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目的探讨盎格鲁-凯尔特人和中国人代谢综合征(IR)患病率和2型糖尿病促发因素。方法采用横断面研究,收集1992—2004年澳大利亚阿尔弗雷德王子医院和北京306医院门诊筛查糖尿病病程小于2a的病例资料,1016名盎格鲁-凯尔特人和1514名中国人,按发病时年龄分层后分析其IR(WHO标准)及其构成因素。结果在盎格鲁-凯尔特早发糖尿病病人中,IR患病率较高,且体质指数(BMI)与发病年龄呈显著负相关(r=-0.300;P<0.01),BMI每增加1kg/m2,发病年龄减小0.5岁。低发病年龄组可见IR患病率增加、甘油三酯(TG)升高以及高密度脂蛋白(HDL)降低;中国人发病年龄与BMI、IR、TG或HDL无关联。结论在凯尔特人中IR是2型糖尿病的重要促发因素,而在中国人中并非如此。提示中国人群中提早发生的beta细胞缺乏是糖尿病发病的更重要的促发因素。2型糖尿病具有异质性,因此,糖尿病的预防需要更多人种特异性的治疗策略。
Objective To investigate the prevalence of metabolic syndrome (IR) and type 2 diabetes in Anglo-Celtic and Chinese populations. Methods A cross-sectional study was conducted to collect data on the out-patient screening of diabetes mellitus of less than 2a from Prince Alfred Hospital in Australia and 306 Hospital in Beijing from 1992 to 2004. A total of 1016 Anglo-Celtic and 1514 Chinese were enrolled in this study. Age stratified analysis of its IR (WHO standards) and its components. Results In the Anglo-Celtic patients with early-onset diabetes mellitus, the prevalence of IR was higher and there was a significant negative correlation between body mass index (BMI) and age of onset (r = -0.300; P <0.01) , Age of onset decreased by 0.5 years. Low incidence of age group showed increased prevalence of IR, elevated triglycerides (TG) and decreased high density lipoprotein (HDL); Chinese age of onset was not associated with BMI, IR, TG or HDL. Conclusions IR is an important predisposing factor for type 2 diabetes in Celtic but not in Chinese. Suggesting that the early onset of beta cell deficiency in the Chinese population is a more important contributing factor in the pathogenesis of diabetes. Type 2 diabetes is heterogeneous, therefore, prevention of diabetes requires more ethnic specific treatment strategies.