Association of Previous Schistosome Infection With Diabetes and Metabolic Syndrome: A Cross-Sectional Study in Rural China

Abstract

Schistosome antigens modulate host metabolic profiles and reduce the risk of diabetes in experimental animals. This association has not previously been examined in humans. The objective of the study was to evaluate whether previous schistosome infection (PSI) is related to the development of diabetes and metabolic syndrome. A cross-sectional study was conducted in 9539 participants aged 40 years and older in a rural community in China. Information on a history of schistosome infection was collected by personal interview and cross-referenced with local infectious disease registry. The associations between PSI and diabetes or metabolic profiles were evaluated using logistic regression models in participants aged 60 years and older (n = 3913). Participants with PSI (n = 463) had significantly lower levels of adjusted fasting blood glucose, postprandial blood glucose, glycated hemoglobin A1c, and homeostasis model assessment of insulin resistance as well as a lower prevalence of diabetes (14.9% vs 25.4%, P < .0001) and metabolic syndrome (14.0% vs. 35.0%, P < .0001) compared with the uninfected, contemporaneous controls (n = 3450). Logistic regression analysis revealed that the adjusted odds ratios and 95% confidence interval of prevalent diabetes and metabolic syndrome associated with PSI were 0.51 (0.34-0.77) and 0.40 (0.27-0.58), respectively. The associations between PSI and the lower prevalence of diabetes and a better metabolic profile in rural Chinese need to be confirmed in other populations. If confirmed, the protecting effect of helminth infection could be reconsidered in terms of therapeutic strategies for the treatment of diabetes and metabolic diseases.