Presence and significance of intestinal unicellular parasites in a morbidly obese population

• Published in: International Journal of Obesity Vol. 46; no. 1; pp. 220 - 227
• Main Authors: Caudet, J., Trelis, M., Cifre, S., Soriano, J. M., Merino-Torres, J. F.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2022; Nature Publishing Group
• Subjects: 38/77; 59; 631/326/1762; 692/163/2743/393; Adult; Animals; Blastocystis - pathogenicity; Body composition; Chronic illnesses; Colonization; Cross-Sectional Studies; Epidemiology; Female; Gastrointestinal Tract - abnormalities; Gastrointestinal Tract - physiopathology; Giardia; Health Promotion and Disease Prevention; Humans; Insulin; Insulin resistance; Internal Medicine; Intestinal microflora; Intestine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic disorders; Metabolic syndrome; Metabolism; Microbiota; Microenvironments; Microorganisms; Nutrient deficiency; Obesity; Obesity, Morbid - complications; Obesity, Morbid - epidemiology; Obesity, Morbid - physiopathology; Parasites; Parasites - metabolism; Parasites - pathogenicity; Pathogenesis; Protozoa; Public Health; Signs and symptoms; Spain - epidemiology; Spain
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-021-00980-6

Background Obesity is a chronic disease whose pathogenesis has been related to changes in the intestinal microbiota. Yet, the role of protozoa and other unicellular eukaryotic parasites in this microenvironment is still largely unknown. Their presence within the gut ecosystem in obese subjects warrants further study, as well as their influence on the host metabolism and comorbidities. Methods Herein, a single center, cross-sectional study of 104 obese individuals was performed to assess the presence of six intestinal unicellular parasites in stool using a commercially available kit, and to evaluate its relationship with the presence of abdominal symptoms, metabolic comorbidities, variations in body composition and nutritional deficiencies. Results The overall parasitic colonization rate was 51%, with Blastocystis sp., identified as the most frequent (44.2%), followed by Dientamoeba fragilis (11.5%) and Giardia intestinalis (8.7%), and significantly related to the consumption of ecological fruits and vegetables. Contrary to what previous studies pointed out, colonization with parasites species was significantly associated with fewer abdominal symptoms and depositions per day. The presence of parasites did not correlate with any nutritional deficiencies nor differences in body composition, while it did with significant lower HOMA-IR levels and a lower trend towards metabolic syndrome. Conclusion Obese subjects frequently harbor unicellular enteric parasites, apparently without clinical nor nutritional harm. This evidence suggests that carrying these microorganisms, from an endocrinological perspective, has a beneficial effect, especially on insulin resistance and possibly on the development of related comorbidities.