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Antibody levels to persistent pathogens and incident stroke in Mexican Americans
Shawnita Sealy-Jefferson1, Brenda W Gillespie, Allison E Aiello
1Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, United States of America. ssealyj@med.wayne.edu
Background:
Persistent pathogens have been proposed as risk factors for stroke; however, the evidence remains inconclusive. Mexican Americans have an increased risk of stroke especially at younger ages, as well as a higher prevalence of infections caused by several persistent pathogens.
Methodology/Principal:
Findings Using data from the Sacramento Area Latino Study on Aging (n = 1621), the authors used discrete-time regression to examine associations between stroke risk and (1) immunoglobulin G antibody levels to Helicobacter pylori (H. pylori), Cytomegalovirus, Varicella Zoster Virus, Toxoplasma gondii and Herpes simplex virus 1, and (2) concurrent exposure to several pathogens (pathogen burden), defined as: (a) summed sero-positivity, (b) number of pathogens eliciting high antibody levels, and (c) average antibody level. Models were adjusted for socio-demographics and stroke risk factors. Antibody levels to H. pylori predicted incident stroke in fully adjusted models (Odds Ratio: 1.58; 95% Confidence Interval: 1.09, 2.28). No significant associations were found between stroke risk and antibody levels to the other four pathogens. No associations were found for pathogen burden and incident stroke in fully adjusted models.
Conclusions/Significance:
Our results suggest that exposure to H. pylori may be a stroke risk factor in Mexican Americans and may contribute to ethnic differences in stroke risk given the increased prevalence of exposure to H. pylori in this population. Future studies are needed to confirm this association.
Insights
Helicobacter pylori (H. pylori) infection is linked to increased stroke risk in Mexican Americans. This finding may explain higher stroke rates in this ethnic group due to H. pylori prevalence.
Area of Science:
- Epidemiology
- Infectious Disease
- Neurology
Background:
- Persistent pathogens are potential stroke risk factors, but evidence is inconclusive.
- Mexican Americans face higher stroke risk, particularly at younger ages, and have increased prevalence of certain persistent infections.
Purpose of the Study:
- To investigate the association between persistent pathogens and stroke risk in Mexican Americans.
- To determine if specific pathogen exposures, including Helicobacter pylori (H. pylori), predict incident stroke.
Main Methods:
- Utilized discrete-time regression analysis on data from the Sacramento Area Latino Study on Aging (n=1621).
- Examined immunoglobulin G antibody levels to H. pylori, Cytomegalovirus, Varicella Zoster Virus, Toxoplasma gondii, and Herpes simplex virus 1.
- Assessed pathogen burden based on summed sero-positivity, number of high antibody-level pathogens, and average antibody level, adjusting for socio-demographics and stroke risk factors.
Main Results:
- Elevated antibody levels to H. pylori were significantly associated with increased incident stroke risk (OR: 1.58; 95% CI: 1.09, 2.28).
- No significant associations were found between stroke risk and antibody levels to Cytomegalovirus, Varicella Zoster Virus, Toxoplasma gondii, or Herpes simplex virus 1.
- Pathogen burden, by any measure, did not show a significant association with incident stroke risk.
Conclusions:
- Exposure to H. pylori may represent a stroke risk factor in the Mexican American population.
- This association could contribute to observed ethnic disparities in stroke risk.
- Further research is necessary to validate the link between H. pylori and stroke.
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