Tracey Ella F, McDermott Robyn A, McDonald Malcolm I
College of Medicine & Dentistry, Division of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia.
Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia.
Diabetes Res Clin Pract. 2016 Oct;120:209-20. doi: 10.1016/j.diabres.2016.08.014. Epub 2016 Aug 25.
There is increasing evidence on the role of helminth infections in modifying autoimmune and allergic diseases. These infections may have similar effect in other inflammatory processes, such as insulin resistance. This review aims to examine the literature on the effect of helminthic infections on metabolic outcomes in humans.
Using the PRISMA protocol, we searched the literature using PubMed, MEDLINE, and a manual review of reference lists. Human studies published in English after 1995 were included. Four papers were included in this review. Data was extracted and a meta-analysis was conducted using a random-effects model. Heterogeneity was assessed using Tau(2) and I(2) tests.
The included studies found that infection was associated with lower glucose levels, less insulin resistance, and/or a lower prevalence of metabolic syndrome (MetS) or type 2 diabetes mellitus (T2DM). Meta-analysis showed that participants with a previous or current helminth infection were 50% less likely to have an endpoint of metabolic dysfunction in comparison to uninfected participants (OR 0.50; 95% CI 0.38-0.66).
This review has shown that helminth infections can be associated with improved metabolic outcomes. Understanding of the mechanisms underlying this relationship could facilitate the development of novel strategies to prevent or delay T2DM.
越来越多的证据表明蠕虫感染在改变自身免疫性疾病和过敏性疾病方面发挥作用。这些感染在其他炎症过程中可能具有类似作用，如胰岛素抵抗。本综述旨在研究关于蠕虫感染对人类代谢结局影响的文献。
使用PRISMA方案，我们通过PubMed、MEDLINE检索文献，并对参考文献列表进行人工查阅。纳入1995年后发表的英文人类研究。本综述纳入了四篇论文。提取数据并使用随机效应模型进行荟萃分析。使用Tau(2)和I(2)检验评估异质性。
纳入的研究发现，感染与较低的血糖水平、较少的胰岛素抵抗和/或较低的代谢综合征（MetS）或2型糖尿病（T2DM）患病率相关。荟萃分析表明，与未感染的参与者相比，既往或当前感染蠕虫的参与者出现代谢功能障碍终点的可能性降低50%（比值比0.50；95%置信区间0.38 - 0.66）。
本综述表明蠕虫感染可能与改善代谢结局相关。了解这种关系背后的机制可能有助于开发预防或延缓2型糖尿病的新策略。
