Effect of anthelmintic treatment on serum free IGF-1 and IGFBP-3: a cluster-randomized-controlled trial in Indonesia

Farid Kurniawan,Karin De Ruiter,Em Yunir,Erliyani Sartono,Maria Yazdanbakhsh,Nienke R Biermasz,Dicky L Tahapary,Taniawati Supali,Pradana Soewondo,Johannes W A Smit

doi:10.1038/s41598-020-75781-4

Abstract

In children, soil-transmitted helminth infections have been linked to poor nutritional status and growth retardation in association with lower levels of IGF-1. In adults, IGF-1 has an anabolic and metabolic function and is related to nutritional status. Here, we assessed the impact of helminth infection on free IGF-1 and its major binding protein, IGFBP-3, in adults. The levels of IGF-1 and IGFBP3 were measured in 1669 subjects aged ≥ 16 years, before and after receiving four rounds of albendazole 400 mg/day or matching placebo for three consecutive days. Helminth infection status was assessed by microscopy (Kato-Katz) and PCR. Serum free IGF-1 level was significantly lower in helminth-infected subjects [mean difference and 95% CI − 0.068 (− 0.103; − 0.033), P < 0.001 after adjustment for age, sex, body mass index, and fasting insulin level]. There was no difference in IGFBP-3 level between helminth infected versus non-infected subjects. In the whole study population, albendazole treatment significantly increased serum free IGF-1 level [estimate and 95% CI 0.031 (0.004; − 0.057), P = 0.024] whereas no effect was found on the IGFBP-3 level. Our study showed that helminth infection in adults is associated with lower free IGF-1 levels but not with IGFBP-3 and albendazole treatment significantly increases free IGF-1 levels in the study population.Clinical Trial Registration: https://www.isrctn.com/ISRCTN75636394.

Highlights

Soil-transmitted helminth (STH) infections are still highly prevalent, especially in low- to middle-income countries[1]
To assess causality, we investigated the effect of anthelmintic treatment on serum free Insulin-like growth factor-1 (IGF-1) and IGFbinding protein-3 (IGFBP-3) levels to evaluate the effect of helminth infections on IGF system
The levels of serum fasting insulin, free IGF-1, IGFBP-3, and high-sensitivity C-reactive protein (hsCRP) were comparable between two groups

Summary

Introduction

Soil-transmitted helminth (STH) infections are still highly prevalent, especially in low- to middle-income countries[1]. Of its structural homology with proinsulin[13], IGF-1 binds to the insulin receptor with much lower affinity than insulin and exerts its metabolic properties[14]. These actions include promotes glucose uptake and transport in certain peripheral tissues[15], modulates glycogen s ynthesis[16], promotes fatty acid transport[17], and regulates amino acid and glucose intestinal absorption[18,19]. We conducted a study in the adult population living in an area endemic for helminth infection to evaluate the association between STH infections and free IGF-1 concentration as well as its main binding protein, IGFBP-3. To assess causality, we investigated the effect of anthelmintic treatment on serum free IGF-1 and IGFBP-3 levels to evaluate the effect of helminth infections on IGF system

Methods

Results

Conclusion