Environmental factors related to multiple sclerosis in Indian population

PLoS One. 2015 Apr 22;10(4):e0124064. doi: 10.1371/journal.pone.0124064. eCollection 2015.

Abstract

Background: Multiple sclerosis (MS) is less prevalent among Indians when compared to white populations. Genetic susceptibility remaining the same it is possible that environmental associations may have a role in determining disease prevalence.

Aims: To determine whether childhood infections, vaccination status, past infection with Helicobacter pylori (H.pylori), diet, socioeconomic and educational status were associated with MS.

Material and methods: 139 patients and 278 matched control subjects were selected. A validated environmental exposure questionnaire was administered. Estimation of serum H.pylori IgG antibody was done by ELISA. Patients and controls were genotyped for HLA-DRB1*15:01.

Results: In our cohort a significant association was seen with measles (p < 0.007), vegetarian diet (p < 0.001, higher educational status (p < 0.0001) and urban living (p < 0.0001). An inverse relationship was seen with H.Pylori infection and MS (p < 0.001). Measles infection (OR 6.479, CI 1.21-34.668, p < 0.029) and high educational status (OR 3.088, CI 1.212-7.872, p < 0.018) were significant risk factors associated with MS. H.pylori infection was inversely related to MS (OR 0. 319, CI 0.144- 0.706, p < 0.005).

Conclusions: Environmental influences may be important in determining MS prevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial / blood
  • Case-Control Studies
  • Diet, Vegetarian
  • Educational Status
  • Environmental Exposure / adverse effects*
  • Female
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / epidemiology*
  • Helicobacter Infections / ethnology
  • Helicobacter pylori / physiology
  • Histocompatibility Testing
  • Humans
  • Immunoglobulin G / blood
  • India / epidemiology
  • Male
  • Measles / complications
  • Measles / epidemiology*
  • Measles / ethnology
  • Measles / virology
  • Middle Aged
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / epidemiology*
  • Multiple Sclerosis / ethnology
  • Multiple Sclerosis / etiology
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Antibodies, Bacterial
  • Immunoglobulin G

Grants and funding

L.P. received funding from Department of Science and Technology, Government of India (SR/SO/HS/127/2010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.