2型糖尿病家系一级亲属同胞腰臀股围的变化

Changes of waist,hip and thigh circumferences in siblings of first degree relatives in type 2 diabetes mellitus families

目的 研究 2型糖尿病家系一级亲属同胞糖代谢异常及糖耐量正常者的腰、臀、股围变化及其意义。 方法 在 5 6 0个临床表现为 2型糖尿病的家系中 ,去除 1型糖尿病、线粒体糖尿病和收集标本数少的家系后 ,得 4 0 6个 2型糖尿病家系。将其家系一级亲属同胞成员分为正常糖耐量组(NGT组 ,4 2 5例 )、糖耐量减退组 (IGT组 ,79例 )、糖尿病组 (DM组 ,6 94例 ) ,并以同胞配偶中的无糖尿病家族史的正常糖耐量者作为对照组 (C组 ,4 2 9例 ) ,比较各组间腰、臀、股围及其各个比值的 6个参数的差异。 结果 DM组腰围、腰臀比、腰股比、臀股比高于 C组 ,臀围、股围低于 C组 (腰围 P=0 .0 0 5 9,余均 <0 .0 0 1)。NGT组腰臀比 ,腰股比大于 C组 (P分别为 0 .0 0 0 9,0 .0 0 4 5 ) ,股围小于 C组(P=0 .0 32 1) ,均有显著差异。腰围、腰臀比、腰股比在 C组、NGT组、IGT组、DM组有逐渐增高趋势 ,臀围、股围在四组有逐渐减低趋势。去除用胰岛素治疗 ,或体重指数 <2 0 kg/ m2 或空腹血糖 >14mm ol/ L者比较 6个参数在 4组中的差异 ,显示上述变化趋势更显著。 结论 糖代谢异常患者 ,随着糖代谢异常的加重 ,其体脂有重新分布 ,逐渐向中心性肥胖发展的趋势。即腹围渐大 ,臀围 ,尤其是股围有逐渐相对缩小的趋势。值得注意?

Objective To investigate the variations of waist(W), hip(H) and thigh(T) circumferences and their significances in siblings of first degree relatives of type 2 diabetes, who were in normal or abnormal glucose tolerance. Methods 406 families of type 2 diabetes were identified from a total of 560 families with clinical symptoms of type 2 diabetes, excluding families with type 1 diabetes, mitochondria diabetes or families with insufficient samples. The siblings of first degree relatives in those families were divided into three groups: (1) 425 cases with normal glucose tolerance (NGT); (2) 79 cases with impaired glucose tolerance (IGT), and 694 cases with diabetes mellitus (DM). The above three groups were evaluated against the control group (C) with 429 persons which consisted of their spouses with normal glucose tolerance from non diabetes families. The circumferences of waist, hip and thigh were compared among those groups and the differences of six factors including each ratio between any two of the three circumferences were assessed. Results The waist circumference, waist/hip ratio(WHR), waist/thigh ratio(WTR), and hip/thigh ratio(HTR) in DM group were larger or higher than those in control group, whereas hip and thigh circumferences were smaller or lower ( P values of waist circumference 0.006 and others <0.001). The WHR and WTR in NGT group were larger or higher than those in control group ( P value 0.0009,0.0045 respectively) whereas thigh circumferences were smaller or lower ( P value 0.0321). The differences were all significant statistically. The waist circumferences, WHR and WTR had gradually increasing trend from C , NGT, IGT to DM group, whereas hip and thigh circumferences had gradually decreasing trend. Furthermore, after excluding diabetics with insulin therapy or BMI<20 or FPG>14 mmol/L,the above trends were obvious. Conclusion The body adipose tissues seems to re distributed and to accumulate in the central areas of human body among the patients with abnormal glucose metabolism. This indicates a tendency of waist circumference enlargement and hip and thigh circumferences reduction. This research also indicates that the persons with NGT from the siblings of first degree relatives are differed from those with normal glucose metabolism in our communities. This phenomenon seems to relate to genetics.