正常糖耐量人群糖尿病家族史与血脂紊乱的相关性

The association between dyslipidemia and family history of diabetes in normoglycemic population

目的:探讨糖尿病一级亲属(FDR)人群其糖尿病家族史与血脂紊乱发生的相关性。方法:本研究人群选自REACTION研究基线温州地区参与者。FDR定义为有一个或多个一级亲属(父母、亲兄妹、子女)患有糖尿病。根据中国成人血脂异常防治指南定义血脂紊乱。研究人群根据是否为FDR分为non-FDR组和FDR组,比较2组间血脂紊乱的患病率及其相关代谢指标水平。结果:与non-FDR组相比,FDR人群总胆固醇、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-c)水平较高,高密度脂蛋白胆固醇(HDL-c)水平较低(均P<0.05);FDR人群血脂紊乱的患病率显著高于non-FDR人群(P<0.001);多因素分析发现,TG、LDL-c和HDL-c(均P<0.05)与一级糖尿病家族史呈独立相关;多元Logistic回归分析结果显示一级糖尿病家族史与血脂紊乱的发生呈独立正相关(P<0.001)。结论:在糖耐量及体质量均正常时,FDR人群已出现血脂紊乱的易感性;FDR糖尿病家族史是血脂紊乱发生的独立危险因素。

Objective： The normoglycemic frst-degree relatives of patients with diabetes （FDR） are prefer-able for studies investigating metabolic abnormalities in the early stage of diabetes. The goal of the present study was to explore the association between the family history of diabetes and dyslipidemia. Methods： The present study population was selected from baseline survey of REACTION study in Wenzhou City. FDR was defned as having one or more frst-degree relatives of patients with diabetes （parent, sibling, or offspring. Dyslipidemia was defned according to the Chinese guidelines on prevention and treatment of dyslipidemia in adults. The partici-pants were divided into non-FDR and FDR groups based on their family history of diabetes. Comparisons of the prevalence of dyslipidemia and the levels of related metabolic indexes were conducted between these two groups. Results： Compared with non-FDR, FDR exhibited higher serum levels of TC, TG, and LDL-c, but lower levels of HDL-c （both P〈0.05）. The prevalence of dyslipidemia was greater in FDR （P〈0.001）. Multivariate analysis showed that TG, LDL-c, and HDL-c （both P〈0.05） were associated with the frst-degree family history of diabe-tes independently. Logistic regression analysis revealed the independent association between the frst-degree fam-ily history of diabetes and the present of dyslipidemia （P〈0.001）. Conclusion： FDR are prone to dyslipidemia even with normal glucose tolerance and weight. First-degree family history of diabetes is an independent risk fac-tor of the present of dyslipidemia.