Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters

PLoS One. 2022 May 31;17(5):e0269080. doi: 10.1371/journal.pone.0269080. eCollection 2022.

Abstract

Background: Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between Strongyloides stercoralis infection and T2DM has scarcely been investigated and the protective effect of infection against development of diabetic complications is unclear. In this study, we aimed to investigate the relationship between S. stercoralis infection and T2DM in a rural area of Khon Kaen Province, Thailand. The impact of S. stercoralis infection on diabetic complication-related kidney function biochemical parameters and body-mass index (BMI) was also assessed.

Methodology: Using a cross-sectional study design, S. stercoralis infection and T2DM assessments were conducted between October 2020 and May 2021. Associations between S. stercoralis infection, T2DM, and socioeconomic factors were analyzed using multivariable logistic regression analyses. Diabetic complication-related biochemical parameters relating largely to kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), serum creatinine, uric acid, alanine transaminase (ALT), and low-density lipoprotein cholesterol (LDL-C)) and BMI of participants with and without T2DM were compared between groups with or without S. stercoralis infection.

Results: One hundred and seven out of 704 individuals (15.20%) were positive for S. stercoralis, and 283 people were diagnosed with T2DM. Of those with T2DM, 11.31% (32/283) were infected with S. stercoralis and of those without T2DM, 17.82% (75/421) were infected with S. stercoralis. Multivariate analysis revealed that T2DM was inversely correlated with S. stercoralis infection (Adjusted OR = 0.49; 95% CI: 0.30, 0.78; p = 0.003), while male, increasing age, lower education level, and alcohol intake were positively associated with infection. Those infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels than those in the uninfected group.

Conclusion: This finding indicates that S. stercoralis infection was inversely associated with T2DM in northeastern Thailand, but participants infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels. Infection with S. stercoralis might lead to worse complication-related renal biochemical parameters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cross-Sectional Studies
  • Diabetes Complications* / complications
  • Diabetes Mellitus, Type 2*
  • Humans
  • Kidney
  • Male
  • Strongyloides stercoralis*
  • Strongyloidiasis* / complications
  • Strongyloidiasis* / epidemiology
  • Thailand / epidemiology

Grants and funding

This study was supported by Khon Kaen University through the Research Program (RP65-2-001) and the Chronic Kidney Disease Prevention in the Northeast Thailand research project (CKDNET 2017, 2018, 2019). SA received research funds from Thailand Science Research and Innovation (TSRI), through Program Management Unit for Competitiveness (PMUC), number C10F630030. NTH was supported by the Postgraduate Scholarship, Faculty of Medicine, Khon Kaen University, Thailand. The funders have no role in study design, data collection and analyses, or preparation of the manuscript.