粪类圆线虫感染能否预防人类2型糖尿病？来自澳大利亚原住民成年人的证据。
Does Strongyloides stercoralis infection protect against type 2 diabetes in humans? Evidence from Australian Aboriginal adults.
作者信息
Hays Russell, Esterman Adrian, Giacomin Paul, Loukas Alex, McDermott Robyn
机构信息
Kimberley Aboriginal Medical Services Council, PO Box 1377, Broome 6725, WA, Australia; Adjunct Research Fellow James Cook University, James Cook University, Cairns Campus, McGregor Road, Smithfield 4878, QLD, Australia.
Centre for Research Excellence in Chronic Disease Prevention, The Cairns Institute James Cook University, Cairns Campus, Room D3-131, McGregor Road, Smithfield 4878, QLD, Australia; Chair of Biostatistics, Sansom Institute of Health Service Research and School of Nursing and Midwifery, University of South Australia City East Campus, Centenary Building, North Terrace, Adelaide 5000, SA, Australia.
出版信息
Diabetes Res Clin Pract. 2015 Mar;107(3):355-61. doi: 10.1016/j.diabres.2015.01.012. Epub 2015 Jan 21.
OBJECTIVE
To explore the relationship between infection with Strongyloides stercoralis and the likelihood of having type 2 diabetes mellitus (T2DM).
METHODS
Cross-sectional survey of 259 Aboriginal adults living in a remote community in northern Australia during 2013. Prior infection with S. stercoralis was determined by ELISA testing on serum. Main outcomes were eosinophil count, T2DM diagnosis, HbA1c, BMI, fasting lipids, Hb, blood pressure.
FINDINGS
Ninety two participants (36%) had prior infection with S. stercoralis and 131 (51%) had T2DM. Those with previous S. stercoralis infection (ELISA titre ≥0.3) were 61% less likely to have a diagnosis of T2DM than those uninfected, adjusted for age, triglycerides, blood pressure and BMI using propensity score (adjusted OR=0.39, 0.23-0.67, P=0.001).
INTERPRETATION
In this remote community where prevalence of both S. stercoralis and T2DM is very high, infection with S. stercoralis appears to be associated with a significantly reduced risk of T2DM in adults. A plausible immunological mechanism has been identified in animal models. If confirmed, this result may have practical implications for the prevention of T2DM and associated metabolic disorders in humans. This finding should be explored further with larger longitudinal studies in transitional populations where the risk of both conditions is high.
FUNDING
No external funding was required for this study.
目的
探讨粪类圆线虫感染与患2型糖尿病（T2DM）可能性之间的关系。
方法
对2013年居住在澳大利亚北部一个偏远社区的259名原住民成年人进行横断面调查。通过对血清进行酶联免疫吸附测定（ELISA）检测来确定既往是否感染粪类圆线虫。主要观察指标为嗜酸性粒细胞计数、T2DM诊断、糖化血红蛋白（HbA1c）、体重指数（BMI）、空腹血脂、血红蛋白（Hb）、血压。
研究结果
92名参与者（36%）既往感染过粪类圆线虫，131名（51%）患有T2DM。既往感染粪类圆线虫的患者（ELISA滴度≥0.3）经倾向性评分调整年龄、甘油三酯、血压和BMI后，被诊断为T2DM的可能性比未感染者低61%（调整后的比值比=0.39，0.23 - 0.67，P = 0.001）。
解读
在这个粪类圆线虫和T2DM患病率都非常高的偏远社区，粪类圆线虫感染似乎与成年人患T2DM的风险显著降低有关。在动物模型中已经确定了一种可能的免疫机制。如果得到证实，这一结果可能对人类预防T2DM及相关代谢紊乱具有实际意义。这一发现应在两种疾病风险都很高的过渡人群中通过更大规模的纵向研究进一步探索。
资金来源
本研究无需外部资金。
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