期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 38, 期 3, 页码 775-787出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyn273
关键词
SEP; CMV; HSV-1; co-infection; cardiovascular disease; mediation
资金
- University of Michigan-Rackham Graduate School, Rackham Merit Fellowship
- University of Michigan-Medical School, Institute of Gerontology, Pepper Center Research Career Development Core
- Robert Wood Johnson Health and Society Scholars Program, University of Michigan
- National Institutes of Health [R21 NR011181-01]
- Centers for Integrative Approach to Health Disparities [P60 MD002249]
- NATIONAL INSTITUTE OF NURSING RESEARCH [R21NR011181] Funding Source: NIH RePORTER
- National Institute on Minority Health and Health Disparities [P60MD002249] Funding Source: NIH RePORTER
Background Numerous studies have documented a strong inverse association between cardiovascular disease and socioeconomic position (SEP). Several infections are associated with both cardiovascular disease and SEP; hence infection may form an important link between SEP and cardiovascular disease. This study examines whether seropositivity to cytomegalovirus (CMV), to herpes simplex virus type-1 (HSV-1), and/or to both pathogens mediates the relationship between SEP and cardiovascular disease history in a nationally representative sample of the United States. Methods We conducted a cross-sectional study of subjects 545 years of age, who were tested for seropositivity to CMV, HSV-1 or both pathogens and assessed for cardiovascular disease history in the National Health and Nutrition Examination Survey III. Cardiovascular disease history was defined as history of stroke, heart attack and/or congestive heart failure and SEP as education level. Results SEP was associated with CMV, HSV-1 and seropositivity to both pathogens. CMV seropositivity was associated with cardiovascular disease history even after adjusting for confounders as well as SEP. The odds of reporting a history of cardiovascular disease for those with less than a high school education compared with those with more than a high school education decreased by 7.7% after adjusting for CMV (Sobel mediation test for CMV, P = 0.0006). In contrast, neither seropositivity to HSV-1 nor to both pathogens was associated with cardiovascular disease history after adjusting for SEP. Conclusions Persistent pathogens such as CMV infection may explain a portion of the relationship between SEP and cardiovascular disease in the United States. Further studies examining additional pathogens and sociobiological mechanisms are warranted.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据