The Prevalence of Intestinal Parasites Is Not Greater Among Individuals With Irritable Bowel Syndrome: A Population-based Case-control Study
The Prevalence of Intestinal Parasites Is Not Greater Among Individuals With Irritable Bowel Syndrome: A Population-based Case-control Study
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DOI：
10.1016/j.cgh.2014.07.065
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发表时间：
2015-03-01
影响因子：
12.6
通讯作者：
Bytzer, Peter
中科院分区：
文献类型：
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作者：
Krogsgaard, Laura Rindom;Engsbro, Anne Line;Bytzer, Peter
背景与目的：在肠易激综合征（IBS）患者粪便中检出脆弱双阿米巴（Dientamoeba fragilis）和囊虫（Blastocystis）寄生虫，可能与IBS的发病有关。我们提出，与无症状对照组相比，肠易激综合征患者中寄生虫的患病率较高，这将支持这一机制。我们的目的是确定这些寄生虫在IBS受试者（病例）和对照组中的流行情况，并确定与寄生虫携带相关的危险因素。方法：我们对丹麦一家基于互联网的研究机构的成年人进行了一项基于人群的病例对照研究。2010年1月，受试者根据肠易激综合征罗马III标准填写了一份问卷，并回答了与寄生虫携带相关因素的问题。调查对象（n = 483）被要求提交粪便样本进行寄生虫检测；分析124例病例和204例对照。结果：对照组感染比例大于病例（50% vs 36%; P = 0.01）。在对照组的粪便样本中检测到脆性肠裂菌的比例高于病例（35%对23%，P = 0.03），囊虫（22%的对照组对15%的病例，P = 0.09）和携带1种以上寄生虫的对照组的比例更高（16%的对照组对8%的病例，P = 0.05）。脆弱肠杆菌感染与家庭中有5至18岁的儿童有关，囊虫感染与高收入（>= 600,000丹麦克朗/年，约100,000美元/年）、家庭中没有动物以及饮用瓶装水有关。结论：丹麦无症状背景人群的粪便样本中检测到脆性肠裂菌和囊胚菌的比例高于有肠易激综合征症状的人群。这些发现表明，这些寄生虫不太可能在肠易激综合征的发病机制中起直接作用。需要进行纵向研究以了解它们在胃肠道健康中的作用。
BACKGROUND & AIMS: The parasites Dientamoeba fragilis and Blastocystis have been detected in feces from patients with irritable bowel syndrome (IBS), therefore these parasites may be involved in IBS pathogenesis. We proposed that a higher prevalence of the parasites in IBS subjects compared with asymptomatic controls would support such a mechanism. We aimed to determine the prevalence of these parasites in IBS subjects (cases) and controls and to identify risk factors associated with parasite carriage.METHODS: We performed a population-based, case-control study of an adult population from an internet-based research institute in Denmark. In January 2010, subjects completed a questionnaire based on the Rome III criteria for IBS and answered questions on factors associated with parasite carriage. Respondents (n = 483) were asked to submit fecal samples for parasite testing; samples were analyzed from 124 cases and 204 controls.RESULTS: A greater proportion of controls than cases carried the parasites (50% vs 36%; P =.01). D fragilis was detected in a greater proportion of fecal samples from controls than cases (35% vs 23%; P =.03), as was Blastocystis (22% of controls vs 15% of cases; P =.09), and a greater percentage of controls carried more than 1 species of parasite (16% of controls vs 8% of cases; P =.05). D fragilis infection was associated with having children 5 to 18 years old in the household and Blastocystis infection was associated with high income (>= 600,000 Danish Kroner/y, approximately $100,000 US dollars/y), no animals in the household, and drinking bottled water.CONCLUSIONS: D fragilis and Blastocystis were detected in a greater proportion of fecal samples from the asymptomatic background population in Denmark than from subjects with IBS symptoms. These findings indicate that these parasites are not likely to have a direct role in the pathogenesis of IBS. Longitudinal studies are required to understand their role in gastrointestinal health.