2型糖尿病先证者发病年龄对遗传表型影响的研究  

The Study on the Impact of Onset Age of the Type 2 Diabetes Proband on the Genetic Phenotype CHEN

作　　者：陈明卫[1] 杨明功[1] 王长江[1] 王佑民[1] 章秋[1] 包爱民[1] 孙海燕[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,安徽合肥230032

出　　处：《中国慢性病预防与控制》2006年第4期230-232,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨2型糖尿病(DM)先证者发病年龄对糖耐量正常一级亲属的胰岛素抵抗(IR)表型及胰岛β细胞功能的影响。方法选择186个2型DM核心家系中186例2型DM先证者和489例糖耐量正常的一级亲属。根据先证者发病年龄的四分位数,分别选取最低四分位数发病年龄的先证者(发病年龄<42岁)的一级亲属127例(为一级亲属1组)和最高四分位数发病年龄的先证者(发病年龄>55岁)的一级亲属118例(为一级亲属2组)进行研究。应用HOMAI-R,△I30/△G30(包括△I30.△G30-1H.OMAI-R-1)分别评估胰岛素敏感性和胰岛β细胞功能。结果一级亲属1组的腰臀围比、收缩压、甘油三酯、HOMAI-R均高于一级亲属2组,△I30/△G30、△I30.△G30-1H.OMAI-R-1均低于一级亲属2组,差别有统计学意义(P<0.05或0.01)。结论早发2型DM先证者的糖耐量正常一级亲属可能具有更明显的IR表型特点和β细胞功能降低。Objective To explore the impact of onset age of the type 2 diabetic （T2DM） proband on the phenotype of insulin resistance and β-cell function in normoglycemic fast-degree relatives. Methods 186 T2DM probands and 489 normoglycemic firstdegree relatives were selected from 186 T2DM nuclear families. 127 first-degrec relatives （FDR1 group） of probands with early-onset diabetes （1st quartile, age of diabetes onset 〈 42 yr） and 118 first-degrec relatives （FDR2 group） of probands with late-onset diabetes （4 th quartile, age of diabetes onset 〉 55 yr） were identified to intensively study from 489 normoglycemic fast-degrec relatives. The homeostasis model assessment of insulin resistance （HOMA-IR） was used to estimate insulin sensitivity; It-cell function was quantified as the ratio of the incremental insulin to glucose responses over the fast 30 min （△I30/△G30） during the oral glucose tolerance test. The latter measure was also adjusted for the assay of insulin sensitivity as it modulated β-cell function （△ I30.△G30^-1.HOMA-IR）. Results The mean waist/ hip circumference ratio, systolic blood pressure, triglyceride and HOMA-IR were significantly higher in FDR1 group than those in FDR2 group and △I30/△G30, △I30 △G30^-1.HOMA-IR were significantly lower in FDR1 group than those in FDR2 group （all P〈0.05-0.01）. Conclusions The normoglycemic fast-degrec relatives of the probands with early-onset diabetes had distinct phenotype of insulin resistance and lower β-cell function than those in relatives of the probands with late-onset disease.

关 键 词：糖尿病 2型 一级亲属 先证者 胰岛素抵抗 Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]