Epidemiological transition in Indonesia : impact of helminths and urbanization on the development of Type 2 diabetes

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Epidemiological transition in Indonesia : impact of helminths and urbanization on the development of Type 2 diabetes

Type: Doctoral Thesis
Title: Epidemiological transition in Indonesia : impact of helminths and urbanization on the development of Type 2 diabetes
Author: Tahapary, D.L.
Issue Date: 2017-09-19
Keywords: Helminths
Urbanization
Diabetes
Insulin resistance
Leptin
Adiponectin
Anthelmintic
Rural
Indonesia
Abstract: The main objective of this thesis is to improve understanding of the role of helminth infections in the development of insulin resistance (IR), hence Type 2 Diabetes (T2D), in the light of increasing urbanization in Indonesia. Our large-scale cluster-randomized controlled trial was performed in a rural area of Indonesia, which is endemic for soil-transmitted helminth (STH), and has been previously reported to have a low prevalence of IR and T2D. In STH-infected subjects, as assessed by microscopy, 12-month anthelmintic treatment increased IR, which was mediated by an increase in BMI and leptin to adiponectin ratio, as well as reduction in eosinophil count. Next, we also aimed to assess the different metabolic profile between populations living in rural and urban area, and to study the relative protective effect of rural environment to high-fat diet (HFD). In comparison to those living in rural area, individuals living in urban area had higher whole body IR, which was mainly mediated by the higher adiposity and leptin level, which were progressively increased with increased duration of time spent in urban area. Different environmental factors (including past or current exposure to STH) did not seem to affect the metabolic response to HFD intervention, independent from adiposity.
Promotor: Supervisor: Yazdanbakhsh M., Smit J.W.A. Co-Supervisor: Sartono E.
Faculty: Faculty of Medicine, Leiden University Medical Center (LUMC)
University: Leiden
Uri: urn:isbn:9789461828255
Handle: http://hdl.handle.net/1887/52966
 

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