Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters

Abstract

Background Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between Strongyloides stercoralis infection and T2DM has scarcely been investigated and the protective effect of infection against development of diabetic complications is unclear. In this study, we aimed to investigate the relationship between S. stercoralis infection and T2DM in a rural area of Khon Kaen Province, Thailand. The impact of S. stercoralis infection on diabetic complication-related kidney function biochemical parameters and body-mass index (BMI) was also assessed. Methodology Using a cross-sectional study design, S. stercoralis infection and T2DM assessments were conducted between October 2020 and May 2021. Associations between S. stercoralis infection, T2DM, and socioeconomic factors were analyzed using multivariable logistic regression analyses. Diabetic complication-related biochemical parameters relating largely to kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), serum creatinine, uric acid, alanine transaminase (ALT), and low-density lipoprotein cholesterol (LDL-C)) and BMI of participants with and without T2DM were compared between groups with or without S. stercoralis infection. Results One hundred and seven out of 704 individuals (15.20%) were positive for S. stercoralis, and 283 people were diagnosed with T2DM. Of those with T2DM, 11.31% (32/283) were infected with S. stercoralis and of those without T2DM, 17.82% (75/421) were infected with S. stercoralis. Multivariate analysis revealed that T2DM was inversely correlated with S. stercoralis infection (Adjusted OR = 0.49; 95% CI: 0.30, 0.78; p = 0.003), while male, increasing age, lower education level, and alcohol intake were positively associated with infection. Those infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels than those in the uninfected group. Conclusion This finding indicates that S. stercoralis infection was inversely associated with T2DM in northeastern Thailand, but participants infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels. Infection with S. stercoralis might lead to worse complication-related renal biochemical parameters.

Strongyloides stercoralis infection reduces Fusicatenibacter and Anaerostipes in the gut and increases bacterial amino-acid metabolism in early-stage chronic kidney disease

“…Fecal samples were collected during a previous study in Nam Phong and Ubonrat Districts, Khon Kaen Province, northeastern Thailand [ 13 ]. After collection, a portion of each fecal sample was rapidly processed to identify S. stercoralis infection using the modified agar plate culture (mAPC) technique [ 13 ].…”

“…Fecal samples were collected during a previous study in Nam Phong and Ubonrat Districts, Khon Kaen Province, northeastern Thailand [ 13 ]. After collection, a portion of each fecal sample was rapidly processed to identify S. stercoralis infection using the modified agar plate culture (mAPC) technique [ 13 ]. Another portion was tested for the presence of parasite eggs and larvae using the formalin-ether concentration technique (FECT) as was previously reported [ 13 ].…”

“…After collection, a portion of each fecal sample was rapidly processed to identify S. stercoralis infection using the modified agar plate culture (mAPC) technique [ 13 ]. Another portion was tested for the presence of parasite eggs and larvae using the formalin-ether concentration technique (FECT) as was previously reported [ 13 ]. Most of the remaining sample was frozen (−80 °C) and stored for later analysis.…”

“…In Khon Kaen, in northeastern Thailand, the prevalence is 26.8% with most individuals having early-stage CKD (stages 1–3) [ 4 ]. The high prevalence of CKD patients in this part of Thailand is accompanied by a high prevalence of Strongyloides stercoralis infection (15.2%) [ 4 , 13 , 14 ]. Around 600 million people worldwide are infected by this soil-transmitted helminth [ 15 ].…”

Seroprevalence and associated risk factors of strongyloidiasis in indigenous communities and healthcare professionals from Brazil

“…stercoralis [ 14 ] and results in persistent infections lasting decades in endemic areas [ 15 ]. Prevalence in adults is higher than in children, possibly due to continuing exposure with age [ 16 , 17 ]. Cumulative exposure and autoinfection cycle favor the perpetuation of infection [ 18 ], particularly in areas with low hygiene and socioeconomic standards [ 19 ].…”