论文部分内容阅读
研究2型糖尿病(T2DM)患者一级亲属(FDR)与无家族史个体代谢综合征及胰岛分泌功能的差异。共纳入研究对象1 929例,其中T2DM患者的FDR组505例、无糖尿病家族史的对照者1 424例(对照组)。测量两组成员血压、体重、腰围;行OGTT,检测空腹及2 h血糖、胰岛素水平;测定空腹血脂、尿酸;计算体重指数、HOMA-胰岛素抵抗指数(homeostasis model assessment of insulin resistant,HOMA-IR)、胰岛素敏感指数(insulin sensitivity in-dex,ISI)、胰岛β细胞功能指数(homeostasis model assessment of-βcell function,HOMA-β)及葡萄糖处置指数(dis-position index,DI),并比较各组间上述指标的差异。在校正年龄、性别后,FDR组HOMA-IR高于对照组,ISI、DI和HOMA-β低于对照组(P<0.05)。FDR组合并三种及三种以上代谢异常的发生率及发生代谢综合征的风险升高(P<0.05)。随着代谢异常的个数增加,FDR组HOMA-IR逐渐升高,而HOMA-β、DI和ISI有递减趋势,但在代谢异常个数≥4时,HOMA-IR不再增加,ISI不再降低。家系FDR比无家族史的对照表现出更多的代谢异常,并且随着代谢异常的增多又造成β细胞功能和胰岛素敏感性的恶化,有必要进行各项代谢指标的监测和早期预防性干预,以预防糖尿病发生。
To investigate the differences of metabolic syndrome and pancreatic islet secretion between first-degree relatives (FDR) and non-family history individuals with type 2 diabetes mellitus (T2DM). A total of 1 929 subjects were enrolled, including 505 FDR patients with T2DM and 1 424 controls without family history of diabetes (control group). The blood pressure, body weight and waist circumference of the two groups were measured. OGTT was performed to detect the fasting and 2-hour blood glucose and insulin levels. Fasting blood lipids and uric acid were measured. Body mass index, HOMA-insulin resistance (HOMA-IR) , Insulin sensitivity in-dex (ISI), homeostasis model assessment of -cell function (HOMA-β) and dis-position index (DI) Differences between the above indicators. After adjusting for age and gender, HOMA-IR in FDR group was higher than that in control group, and ISI, DI and HOMA-β were lower than those in control group (P <0.05). FDR combination of three and three or more metabolic abnormalities and the occurrence of metabolic syndrome risk increased (P <0.05). With the increase of the number of metabolic abnormalities, the HOMA-IR of FDR group increased gradually, while the HOMA-β, DI and ISI decreased gradually. However, the number of HOMA-IR no longer increased and the ISI no longer increased when the number of metabolic abnormalities≥4 reduce. Family FDR showed more metabolic abnormalities than controls without family history, and with the metabolic abnormalities resulting in β-cell function and insulin sensitivity deterioration, it is necessary to carry out monitoring of various metabolic indicators and early preventive intervention, To prevent diabetes.