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[家系中2型糖尿病的疾病特征及危险因素]

[The disease characteristics and risk factors of type 2 diabetes mellitus in pedigrees].

作者信息

Gao Jian-Bo, Cheng Jin-Luo, Ding Hui-Ping, Shen Mo-Yu

机构信息

Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Changzhou, Nanjing Medical University, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2011 Jun;50(6):474-7. doi: 10.3760/cma.j.issn.0578-1426.2011.06.007.

Abstract

OBJECTIVE

To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees.

METHODS

A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM), maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained.

RESULTS

No gender difference was found in the prevalence of T2DM (42.59% in male and 48.18% in female respectively, P > 0.05), nor was the newly diagnosed rate (9.89% in male and 11.82% in female, P > 0.05). The onset age was (63.3 ± 12.4) years old in the first generation [(64.4 ± 12.5) years in male and (62.3 ± 10.3) years in female], (47.1 ± 8.7) years old in the second generation [(48.2 ± 9.3) years in male and (46.1 ± 8.1) years in female], (29.6 ± 10.2) years old in the third generation [(28.9 ± 9.5) years in male and (30.0 ± 10.4) years in female]. Compared with normal glucose tolerance (NGT) subjects, newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM [(68.4 ± 12.4) kg, (69.5 ± 11.0) kg and (69.1 ± 9.6) kg] and IGR [(66.1 ± 10.7) kg, (65.9 ± 10.7) kg and (65.7 ± 10.4) kg], when compared with NGT [(61.0 ± 10.2) kg, (59.5 ± 11.0) kg and (60.1 ± 10.4) kg, all P < 0.05]. The same results were obtained with waist circumference and waist-hip ratio [(4.1 ± 12.5) cm and 0.92 ± 0.36 in newly diagnosed T2DM while (89.1 ± 10.7) cm and 0.90 ± 0.64 in IGR], when compared with NGT [(82.5 ± 10.1) cm and 0.82 ± 0.25], all P < 0.05.

CONCLUSIONS

No gender difference was found in the onset characteristics of T2DM. High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.

摘要

目的

探讨家系中2型糖尿病(T2DM)发病的特点及危险因素。

方法

根据美国糖尿病协会(ADA)标准,通过口服葡萄糖耐量试验(OGTT)对865名受试者进行筛查和诊断。通过临床特征以及胰岛素和自身抗体(包括谷氨酸脱羧酶抗体、胰岛细胞抗体和胰岛素自身抗体)的实验室检测,排除1型糖尿病(T1DM)、青年发病的成年型糖尿病(MODY)和线粒体糖尿病。共获得182个T2DM家系。

结果

T2DM患病率无性别差异(男性为42.59%,女性为48.18%,P>0.05),新诊断率也无性别差异(男性为9.89%,女性为11.82%,P>0.05)。第一代发病年龄为(63.3±12.4)岁[男性为(64.4±12.5)岁,女性为(62.3±10.3)岁],第二代发病年龄为(47.1±8.7)岁[男性为(48.2±9.3)岁,女性为(46.1±8.1)岁],第三代发病年龄为(29.6±10.2)岁[男性为(28.9±9.5)岁,女性为(30.0±10.4)岁]。与糖耐量正常(NGT)受试者相比,新诊断的T2DM和糖调节受损(IGR)受试者高血压、高脂血症和吸烟的患病率更高,但体力活动较少。新诊断的T2DM[(68.4±12.4)kg、(69.5±11.0)kg和(69.1±9.6)kg]和IGR[(66.1±10.7)kg、(65.9±10.7)kg和(65.7±10.4)kg]在诊断前五年、诊断前一年和诊断时的体重与NGT[(61.0±10.2)kg、(59.5±11.0)kg和(60.1±10.4)kg]相比,差异均有统计学意义(均P<0.05)。腰围和腰臀比也得到相同结果[新诊断的T2DM为(89.1±10.7)cm和0.92±0.36,IGR为(89.1±10.7)cm和0.90±0.64],与NGT[(82.5±10.1)cm和0.82±0.25]相比,差异均有统计学意义(均P<0.05)。

结论

T2DM发病特点无性别差异。肥胖、高血压、高脂血症和吸烟的高患病率以及较少的体力活动与T2DM有关。

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