower triglycerides in females with extreme obesity but lower HDL-C in normal-weight females. Conclusions: CMV infection was found to be associated with unique MetS phenotypes that differ between BMI categories and gender. Seropositive normal-weight females had a higher prevalence of MetS and dyslipidemia, while infection in females with extreme obesity was associated with a more metabolically benign profile.