Tan Jonathan T, Tan Luor Shyuan M, Chia Kee Seng, Chew Suok Kai, Tai E Shyong
Center for Molecular Epidemiology, National University of Singapore, Singapore.
Diabetes Res Clin Pract. 2008 Nov;82(2):268-75. doi: 10.1016/j.diabres.2008.08.005. Epub 2008 Sep 18.
To evaluate family history (FH) of type 2 diabetes (T2DM) as a risk factor for impaired fasting glucose (IFG), impaired glucose tolerance (IGT), T2DM and related metabolic traits in South East Asia and to compare the effects of a paternal versus maternal history.
We studied 4717 men and women (68% Chinese, 18% Malays and 14% Asian Indians) living in Singapore. FH was considered positive if at least one first degree relative had T2DM. Obesity, fasting lipids, glucose and insulin levels were measured for all subjects. Insulin resistance (IR) was estimated by homeostasis model assessment (HOMA). An oral glucose tolerance test was carried for all subjects except those on diabetes medication.
A positive FH was associated with increased risk of IFG/IGT (OR=1.67, 95% CI=1.42-1.97) and T2DM (OR=2.95, 95% CI=2.36-3.70) as well as higher levels of obesity, HOMA-IR, fasting triglyceride (TG), and lower levels of high density lipoprotein (HDL) cholesterol and HOMA-beta. A maternal history of T2DM appeared to have a greater impact on obesity-related traits than a paternal history of T2DM. Compared to individuals with no FH of T2DM, a maternal history was associated with (i) greater body mass index (BMI) (24.15kg/m(2) vs. 23.42kg/m(2), p=0.016) and waist-to-hip ratio (WHR) (0.874 vs. 0.865, p=0.037) in men; and (ii) greater WHR (0.788 vs. 0.779, p=0.004), fasting triglyceride (1.23mmol/L vs. 1.09mmol/L, p<0.001), HOMA-IR (2.02 vs. 1.75, p<0.001), fasting plasma glucose (5.25mmol/L vs. 5.18mmol/L, p=0.005) and 2-h plasma glucose (6.01mmol/L vs. 5.78mmol/L, p=0.001) and lower HDL-C (1.41mmol/L vs. 1.47mmol/L, p=0.031) in women.
T2DM appears to be heritable in South East Asians with excess maternal transmission of obesity, IR and dyslipidemia.
评估2型糖尿病（T2DM）家族史作为东南亚空腹血糖受损（IFG）、糖耐量受损（IGT）、T2DM及相关代谢特征的危险因素，并比较父系家族史与母系家族史的影响。
我们研究了居住在新加坡的4717名男性和女性（68%为华人，18%为马来人，14%为亚洲印度人）。如果至少有一位一级亲属患有T2DM，则家族史被视为阳性。测量了所有受试者的肥胖、空腹血脂、血糖和胰岛素水平。通过稳态模型评估（HOMA）估计胰岛素抵抗（IR）。除正在接受糖尿病治疗的患者外，所有受试者均进行了口服葡萄糖耐量试验。
家族史阳性与IFG/IGT风险增加（OR=1.67，95%CI=1.42-1.97）和T2DM风险增加（OR=2.95，95%CI=2.36-3.70）相关，同时肥胖、HOMA-IR、空腹甘油三酯（TG）水平较高，高密度脂蛋白（HDL）胆固醇和HOMA-β水平较低。T2DM的母系家族史似乎比父系家族史对肥胖相关特征的影响更大。与无T2DM家族史的个体相比，母系家族史与以下情况相关：（i）男性的体重指数（BMI）更高（24.15kg/m²对23.42kg/m²，p=0.016）和腰臀比（WHR）更高（0.874对0.865，p=0.037）；（ii）女性的WHR更高（0.788对0.779，p=0.004）、空腹甘油三酯更高（1.23mmol/L对1.09mmol/L，p<0.001）、HOMA-IR更高（2.02对1.75，p<0.
