Abstract
Infection with parasitic helminths has been reported to improve insulin sensitivity and glucose homeostasis, lowering the risk for type 2 diabetes. However, little is known about its impact on whole-body lipid homeostasis, especially in obese individuals. For this purpose, a cross-sectional study was carried out in lean and overweight/obese adults residing in the Lambaréné region of Gabon, an area endemic for Schistosoma haematobium. Helminth infection status, peripheral blood immune cell counts, and serum metabolic and lipid/lipoprotein levels were analyzed. We found that urine S. haematobium egg-positive individuals exhibited lower serum total cholesterol (TC; 4.42 vs 4.01 mmol/L, adjusted mean difference [95%CI] -0.30 [-0.68,-0.06]; P = 0.109), high-density lipoprotein (HDL)-C (1.44 vs 1.12 mmol/L, -0.24 [-0.43,-0.06]; P = 0.009) and triglyceride (TG; 0.93 vs 0.72 mmol/L, -0.20 [-0.39,-0.03]; P = 0.022) levels than egg-negative individuals. However, when stratified according to body mass index, these effects were only observed in overweight/obese infected individuals. Similarly, significant negative correlations between the intensity of infection, assessed by serum circulating anodic antigen (CAA) concentrations, and TC (r = -0.555; P<0.001), HDL-C (r = -0.327; P = 0.068), LDL-C (r = -0.396; P = 0.025) and TG (r = -0.381; P = 0.032) levels were found in overweight/obese individuals but not in lean subjects. Quantitative lipidomic analysis showed that circulating levels of some lipid species associated with cholesterol-rich lipoprotein particles were also significantly reduced in overweight/obese infected individuals in an intensity-dependent manner. In conclusion, we reported that infection with S. haematobium is associated with improved lipid profile in overweight/obese individuals, a feature that might contribute reducing the risk of cardiometabolic diseases in such population.
Highlights
About one quarter of Earth inhabitants are infected with parasitic helminths and most of them are living in Africa [1]
Infection with parasitic helminths has been reported to be beneficial for metabolic homeostasis by improving insulin sensitivity and lowering the risk for developing type 2 diabetes
In the framework of a cross-sectional study conducted in an endemic rural area, we have investigated the impact of infection with Schistosoma hematobium on serum lipid homeostasis in adult individuals with a broad range of body weight
Summary
About one quarter of Earth inhabitants are infected with parasitic helminths and most of them are living in Africa [1]. Schistosomiasis affects 200 to 300 million people worldwide [1], especially in the poorest regions of the low and middle income countries (LMIC), and remains a major public health problem in these endemic areas [3, 4], where it co-exists with other health condition, including non-communicable diseases (NCDs). NCDs such as obesity, metabolic syndrome and type 2 diabetes (T2D) are increasing in industrialized countries and in developing countries that experienced rapid ruralurban transition, notably in Africa [5,6,7]. Obesity is often associated with chronic low-grade inflammation, called meta-inflammation, which contributes to peripheral and systemic insulin resistance, alterations of glucose and lipid metabolism, and leads to the development of T2D and related cardiovascular diseases [8]. Meta-inflammation mostly results from alterations in the composition and/or activation state of a variety of innate and adaptive immune cells in metabolic organs, notably in adipose tissue and the liver, creating a pro-inflammatory environment that contribute to tissue-specific insulin resistance and whole-body metabolic dysfunctions [9]
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