2型糖尿病家族史是糖耐量正常个体发生代谢综合征的独立危险因素  

Family history of type 2 diabetes is an independent risk factor for metabolic syndrome in subjects with normal glucose tolerance

作　　者：高洪伟[1] 王海宁[1] 洪天配[1] 李琼芳[1] 

机构地区：[1]北京大学第三医院内分泌科,100083

出　　处：《中国糖尿病杂志》2008年第2期83-86,共4页Chinese Journal of Diabetes

基　　金：国家973项目子课题资助项目(2006CB503900);北京市自然科学基金资助项目(7062067);国家自然科学基金资助项目(30771032;30700879)

摘　　要：目的研究糖耐量正常(NGT)的2型糖尿病(T2DM)一级亲属中代谢综合征(MS)的相关危险因素。方法采用横断面研究,比较182例T2DM家族史阳性(FH+)与126例家族史阴性(FH-)NGT个体的人体测量指标和代谢参数的差异,分析MS的相关危险因素。结果FH+个体的腰围和OGTT血糖曲线下面积显著高于FH-个体,而胰岛β细胞功能指数则显著低于FH-个体。Lo-gistic分析显示,T2DM家族史是MS和中心性肥胖的独立危险因素,OR值分别为3.33和2.59;中心性肥胖是高血压、高TG血症及低HDL-C血症的独立危险因素,OR值分别为1.41、1.43及1.07。结论T2DM家族史可能是NGT的一级亲属发生中心性肥胖和MS的独立危险因素。早期生活方式干预可使该人群避免发生中心性肥胖,从而减少发生MS甚或心血管疾病的风险。Objective TO investigate the risk factors for metabolic syndrome in normal glucose-tolerant first degree relatives of type 2 diabetes. Methods A cross-sectional study was conducted on 182 individuals with familial history of type 2 diabetes （FH^＋ ） and 126 subjects without family history of type 2 diabetes （FH^-）. All the enrolled subjects had a normal glucose tolerance. Anthropometric indices and metabolic parameters were observed, and the risk factors for metabolic syndrome were analyzed. Results Compared with （FH^-） subjects, waist circumference（WC） and the area under curve of plasma glucose levels after OGTT（AUCGlu） were significantly increased in FH^＋ individuals （WC： 83.4±9.4 cm vs 82.4±8.6 cm and AUCglu：878.7±143.7 mmol · min/L vs 850. 7±144.5 mmol·min/L ）. Islet β-cell function index （HOMA-B）, however, was remarkably decreased in FH^＋ individuals. Logistic analysis showed that the familial history of type 2 diabetes was an independent risk factor for metabolic syndrome and central obesity, with OR values 3. 33 and 2.59 respectively. Moreover, central obesity was an independent risk factor for hypertension, increased triglyceride and decreased high density lipoprotein-cholesterol （HDL- C）, with OR values 1.41, 1.43 and 1.07 respectively. Conclusions The familial history of type 2 diabetes might be an independent risk factor for central obesity and metabolic syndrome in normal glucose-tolerant first degree relatives of type 2 diabetes. Therefore, early lifestyle intervention is required to diminish their risk for the development of metabolic syndrome or cardiovascular diseases.

关 键 词：代谢综合征 糖尿病 2型 家族史 中心性肥胖 

分 类 号：R589[医药卫生—内分泌] R587.1[医药卫生—内科学]