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Antibody Levels to Persistent Pathogens and Incident Stroke in Mexican Americans.doc

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Antibody Levels to Persistent Pathogens and Incident Stroke in Mexican Americans

AntibodyLevelstoPersistentPathogensandIncident StrokeinMexicanAmericans ShawnitaSealy-Jefferson1*,BrendaW.Gillespie2,3,AllisonE.Aiello4,MaryN.Haan5, LewisB.Morgenstern6,7,LyndaD.Lisabeth4,6 1DepartmentofFamilyMedicineandPublicHealthSciences,WayneStateUniversitySchoolofMedicine,Detroit,Michigan,UnitedStatesofAmerica,2Departmentof Biostatistics,UniversityofMichigan,SchoolofPublicHealth,AnnArbor,Michigan,UnitedStatesofAmerica,3CenterforStatisticalConsultationandResearch,University of Michigan, Ann Arbor, Michigan, United States of America, 4Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan,SchoolofPublicHealth,AnnArbor,Michigan,UnitedStatesofAmerica,5DepartmentofEpidemiologyandBiostatistics,UniversityofCalifornia,SanFrancisco, California, United States of America, 6Stroke Program, University of Michigan Medical School, Ann Arbor, Michigan, United States of America, 7Department of Epidemiology,UniversityofMichigan,SchoolofPublicHealth,AnnArbor,Michigan,UnitedStatesofAmerica Abstract Background: Persistent pathogens have been proposed as risk factors for stroke; however, the evidence remains inconclusive.MexicanAmericanshaveanincreasedriskofstrokeespeciallyatyoungerages,aswellasahigherprevalence ofinfectionscausedbyseveralpersistentpathogens. Methodology/Principal:FindingsUsingdatafromtheSacramentoAreaLatinoStudyonAging(n=1621),theauthorsused discrete-time regression to examine associations between stroke risk and (1) immunoglobulin G antibody levels to Helicobacterpylori(H.pylori),Cytomegalovirus,VaricellaZosterVirus,ToxoplasmagondiiandHerpessimplexvirus1,and(2) concurrent exposure to several pathogens (pathogen burden), defined as: (a) summed sero-positivity, (b) number of pathogenselicitinghighantibodylevels,and(c)averageantibodylevel.Modelswereadjustedforsocio-demographicsand stroke risk factors. Antibody levels to H. pylori predicted incident stroke in fully adjusted models (Odds Ratio: 1.58; 95% ConfidenceInt