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目的对46个家庭171例糖尿病患者的183例未发糖尿病的同胞进行胰岛细胞抗体,胰岛β细胞功能和糖代谢的检测。以观察糖尿病特别是LADA患者的家族聚集性和胰岛细胞抗体在LADA发病中的预测性。方法对家族同胞中有2例或2例以上先证糖尿病患者检测其及其他同胞的胰岛细胞抗体(GADA、ICA、IA-2A和IAA)。胰岛细胞功能(空腹,标准餐负荷后2小时血糖和C肽)以及BMI,腰/臀比。观察:①家族集聚性糖尿病患者胰岛细胞抗体阳性率;②未发病同胞中胰岛细胞阳性率,胰岛细胞功能,3年中家族同胞中新发糖尿病的概率。结果①家族集聚性糖尿病患者同胞中胰岛细胞抗体较一般人群相比高,差异具有统计学意义(P<0.05);②IFG、IGT异常者多,与一般人群相比,差异具有统计学意义(P<0.05);③进展为LADA的比例高,与一般人群发病率相比差异具有统计学意义(P<0.05);④BMI,腰/臀比低于一般2型糖尿病患者,差别无统计学意义。结论 LADA具有家族聚集性,LADA患者的家族同胞中胰岛细胞抗体阳性率高于一般人群,IFG、IGT以及糖尿病的发生率高于一般人群。
Objective To detect islet cell antibodies, pancreatic β-cell function and glucose metabolism in 183 non-diabetic sibs from 171 families with diabetes in 46 families. To examine familial aggregation and islet cell antibody predictive of LADA in patients with diabetes, especially in patients with LADA. Methods The islet cell antibodies (GADA, ICA, IA-2A and IAA) were detected in two or more proband diabetic patients in their sibs. Islet cell function (fasting, 2-hour postprandial blood glucose and C-peptide) and BMI, waist / hip ratio. The positive rates of islet cell antibody in familial diabetic patients, positive rates of islet cells, islet cell function, and the probability of new onset diabetes in 3-year-old siblings were also observed. Results ① Compared with the general population, there was a significant difference in islet cell antibody in siblings with familial aggregation diabetes mellitus (P <0.05). ② There were more abnormalities of IFG and IGT, and the difference was statistically significant (P <0.05). ③The proportion of progression to LADA was high, which was significantly lower than that of the general population (P <0.05) .④BMI and waist / hip ratio were lower than those of type 2 diabetes patients. There was no significant difference between them. Conclusions LADA has familial aggregation. The positive rate of islet cell antibodies in family members of LADA patients is higher than that of general population. The incidence of IFG, IGT and diabetes is higher than that of general population.