Inverse Associations of Schistosoma mansoni Infection and Metabolic Syndromes in Humans: A Cross-Sectional Study in Northeast Ethiopia

Abstract

Background: Recent animal and retrospective human studies have demonstrated that Schistosoma mansoni infection may have potential to protect against development of metabolic syndromes. Thus, the aim of this study was to assess metabolic panel among S. mansoni egg positives and egg negatives in stool examinations. This study was a cross-sectional study, conducted involving 120 participants from S. mansoni endemic town (Kemise) and 61 from non-endemic town (Kombolcha), Northeast Ethiopia. Stool samples were collected and examined for S. mansoni and other helminths using Kato-Katz method. Furthermore, blood samples were collected and used for determination of blood sugar, lipid profile tests, insulin, and C-reactive protein. Data were analyzed using SPSS software version 20. Chi-square test, independent mean t-test, and logistic regression models were employed on data. P values less than .05 were considered as statistically significant. Results: S. mansoni infected participants (n = 41; all from Kemise) had significantly lower levels of fasting blood sugar, low prevalence of dyslipidemia (at least one or more abnormal lipid profile tests; total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides) as compared with controls (n = 79 in Kemise and 61 in Kombolcha). Moreover, logistic regression model indicated that with the adjusted odds ratios, there was significant inverse association between S. mansoni infection and impaired fasting glucose (adjusted odds ratio −0.181, 95% confidence interval: 0.042-0.774). Conclusions: Low fasting blood sugar and reduced prevalence of dyslipidemia in S. mansoni egg positive participants might suggest inverse association of S. mansoni infection and development of metabolic syndromes. Furthermore, large-scale studies are recommended to assess the role of S. mansoni egg and/or worm antigens in modulating the host metabolic profile and reducing the risk of metabolic syndromes, including diabetes mellitus and cardiovascular diseases.

Schistosoma japonicum Infection Leads to the Reprogramming of Glucose and Lipid Metabolism in the Colon of Mice

“…Recently, the reverse relationship between schistosome infection and metabolic syndrome has received attention ( 12 , 20 ). An epidemiological study revealed that schistosome infection is negatively correlated with metabolic diseases in humans ( 26 ). Meanwhile, animal studies confirmed that chronic S. japonicum infection could improve hepatic insulin sensitivity and glucose metabolism in mice ( 13 ).…”

The Impact of Helminth Infection on the Incidence of Metabolic Syndrome: A Systematic Review and Meta-Analysis

“…Of the fourteen studies assessed, nine reported that infection with a parasitic worm had protective effects on diabetes-related parameters (26,(44)(45)(46)(47)(50)(51)(52)(53), however three studies (48,49,55) reported a positive association between specific infections and T2D diagnosis, and two studies (54,56) reported no association. Individual glucose homeostasis related outcomes are summarized in Supplementary Table 4.…”

Schistosome and intestinal helminth modulation of macrophage immunometabolism

“…In the host, schistosomes induce a potent T helper type 2 (Th2) ‐biased immune response and polarization of macrophages to a broad M2 phenotype, which is vital for host survival 114,115 . Interestingly, multiple epidemiological studies have observed an inverse correlation between both active infection and a previous history of schistosome infection and metabolic diseases such as obesity and diabetes, raising interest in the metabolic reprogramming that schistosomes induce in diverse cells of the immune system 105,116–119 . As one of the major players in the pathology of disease, macrophages modulate initiation and disease resolution in schistosomiasis 120 .…”