OBJECTIVES Bacterial vaginosis (BV), a clinical condition characterized by decreased vaginal Lactobacillus spp., is difficult to treat. We examined associations between micronutrient intake and a low-Lactobacillus vaginal microbiota as assessed by molecular methods (termed "molecular-BV"). METHODS This cross-sectional analysis utilized data collected at the baseline visit of the Hormonal Contraception Longitudinal Study, a cohort of reproductive-aged women followed over 2 years while initiating or ceasing hormonal contraception (HC). The Block Brief 2000 Food Frequency Questionnaire was administered and micronutrient intakes were ranked. Vaginal microbiota composition was assessed using 16S rRNA gene amplicon sequencing and clustered into community state types (CSTs) based on the types and relative abundance of bacteria detected. Associations between the lowest estimated quartile intake of nutrients and having a low-Lactobacillus CST (molecular-BV) were evaluated by logistic regression. Separate models were built for each nutrient controlling for age, body mass index, behavioral factors, HC use and total energy intake. We also conducted a literature review of existing data on associations between micronutrient intakes and BV. RESULTS Samples from 104 women were included in this analysis. Their mean age was 25.8 years (SD 4.3), 29.8% were African American, 48.1% were using HC, and 25% had molecular-BV. In adjusted multivariable analyses, the lowest quartile of betaine intake was associated with an increased odds of molecular-BV (aOR 9.2, p value < 0.01, [CI 2.4-35.0]). CONCLUSIONS This is the first study to assess the association between estimated micronutrient intake and molecular-BV. Lower energy-adjusted intake of betaine was associated with an increased risk of molecular-BV. Betaine might have direct effects on the vaginal microenvironment or may be mediated through the gut microbiota. Additional research is needed to determine reproducibility of this finding and whether improved intake of select micronutrients such as betaine decreases the risk of BV and its sequelae.

中文翻译：

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饮食中微量营养素摄入与分子细菌性阴道病之间的关联。

目的细菌性阴道病（BV）是一种临床症状，以阴道乳酸杆菌属菌种减少为特征，很难治疗。我们检查了通过分子方法（称为“分子BV”）评估的微量营养素摄入与低乳酸杆菌阴道菌群之间的关联。方法这项横断面分析利用了激素避孕纵向研究基线访问时收集的数据，该研究是一群育龄妇女在开始或停止激素避孕（HC）后进行了2年以上的随访。进行了《简明2000年食物频率调查表》，并对微量营养素摄入量进行了排名。使用16S rRNA基因扩增子测序评估阴道微生物群组成，并根据检测到的细菌的类型和相对丰度将其分为社区状态类型（CST）。通过Logistic回归评估了估计的最低四分位数养分摄入量与低乳杆菌CST（molecular-BV）之间的关联。针对每种营养物建立了单独的模型，以控制年龄，体重指数，行为因素，HC的使用和总能量摄入。我们还对微量营养素摄入与BV之间相关性的现有数据进行了文献综述。结果该分析包括104名妇女的样本。他们的平均年龄为25.8岁（SD 4.3），其中29.8％是非洲裔美国人，48.1％使用HC，25％使用分子BV。在调整后的多变量分析中，甜菜碱摄入量最低的四分位数与增加的分子BV几率相关（aOR 9.2，p值<0.01，[CI 2.4-35.0]）。结论这是第一项评估微量营养素摄入量与分子BV之间关系的研究。降低能量调节型甜菜碱的摄入量会增加分子BV的风险。甜菜碱可能对阴道微环境有直接影响，或可能通过肠道菌群介导。还需要进一步的研究来确定该发现的可重复性，以及改善选择的微量营养素（如甜菜碱）的摄入量是否会降低BV及其后遗症的风险。