2型糖尿病家系一级亲属非糖尿病同胞血糖、胰岛素和C-肽水平的变化

Changes of glucose、insulin and C- peptide levels in non diabetic siblings of first degree relatives in type 2 diabetes mellitus families

目的 研究 2型糖尿病 (DM)一级亲属 (一级亲 )成员中有关胰岛素 (INS)作用和分泌的 8个参数水平的变化。方法 以 32 0个 2型DM家系中 347名一级亲非DM非糖耐量低减 (IGT)同胞为观察组 ,32 6名非DM非IGT的同胞配偶为对照组 ,比较两组口服葡萄糖耐量试验 (OGTT)中空腹和 2小时血糖 ,INS、C 肽及胰岛素抵抗稳态模型评估 (HOMA IR)和胰岛 β 细胞功能稳态模型评估 (HOMA B)。结果 总组比较 ,一级亲的HOMA B降低 ,空腹血浆葡萄糖 (FPG)增高 (P分别为0 .0 0 2 6和 0 .0 0 0 2 )。进一步发现差异表现在≥ 40岁亚组 ,除HOMA B和FPG有类似总组比较所见的变化外尚可见到在给于 75克葡萄糖负荷后血糖、INS和C 肽水平均高于对照组 (P分别为0 .0 19、0 .0 30和 0 .0 37)。尤其表现在 40～ 6 0岁和BMI 2 2～ 2 7亚组。结论 2型DM一级亲非DM、非IGT同胞 ,尤其超过

Objective To investigate the changes of 8 parameters related to insulin (INS) action and secretion in non diabetes (non DM) siblingsoffirstdegreerelatives (FDRs) in type 2 DM families. Methods 1986 individuals out of the 320 families from Shanghai, Jiangsu and Zhejiang provinces, were investigated and blood sampled. 347 siblings among FDRs who were not DM and IGT patients were selected as FDR group and 326 subjects of their spouses as control group. The oral glucose tolerance test (OGTT) was conducted, 8 parameters including homostasis model assessment (HOMA) insulin resistance (IR), HOMA β cell function (HOMA B) reflecting INS action and INS secretion were compared. Two groups were further divided into subgroups according to age and body mass index (BMI). Analysis of covariance with adjustment of these two factors was used in comparison between groups and subgroups. Results There were statistically significant differences of HOMA B and fasting plasma glucose (FPG) in comparison between two whole groups. HOMA BofFDRgroupwaslower, whreas FPG higher than those of control (P=0.0026 and 0.0002 respectively). Further investigation for <40 yr and ≥40 yr subgroups showed that the differences between FDR and control were revealed in ≥40 yr subgroup in which plasma glucose (PG)、 INS and C peptide (CP) levels were higher than those of control in addition to the similar changes of HOMA B and FPG in the whole group comparison. These changes were mainly revealed in the 40～60 yr subgroup and in the BMI 22～27 subgroup. Conclusion The INS action and INS secretion in FDR non diabetic individuals of type 2 diabetes pedigrees slightly decrease before appearance of IGT, especially in the members over 40 yr.