title: Environmental factors related to multiple sclerosis in Indian population.
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.
  
  
  OBJECTIVE
  To determine whether childhood infections, vaccination status, past infection with Helicobacter pylori (H.pylori), diet, socioeconomic and educational status were associated with MS.
  
  
  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.
authors.affiliation: Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte University, Mangalore, India.
authors.forename: Chaithra
authors.initials: C
authors.lastname: Malli
authors.affiliation: Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte University, Mangalore, India.
authors.forename: Lekha
authors.initials: L
authors.lastname: Pandit
authors.affiliation: Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte University, Mangalore, India.
authors.forename: Anita
authors.initials: A
authors.lastname: D'Cunha
authors.affiliation: Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte University, Mangalore, India.
authors.forename: Sharik
authors.initials: S
authors.lastname: Mustafa
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D014676:Diet, Vegetarian; D004522:Educational Status; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D016480:Helicobacter pylori / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G