Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study.
Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study.
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DOI：
10.14740/jocmr2525w
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发表时间：
2016-05
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影响因子：
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通讯作者：
Alvarado-Soto E
中科院分区：
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作者：
Alvarado-Esquivel C;Salcedo-Jaquez M;Sanchez-Anguiano LF;Hernandez-Tinoco J;Rabago-Sanchez E;Beristain-Garcia I;Liesenfeld O;Estrada-Martinez S;Perez-Alamos AR;Alvarado-Soto E
弓形虫寄生虫在世界各地引起感染。弓形虫感染是全身性的，这种寄生虫可以在心肌中持续存在。我们对弓形虫对心脏病患者的影响知之甚少。我们确定了弓形虫暴露与在墨西哥杜兰戈一家公立医院就诊的心脏病患者之间的关系；还调查了弓形虫暴露与这些患者的社会人口学、行为和临床特征的关系。通过病例对照研究，我们检测了抗t抗体的血清阳性率。使用酶联免疫分析法检测400名心脏病患者和400名年龄和性别匹配的对照组的刚地IgG和IgM抗体。此外，我们通过双变量和多变量分析，分析了标准化问卷所确定的患者特征与弓形虫暴露的关系。400例患者中55例（13.8%）和400例对照中32例（8.0%）有抗t抗体。弓形虫IgG抗体(优势比(OR) = 1.83；95%置信区间（CI）： 1.15 - 2.90；P = 0.01)。anti-T高。55例阳性病例中28例（50.9%）和32例阳性对照中14例（43.8%）检测到弓形虫IgG水平（bb0 ~ 150 IU/mL） （P = 0.51）。Anti-T。55例抗t抗体中有13例（23.6%）检出弓形虫IgM抗体。弓形虫IgG阳性患者中有19例（59.4%）抗t抗体阳性。刚地IgG阳性对照（OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008）。多因素分析显示，弓形虫暴露与出生在杜兰戈州以外呈正相关（OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004），与饮酒呈正相关（OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04）。本研究结果提示弓形虫感染与心脏疾病相关，提示心脏疾病可能与慢性感染有关。这是该人群中弓形虫暴露与饮酒相关的第一份报告。结果值得进一步研究，以确定弓形虫暴露对心脏病患者的流行病学影响。与弓形虫暴露相关的风险因素对于设计未来预防弓形虫暴露的策略至关重要。
The parasite Toxoplasma gondii causes infections all around the world. Infections with T. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact of T. gondii on patients with heart disease. We determined the association between T. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association of T. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated. Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire with T. gondii exposure by bivariate and multivariate analyses. Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed that T. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04). Results obtained in this study indicate that T. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association of T. gondii exposure with alcohol consumption in this population. Results warrant for further research to determine the epidemiological impact of T. gondii exposure on patients with heart diseases. Risk factors associated with T. gondii exposure are critical to design future prevention strategies against T. gondii exposure.