Gerontology Department, Huadong Sanatorium, Wuxi, China.
Parasite Immunol. 2021 Apr;43(4):e12822. doi: 10.1111/pim.12822. Epub 2021 Jan 27.
More than 11 million people were estimated to have been infected by Schistosoma japonicum in China before the 1950s. However, few studies have been conducted to evaluate the longitudinal effects of previous schistosome infection (PSI).
We aimed to evaluate the association of PSI with fatty liver and coronary heart disease in China.
A cross-sectional study was conducted in regions which were all reportedly heavily endemic for S japonicum in China. All data were collected using a questionnaire administered and health examinations by well-trained medical professionals. 2867 participants aged 40 years and older were enrolled. Among these, 731 patients with PSI were selected as study subjects and 2136 subjects served as controls. Comparisons between groups were performed with or without an adjustment for a covariate, using Student's t tests for continuous variables and chi-square testing for categorical variables. Multivariable logistic models were used to estimate the associations between PSI and fatty liver or coronary heart disease.
The PSI participants had significantly lower levels of triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, uric acid, serum creatinine, urea nitrogen, platelet, total protein and globulin as well as a lower prevalence of fatty liver (13.3% vs 53.6%, P < .001) and coronary heart disease (3.4% vs 6.0%, P < .05) compared with the uninfected, contemporaneous controls (without PSI), whereas the PSI participants had higher levels of high-density lipoprotein cholesterol, direct bilirubin and a higher prevalence of hepatic dysfunction compared with those without PSI (P < .05).
We found PSI significantly negatively associated with fatty liver and coronary heart disease. However, further studies on schistosomiasis may provide new directions for prevention and treatment of fatty liver and coronary heart disease.
20 世纪 50 年代以前，估计中国有超过 1100 万人感染日本血吸虫。然而，很少有研究评估既往血吸虫感染（PSI）的纵向影响。
我们旨在评估 PSI 与中国脂肪肝和冠心病的关系。
横断面研究在中国报告的日本血吸虫高度流行地区进行。所有数据均采用问卷调查和由训练有素的医务人员进行的健康检查收集。共纳入 2867 名年龄在 40 岁及以上的参与者。其中，731 例 PSI 患者被选为研究对象，2136 例作为对照。使用学生 t 检验进行连续变量比较，使用卡方检验进行分类变量比较，并进行调整或不调整协变量的组间比较。多变量逻辑模型用于估计 PSI 与脂肪肝或冠心病之间的关联。
PSI 组的甘油三酯、低密度脂蛋白胆固醇、空腹血糖、尿酸、血清肌酐、尿素氮、血小板、总蛋白和球蛋白水平显著降低，脂肪肝（13.3%比 53.6%，P <.001）和冠心病（3.4%比 6.0%，P <.05）的患病率也显著降低，与未感染的同期对照组（无 PSI）相比，而 PSI 组的高密度脂蛋白胆固醇、直接胆红素水平较高，肝功能异常的患病率高于无 PSI 组（P <.05）。
我们发现 PSI 与脂肪肝和冠心病显著负相关。然而，对血吸虫病的进一步研究可能为脂肪肝和冠心病的预防和治疗提供新的方向。
