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家族糖尿病史和生活方式咨询对 2 型糖尿病高危个体心血管代谢风险特征的影响:FIN-D2D 项目的 1 年随访结果。

Family history of diabetes and effectiveness of lifestyle counselling on the cardio-metabolic risk profile in individuals at high risk of Type 2 diabetes: 1-year follow-up of the FIN-D2D project.

机构信息

Pirkanmaa Hospital District, Tampere Institute of Health Sciences, University of Oulu, Finland.

出版信息

Diabet Med. 2012 Feb;29(2):207-11. doi: 10.1111/j.1464-5491.2011.03388.x.

Abstract

AIMS

To investigate whether a positive family history of diabetes is associated with the effectiveness of lifestyle counselling on cardio-metabolic risk factors and glucose tolerance status in a 1-year follow-up in a cohort of Finnish men and women at high risk for Type 2 diabetes.

METHODS

Altogether, 10,149 individuals who had high risk of Type 2 diabetes participated in the implementation programme of the national diabetes prevention programme at baseline. One-year follow-up data were available for 2798 individuals without diabetes. Family history of diabetes was based on self-report. Lifestyle interventions were individual or groups sessions on lifestyle changes. The effectiveness of lifestyle intervention was measured as changes in cardiovascular risk factors, glucose tolerance status and incidence of Type 2 diabetes.

RESULTS

Family history was associated with the effectiveness of lifestyle intervention in men, but not in women. During the 1-year follow-up, body weight, BMI, systolic blood pressure, total cholesterol, LDL cholesterol and score for 10-year risk for fatal cardiovascular disease (SCORE) decreased and glucose tolerance status improved more in men without a family history of diabetes than in men with a family history of diabetes. Of the participating men and women, 10% and 5% developed Type 2 diabetes, respectively. Family history was not related to the incidence of Type 2 diabetes in either gender.

CONCLUSIONS

Men without a family history of diabetes were more successful in responding to lifestyle counselling with regard to cardio-metabolic measurements and glucose tolerance than those with a family history of diabetes. Similar results were not seen in women. In keeping with findings from earlier studies, the prevention of Type 2 diabetes is not influenced by a family history of diabetes.

摘要

目的

在一项针对芬兰高 2 型糖尿病风险人群的研究中,调查一级亲属中有糖尿病史是否与生活方式咨询对心血管代谢风险因素和葡萄糖耐量状态的效果相关,随访时间为 1 年。

方法

共有 10149 名高 2 型糖尿病风险人群参与了国家 2 型糖尿病预防计划的实施项目,在基线时没有糖尿病。有 1 年随访数据的 2798 名个体没有糖尿病。糖尿病家族史基于自我报告。生活方式干预是针对生活方式改变的个体或小组会议。生活方式干预的效果通过心血管风险因素、葡萄糖耐量状态和 2 型糖尿病的发病率变化来衡量。

结果

家族史与男性而非女性的生活方式干预效果相关。在 1 年的随访期间,男性中没有家族史的个体体重、BMI、收缩压、总胆固醇、LDL 胆固醇和 10 年致命心血管疾病风险评分(SCORE)降低,葡萄糖耐量状态改善更为明显,而有家族史的个体则不然。在参与的男性和女性中,分别有 10%和 5%发展为 2 型糖尿病。家族史与两性的 2 型糖尿病发病率均无关。

结论

与一级亲属中有糖尿病史的男性相比,没有家族史的男性在生活方式咨询方面对心血管代谢测量和葡萄糖耐量的反应更为成功。女性则没有出现类似的结果。与早期研究的结果一致,2 型糖尿病的预防不受一级亲属中有糖尿病史的影响。

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