Persistent Pathogens and Incident Stroke in Mexican Americans.

Persistent Pathogens and Incident Stroke in Mexican Americans;Public Health;Health Sciences;Science;Social Sciences;Epidemiological Science

Sealy-Jefferson, ShawnitaMorgenstern, Lewis B. ;

University of Michigan

关键词: Persistent Pathogens and Incident Stroke in Mexican Americans;    Public Health;    Health Sciences;    Science;    Social Sciences;    Epidemiological Science;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/96006/ssealyje_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Stroke is the fourth leading cause of death and a leading cause of disability in adults in the US. Nearly 800,000 people suffer a stroke annually, and more than 143,000 deaths occur as a result. Hispanic Americans are the fastest growing minority population in the US, as well as the most numerous. The majority of Hispanic Americans are of Mexican descent. Mexican Americans (MAs) have an increased risk of stroke especially at younger ages. Traditional risk factors are not likely to fully account for the increased stroke burden in MAs. Chronic infectious pathogens have been proposed as risk factors for stroke, although the evidence remains inconclusive.Using data from the Sacramento Area Latino Study on Aging, we investigated the associations between Immunoglobulin G (IgG) antibody levels to five persistent pathogens including: Cytomegalovirus (CMV), Herpes Simplex Virus Type 1 (HSV1), Toxoplasma gondii (T. gondii), Varicella Zoster Virus (VZV) and Helicobacter pylori (H. Pylori), and incident stroke. Next, we examined the effect of pathogen burden, or concurrent exposure to several pathogens, on stroke risk. Third, we sought to elucidate the mechanism of the H. Pylori- incident stroke association by examining the mediating effects of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor (TNF), homocysteine, folate, Vitamin B12, systolic and diastolic blood pressure, and glucose.We found a significant association between high antibody levels to H. Pylori and incident stroke, in fully adjusted models. There were no significant associations between stroke risk and either antibody levels to CMV, VZV, T. gondii, or HSV1 or seropositivity to each pathogen. We report a significant association between sum of the number of pathogens eliciting a high antibody level, and incident stroke; however attenuation and loss of statistical significance occurred with multivariable adjustment. No associations between summed seropositivity to 0-5 pathogens or average antibody level to 0-5 pathogens and incident stroke were found. Lastly, we found no evidence of mediation of the H. Pylori-incident stroke association by 9 candidate mediators. This research has implications for future population-based research in MAs, as well as studies intervening on persistent pathogen exposure, for reductions in stroke risk.