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慢性弓形虫病是糖尿病的危险因素吗?病例对照研究的系统评价和荟萃分析。

Is chronic toxoplasmosis a risk factor for diabetes mellitus? A systematic review and meta-analysis of case-control studies.

作者信息

Majidiani Hamidreza, Dalvand Sahar, Daryani Ahmad, Galvan-Ramirez Ma de la Luz, Foroutan-Rad Masoud

机构信息

Tarbiat Modares University, Faculty of Medical Sciences, Department of Parasitology, Tehran, Iran.

Kurdistan University of Medical Sciences, Social Determinants of Health Research Center, Sanandaj, Iran.

出版信息

Braz J Infect Dis. 2016 Nov-Dec;20(6):605-609. doi: 10.1016/j.bjid.2016.09.002. Epub 2016 Oct 18.

Abstract

INTRODUCTION

The global protozoan parasite, Toxoplasma gondii, infects many warm-blooded animals and humans by employing different transmission routes. There have been some recent studies on the probable relevance of infectious agents and diabetes. Therefore, we conducted a systematic review and meta-analysis to identify the possible association between chronic toxoplasmosis and diabetes mellitus.

METHODS

This study was conducted following the general methodology recommended for systematic reviews and meta-analysis. Nine English literature databases (Google scholar, PubMed, Scopus, Web of science, Science Direct, Ovid, ProQuest, IngentaConnect, and Wiley Online Library) were searched, up to January 2016. Random effects model was used to determine odds ratios and their 95% confidence intervals.

RESULTS

Our review resulted in a total of seven publications meeting the inclusion criteria. Because of significant heterogeneity, we estimated a common OR by a random effects model at 1.10 (95% CI=0.13-9.57) with p=0.929 and 2.39 (95% CI=1.20-4.75) with p=0.013 for type 1 and type 2 diabetes mellitus, respectively.

CONCLUSION

Despite the limitations such as low number of studies, this meta-analysis suggests chronic toxoplasmosis as a possible risk factor for type 2 DM. However, based on random effects model no statistically significant association was observed between T. gondii and type 1 DM. It is highly recommended for researchers to carry out more accurate studies aiming to better understand this association.

摘要

引言

全球原生动物寄生虫刚地弓形虫通过不同传播途径感染许多温血动物和人类。近期有一些关于感染因子与糖尿病可能相关性的研究。因此,我们进行了一项系统评价和荟萃分析,以确定慢性弓形虫病与糖尿病之间的可能关联。

方法

本研究按照系统评价和荟萃分析推荐的一般方法进行。检索了9个英文文献数据库(谷歌学术、PubMed、Scopus、科学网、Science Direct、Ovid、ProQuest、IngentaConnect和Wiley Online Library),检索截至2016年1月。采用随机效应模型确定比值比及其95%置信区间。

结果

我们的综述共纳入7篇符合纳入标准的文献。由于存在显著异质性,我们通过随机效应模型分别估计1型和2型糖尿病的合并比值比为1.10(95%CI=0.13-9.57),p=0.929;以及2.39(95%CI=1.20-4.75),p=0.013。

结论

尽管存在研究数量较少等局限性,但该荟萃分析表明慢性弓形虫病可能是2型糖尿病的一个危险因素。然而,基于随机效应模型,未观察到弓形虫与1型糖尿病之间存在统计学显著关联。强烈建议研究人员开展更准确的研究,以更好地理解这种关联。

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