Relationship between Carotid Intima Media Thickness and Helminth Infections on Flores Island, IndonesiaReport as inadecuate

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To examine the association between helminth infections and atherosclerosis.


Chronic helminth infection, which can lead to poor nutritional status and anti-inflammatory response, might protect against the development of atherosclerosis.


A cross-sectional study was performed in Flores, Indonesia, an area highly endemic for soil-transmitted helminths STH. Stool samples from 675 participants aged 18–80 years were collected and screened for Trichuris trichiura by microscopy and for Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Strongyloides stercoralis by qPCR. We collected data on body mass index BMI, waist to hip ratio WHR, blood pressure, fasting blood glucose FBG, lipid, high sensitive C-reactive protein hs-CRP, total immunoglobulin-E TIgE and Escherichia coli lipopolysaccharide stimulated cytokines tumor necrosis factor and interleukin-10. In a subset of 301 elderly adults ≥40 years of age carotid intima media thickness cIMT was measured.


Participants with any STH infection had lower BMI kg-m2 mean difference −0.66, 95%CI −1.26, −0.06, WHR −0.01, −0.02, −0.00, total cholesterol mmol-L −0.22, −0.43, −0.01 and LDL-cholesterol mmol-L −0.20, −0.39, −0.00 than uninfected participants. After additional adjustment for BMI the association between helminth infection and total cholesterol mean difference −0.17, 95%CI −0.37, 0.03 as well as LDL-cholesterol −0.15, −0.33, 0.04 was less pronounced. BMI, WHR, and total cholesterol were negatively associated with number species of helminth co-infections. Participants with high TIgE, an indicator of exposure to helminths, had lower FBG, TC, and HDL. The association between TIgE and TC and HDL remained significant after adjustment with BMI. No clear association was found between STH infection or TIgE and mean cIMT.


This cross-sectional study presents evidence that helminth infections were negatively associated with risk factors for cardiovascular disease, an association at least partially mediated by an effect on BMI. The significance of this finding needs to be determined.

Author: Aprilianto Eddy Wiria , Linda J. Wammes, Firdaus Hamid, Olaf M. Dekkers, Margaretta A. Prasetyani, Linda May, Maria M. M. Kaisar,



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