家族性2型糖尿病家系中正常同胞的血糖血脂代谢

Metabolism of glucose and lipid in normal siblings of familial type 2 diabetes

目的:研究家族性2型糖尿病家系一级亲属正常同胞的血糖血脂代谢变化。方法:收集江苏苏南地区2型糖尿病多发家系136个。在排除糖尿病和糖耐量异常的前提下,选择先证者同胞为观察组(n=108),先证者同胞的配偶为对照组(n=92),进行血糖血脂代谢分析。结果:与对照组比较,观察组的三酰甘油犤(11.62±0.74)mmol/L犦、低密度脂蛋白胆固醇犤(3.23±1.39)mmol/L犦、空腹血糖犤(4.59±0.54)mmol/L犦和口服葡萄糖2h血糖犤(5.12±1.16)mmol/L犦升高,差异有显著性意义(t=2.644～2.971,P均0.05);而空腹及口服葡萄糖2h胰岛素犤(11.7±4.9),(37.7±23.7)mu/L犦和C肽水平犤(1.94±1.35),(5.23±3.27)μg/L犦无明显差异(t=0.261～1.254,P均>0.05)。结论:家族性2型糖尿病家系一级亲属在糖耐量正常的情况下血糖、血脂已开始变化,提示有胰岛素不敏感。对该糖尿病高危人群应进行监测及教育以利早期防治。

AIM:To study the changes of blood glucose and lipid levels in normal siblings of first degree relatives of type 2 diabetes families. METHODS:Totally 136 families with type 2 diabetes were collected from south Jiangsu Province.Under the condition of exclusion of those with diabetes and abnormality of glucose tolerance,108 first degree siblings with normal glucose tolerance(NGT) were assigned into the observation group,and 92 NGT spouses of the siblings were assigned into the control group.Blood glucose and lipid levels were compared between the two groups. RESULTS:Compared with the control group,the levels of tricylglycerol(TG)[(11.62±0.74) mmol/L],low density lipoprotein[(3.23±1.39) mmol/L],fasting blood glucose[(4.59±0.54) mmol/L] and that of 2 hours after OGTT[(5.12±1.16) mmol/L] in the observation group were significantly increased(t=2.644-2.971,P< 0.05);while there were no obvious differences in the levels of fasting and 2 hour post taking OGTT insulin[(11.7±4.9),(37.7±23.7)mu/L] and C peptide levels[(1.94±1.35),(5.23±3.27)μg/L](t=0.261-1.254,P >0.05). CONCLUSION:Lucose and lipid abnormality have occurred in NGT relatives of familial type 2 diabetes,indicating that insulin insensitivity exists in this siblings.These high risk groups of diabetes should be monitored and educated for early prevention and treatment.