糖尿病家族史在糖尿病发病中的地位  

Influence of family history on onset of diabetes mellitus in patients with newly diagnosed impaired fasting glucose

作　　者：袁放[1] 郑和晰[1] 江缨[1] 吴天凤[1] 俞晓映[1] 

机构地区：[1]浙江医院内分泌科,杭州310013

出　　处：《中国预防医学杂志》2009年第9期845-848,共4页Chinese Preventive Medicine

摘　　要：目的探讨糖尿病家族史对代谢综合征组分及胰岛β细胞功能和胰岛素抵抗的影响。方法选取新诊断空腹血糖受损者,根据糖尿病家族史(FH)的有无各入选30例患者,并选取年龄、性别相匹配的正常组30例作对照,分别观察体质指数(BMI)、测定空腹血糖(FBG)、空腹血胰岛素(FINS)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及尿酸(UA)水平,通过OGTT测餐后2 h血糖(2hBG)、餐后2 h血胰岛素(2hINS)、询问高血压病史。结果与FH-组相比,FH+组发病年龄早于FH-组(56.36±12.50vs62.63±12.24),FH+组与FH-组相比BMI、UA、TC、LDL-C、TG、FINS、2hINS、HOMA-β(36.62±14.21vs44.61±19.73)、HOMA-IR(2.48±1.40vs2.83±1.37)均降低,而HDL-C增高。FH+组与正常对照组相比BMI、UA、TC、LDL-C、TG、HOMA-IR(2.48±1.40vs2.16±1.21)仍高,HDL-C、HOMA-β(36.62±14.21vs48.32±13.26)低,经年龄校正后,差异有统计学意义(P<0.05)。结论有糖尿病家族史者由于遗传缺陷导致胰岛β细胞功能差,糖尿病发病年龄轻,虽胰岛素抵抗及代谢综合征成分不及无糖尿病家族史者,但与正常对照组相比仍高。Objective To evaluate the influence of family history on the components of metabolic syndrome,beta-cell function and insulin resistance in cases with impaired fasting glucose.Methods Cases of impaired fasting glucose with or without family history（FH） of diabetes mellitus were recruited respectively（n=30 in each）.Thirty cases of age and gender matched healthy persons were selected as controls.After oral glucose tolerance test（OGTT）（75 g）,FBG,2hBG,FINS,2hINS,TG,TC,HDL-C,LDL-C,UA were tested.HOMA-β and HOMA-IR were calculated.Results Compared with those of patients with impaired fasting glucose and negative FH,the onset age was younger[（56.36±12.50）vs（62.63±12.24）],levels of BMI,UA,TC,LDL-C,TG,2hBG,FINS,2hINS,HOMA-β[（36.62±14.21）vs（44.61±19.73）]and HOMA-IR[（2.48±1.40）vs（2.83±1.37）]were lower,and level of HDL-C was higher in patients with positive FH.Compared with those of healthy persons,levels of BMI,UA,TC,LDL-C,TG,HOMA-IR[（2.48±1.40）vs（2.16±1.21）]were higher,and those of LDL-C,HOMA-β[（36.62±14.21）vs（48.32±13.26）]were lower in FH positive group.Logistic regression analysis indicated that positive FH corresponded with the levels of FINS,2hINS,BMI,TG and HDL-C.Conclusion The age of onset of impaired fasting glucose is younger in patients with positive family history than in those without family history and is predisposed to suffer from DM if metabolic syndrome components are not well controlled.

关 键 词：糖尿病 2型 家族史 Β细胞功能 胰岛素抵抗 代谢综合征 

分 类 号：R587.1[医药卫生—内分泌]