2型糖尿病家系胰岛素抵抗及危险因素分析  

Analysis on risk factors of insulin resistance clustering in type 2 diabetes mellitus families

作　　者：吴雪霁[1] 周玲[1] 周金意[1] 王劲松[2] 成金罗[3] 沈默宇[3] 

机构地区：[1]南京医科大学流行病与卫生统计学系,南京210029 [2]扬州大学医学院 [3]江苏省常州市第二人民医院内分泌科

出　　处：《中国公共卫生》2006年第7期777-779,共3页Chinese Journal of Public Health

基　　金：国家自然科学基金(30371241);江苏省社会发展基金资助(BS2000031)

摘　　要：目的研究2型糖尿病(T2DM)家系人群的胰岛素抵抗与心血管疾病危险因素聚集的关系。方法选取2型糖尿病家系115个,共计570人,其中268例糖尿病患者为病例组,非糖尿病一级血缘亲属302人为内对照组,健康者161人为外对照组,应用χ2检验以及二项分类Logistic回归方法。结果3组的心血管危险因素聚集程度与胰岛素抵抗程度有关(均P<0.05)。随着胰岛素抵抗指数(HOMA-IR)的增高,3组人群的心血管疾病危险因素聚集的风险均增加。内对照组的胰岛初期分泌功能指数的平均水平高于T2DM人群和外对照人群(P=0.018,0.000)。结论健康人群在未发生糖尿病之前均有胰岛素抵抗,因胰岛β细胞代偿性分泌增加,故不发病;当其失代偿时,则导致糖尿病发生。胰岛素抵抗为心血管疾病危险因素聚集的基础,心血管疾病危险因素聚集则是导致家系2型糖尿病高发的原因之一。Objective To explore the relationship between insulin resistance and the clustering of Cardiovascular Disease （CVD） among relatives of T2DM family and health people. Methods 115 T2DM families were selected, which contained 268 cases as the case group, 302 relatives but nondiabetic individuals from these families as the inner control group and 161 healthy ones as outer control group that contained 570 subjects in all. Chi - test and binary logistic regression were used. Resuits Insulin resistance and risk - factor clustering had association among these three groups （All P 〈 0.05 ）. Then what instalin resistance was the base of clustering of CVD in multiple familial type 2 diabetes mellitus was uncovered. The value of OR increased with the value of HOMA - IR growing. The mean of insulin secretion in inner - group was higher than that of both T2DM group and outer- group（P = 0. 018, 0. 000）. Conclusion Whether the individuals in relative group in families with type 2 diabetes or in the health group all have severe insulin resistance before getting CVD. However, their β cells could secrete instead of dysfunction of insulin resistance as a prevention. And cardiovascular risk factors clustering may be the reason of type 2 diabetes mellitus. Insulin resistance may be the basis of multiple familial type 2 diabetes mellitus.

关 键 词：2型糖尿病 家系 胰岛素抵抗 心血管危险因素 聚集 

分 类 号：R541.8[医药卫生—心血管疾病]