Abstract
Emerging evidence suggests that helminths might confer protection against the development of type 2 diabetes. We aimed to assess the role of adipokines in mediating the effect of helminths on insulin resistance. Serum samples were obtained from a randomized-controlled trial of anthelmintic treatment in an area endemic for soil-transmitted helminths (STH), Flores Island, Indonesia. In STH-infected subjects, anthelmintic treatment significantly increased the ratio of leptin to adiponectin (treatment effect factor (95% confidence interval (CI)), P-value for interaction: 1.20 (1.06–1.35), P=0.010), which largely stemmed from a significant reduction in adiponectin (0.91 (0.85–0.98), P=0.020) and a trend for an increase in leptin level (1.10 (1.00–1.21), P=0.119). No significant effect on resistin level was observed. This increase in leptin to adiponectin ratio seemed to contribute to the observed effect of deworming on increased insulin resistance (IR) as adjustment for leptin to adiponectin ratio attenuated the effect on IR from 1.07 (1.01–1.14, P=0.023) to 1.05 (0.99–1.11, P=0.075). Anthelmintic treatment in STH-infected subjects increases leptin to adiponectin ratio which may in small part contribute to the modest increase in IR. Further studies will be needed to assess the effect of the changes in adipokine levels on the host immune response and metabolism.
Highlights
Emerging evidence suggests that helminths might confer protection against the development of type 2 diabetes (T2D),[1,2,3,4,5] presumably by modulating the host immune responses.[6,7,8]
We have recently reported that removal of helminth infections increases insulin resistance (IR),[9] which is mainly mediated by the increase in adiposity,[9] suggesting a central role of adipose tissue (AT).[10,11,12,13]
Whereas leptin promotes pro-inflammatory immune responses and inhibits the proliferation of regulatory T cells, adiponectin induces the secretion of anti-inflammatory cytokines.[15]
Summary
Emerging evidence suggests that helminths might confer protection against the development of type 2 diabetes (T2D),[1,2,3,4,5] presumably by modulating the host immune responses.[6,7,8] in addition to the more established risk factors, such as sedentary lifestyle and high-energy foods, current deworming programs in parallel with rapid socioeconomic development might potentially contribute to the development of T2D in many low and middleincome countries.[6]. The imbalance between those two adipokines, leptin to adiponectin (L/A) ratio, has been reported to be associated with pro-inflammatory conditions and IR.[16,17]
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