182个2型糖尿病家系865人调查分析

An investigation among 865 subjects from 182 familial type 2 diabetes pedigrees

目的 建立一个可用于系统研究2型糖尿病的高发家系人群,对2型糖尿病家系的发病情况、临床及生化指标进行分析.方法 按美国糖尿病学会标准,已诊断有糖尿病家族史的糖尿病先证者进行三代家族史和血统成员的调查研究,全部非患者采血做口服葡萄糖耐量试验确认,并对新老患者用免疫学方法,系谱分析和分子生物学方法排除1型糖尿病、青少年发病的成年型糖尿病(MODY)和线粒体遗传阳性家系,最终筛选出具有2个或2个以卜2型糖尿病患者的家系182个(实际调查共865人)并进行分析.全部家系成员均检查血糖、血脂、胰岛素C肽释放试验.结果 受调查的865名成员中2型糖尿病、单纯空腹血糖受损、单纯葡萄糖耐量减退、空腹血糖受损合并葡萄糖耐量减退总患病率为59.88%,2型糖尿病患病率为45.43%.新榆出2型糖尿病患者94例,单纯空腹血糖受损者14例,单纯葡萄糖耐量减退者61例,空腹血糖受损合并葡萄糖耐量减退者27例.先证者父、母、同胞、子女的患病率明显高于普通人群.糖尿病组收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、甘油二酯、体重指数、胰岛素抵抗指数明显高于空腹血糖受损和(或)葡萄糖耐量减退组或未发病者.在2型糖尿病发病前的葡萄糖耐量减退阶段,收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、体重指数、胰岛素抵抗指数也高于正常人群.结论 2型糖尿病发病具有明显的家族聚集性,高血压、高血脂、肥胖是2型糖尿病的高危因素,胰岛素抵抗在糖尿病发病前已存在.

Objective To constitute a crowd of multiple familial type 2 diabetes mellitus (T2DM)and to observe the effects of several risk factors of hypertension,lipid metabolic disorder,obesity and insulin resist.Methods According to American Diabetes Association criteria of diabetes,pedigrees with two or over two T2DM patients were chosen and all people were diagnosed by OGTT.Eight hundred and sixty-five persons from 182 pedigrees with two or more T2DM patients were analyzed after the type 1 diabetes mellitus,maturity onset diabetes of the young(MODY) and mitochondrial gene mutation pedigrees were excluded.The survey includes tests of blood glucose,insulin,C-peptide,lipids,etc.Results The prevalence of T2DM and impared glucose regulation impaired glucose regulation (IGR) was 59.88%,the prevalence of T2DM was 45.43%,including 94 T2DM and 102 IGR newly discovered,the prevalence of T2DM and IGR in the diabetes family was significant higher than those in the common populations.The systolic pressure,diastolic pressure blood lipid,BMI,HOMA-IR in diabetic group were obviously higher than those in IGR group or normal group.Conclusion There is significant familial aggregation in T2DM.The history of hypertension and hyperlipidemia and obesity are the risk factors of T2DM or IGR patients.Insulin resistance exists before the attack of diabetes mellitus.