弓形虫暴露与心脏病之间的关联：一项病例对照研究。
Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study.
作者信息
Alvarado-Esquivel Cosme, Salcedo-Jaquez Misael, Sanchez-Anguiano Luis Francisco, Hernandez-Tinoco Jesus, Rabago-Sanchez Elizabeth, Beristain-Garcia Isabel, Liesenfeld Oliver, Estrada-Martinez Sergio, Perez-Alamos Alma Rosa, Alvarado-Soto Ediyair
机构信息
Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico.
Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico.
出版信息
J Clin Med Res. 2016 May;8(5):402-9. doi: 10.14740/jocmr2525w. Epub 2016 Mar 20.
BACKGROUND
The parasite Toxoplasma gondii causes infections all around the world. Infections with T. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact of T. gondii on patients with heart disease. We determined the association between T. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association of T. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated.
METHODS
Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire with T. gondii exposure by bivariate and multivariate analyses.
RESULTS
Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed that T. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04).
CONCLUSIONS
Results obtained in this study indicate that T. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association of T. gondii exposure with alcohol consumption in this population. Results warrant for further research to determine the epidemiological impact of T. gondii exposure on patients with heart diseases. Risk factors associated with T. gondii exposure are critical to design future prevention strategies against T. gondii exposure.
背景
寄生虫弓形虫在全球范围内引发感染。弓形虫感染是全身性的，该寄生虫可在心肌中持续存在。关于弓形虫对心脏病患者的影响，人们了解甚少。我们确定了墨西哥杜兰戈一家公立医院中，弓形虫暴露与心脏病患者之间的关联；还调查了弓形虫暴露与这些患者的社会人口学、行为和临床特征之间的关联。
方法
通过病例对照研究，我们使用酶联免疫分析法检测了400例心脏病患者和400例年龄及性别匹配的对照者中抗弓形虫IgG和IgM抗体的血清阳性率。此外，我们通过双变量和多变量分析，分析了由标准化问卷确定的患者特征与弓形虫暴露之间的关联。
结果
400例患者中有55例（13.8%）、400例对照者中有32例（8.0%）具有抗弓形虫IgG抗体（优势比（OR）=1.83；95%置信区间（CI）：1.15 - 2.90；P = 0.01）。在55例阳性病例中有28例（50.9%）、32例阳性对照者中有14例（43.8%）的抗弓形虫IgG水平较高（>150 IU/mL）（P = 0.51）。在55例抗弓形虫IgG阳性患者中有13例（23.6%）、32例抗弓形虫IgG阳性对照者中有19例（59.4%）检测到抗弓形虫IgM抗体（OR = 0.21；95% CI：0.08 - 0.54；P = 0.0008）。多变量分析显示，弓形虫暴露与出生于杜兰戈州以外地区呈正相关（OR = 2.93；95% CI：1.40 - 6.13；P = 0.004），与饮酒呈正相关（OR = 2.04；95% CI：1.01 - 4.12；P = 0.04）。
结论
本研究获得的结果表明，弓形虫感染与心脏病有关，并提示心脏病可能与慢性感染有关。这是该人群中弓形虫暴露与饮酒之间存在关联的首次报告。研究结果值得进一步开展研究，以确定弓形虫暴露对心脏病患者的流行病学影响。与弓形虫暴露相关的风险因素对于设计未来预防弓形虫暴露的策略至关重要。
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