关于非洲蠕虫对糖尿病的作用的数据有限。我们调查了成人血吸虫和土蠕虫感染是否与β细胞功能和胰岛素抵抗有关。
在2016-2017年期间对成年人进行了横断面研究。人口统计,血吸虫和地球蠕虫感染,收集HIV和胰岛素数据。口服葡萄糖耐量试验期间的胰岛素(空腹,30和120分钟),总胰岛素分泌指数,促胰岛素指数,HOMA-β,和HOMA-IR是β细胞功能和胰岛素抵抗的主要结局指标,分别。广义估计方程和广义线性模型分别通过HIV状态评估了血吸虫和地蠕虫感染与结果指标的关联。结果以边际均值表示,CI为95%。
获得了1718名参与者的数据。血吸虫感染与较高的30分钟胰岛素(24.2mU/L,95%CI:6.9,41.6)和总体胰岛素分泌指数(13.3pmol/L/mmol/L;3.7,22.9)在未感染HIV的参与者中,但空腹胰岛素较低(-0.9mU/L;-1.6,-0.2),120分钟胰岛素(-12.0mU/L;-18.9,-5.1),和HOMA-IR(-0.3mmol/L;-0.6,-0.05)在尚未接受抗逆转录病毒治疗(ART)的HIV感染参与者中。在没有接受ART的HIV感染参与者中,土蠕虫感染与空腹胰岛素降低有关(-0.9mU/L;-1.6,-0.2),120分钟胰岛素(-9.1mU/L;-17.3,-1.0),HOMA-β(-8.9mU/L)/(mmol/L;-15.3,-2.6)和总体胰岛素释放指数(-5.1pmol/L/mmol/L;-10.3,0.02),尽管这一点意义不大。在ART上没有关联。
在未感染HIV的参与者中,血吸虫感染与较高的β细胞功能相关,而在未接受ART的HIV感染参与者中,血吸虫和土虫感染与β细胞功能降低相关。
Data on the role of helminths on diabetes in Africa are limited. We investigated whether
Schistosoma and geohelminth infections are associated with β-cell function and insulin resistance among adults.
A cross-sectional
study was conducted among adults during 2016-2017. Demography,
Schistosoma and geohelminth infections, HIV and insulin data were collected. Insulin during an oral glucose tolerance test (fasting, 30, and 120-min), overall insulin secretion index, insulinogenic index, HOMA-β, and HOMA-IR were main outcome measures for β-cell function and insulin resistance, respectively. Generalized estimating equations and generalized linear models assessed the association of
Schistosoma and geohelminth infections with outcome measures separately by HIV status. Outcomes were presented as marginal means with 95% CI.
Data were obtained for 1718 participants. Schistosoma infection was associated with higher 30-min insulin (24.2 mU/L, 95% CI: 6.9, 41.6) and overall insulin secretion index (13.3 pmol/L/mmol/L; 3.7, 22.9) among HIV-uninfected participants but with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-12.0 mU/L; -18.9, -5.1), and HOMA-IR (-0.3 mmol/L; -0.6, -0.05) among HIV-infected participants not yet on antiretroviral therapy (ART). Among HIV-infected participants not on ART, geohelminth infection was associated with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-9.1 mU/L; -17.3, -1.0), HOMA-β (-8.9 mU/L)/(mmol/L; -15.3, -2.6) and overall insulin release index (-5.1 pmol/L/mmol/L; -10.3, 0.02), although this was marginally significant. There was no association among those on ART.
Schistosoma infection was associated with higher β-cell function among HIV-uninfected participants whereas Schistosoma and geohelminth infections were associated with reduced β-cell function among HIV-infected participants not on ART.