Department of Endocrinology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
Diabetes Technol Ther. 2012 Jun;14(6):463-8. doi: 10.1089/dia.2011.0245. Epub 2012 Mar 9.
This study investigated the impact of family history of diabetes (FHD) on β-cell function among Chinese with normal glucose tolerance.
A multistage, stratified, cluster random sampling method was used to select a provincially representative sample from Fujian Province. Eventually, a total of 1,183 subjects were entered into the analysis. Several indexes were used to assess the function of β cells, including homeostasis model assessment (HOMA) of insulin resistance (IR), HOMA of β cells, insulinogenic index (IGI), and disposition index.
Overweight, increased body mass index, higher low-density lipoprotein cholesterol, and higher total cholesterol (TC) were the dominant features of positive FHD (FHD(+)). The FHD(+) subjects had lower insulin sensitivity (P<0.05). FHD(+) subjects showed higher risk of IR after adjusting for other risk factors (odds ratio 1.523 [1.272-2.009]). However, there was no significant difference in insulin secretion between the two groups. With the use of the multiple linear regression model, waist circumference (WC) and triglycerides (TGs) were found to be independent risk factors of the decline of insulin sensitivity in FHD(+) subjects, and insulin sensitivity declined significantly (P<0.05) with the increase of WC and TGs. In addition, the offspring of fathers with diabetes (PT2D) were much older and had higher TC than those of mothers with diabetes (MT2D). After adjusting for gender of the parents, there was no difference between MT2D and PT2D on insulin sensitivity.
Inheritance if diabetes is associated with the decline of insulin sensitivity. In addition, insulin sensitivity declined with increasing WC and TG in FHD(+) subjects.
本研究旨在探讨中国糖耐量正常人群中糖尿病家族史(FHD)对β细胞功能的影响。
采用多阶段、分层、整群随机抽样方法,从福建省抽取具有代表性的省级样本。最终,共有 1183 名受试者纳入分析。采用稳态模型评估胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HOMA-β)、胰岛素分泌指数(IGI)和胰岛β细胞功能指数(DI)等指标评估β细胞功能。
超重、体重指数增加、低密度脂蛋白胆固醇和总胆固醇(TC)升高是 FHD(+)的主要特征。FHD(+)组的胰岛素敏感性较低(P<0.05)。在调整其他危险因素后,FHD(+)组发生 IR 的风险更高(比值比 1.523[1.272-2.009])。然而,两组之间的胰岛素分泌没有显著差异。使用多元线性回归模型发现,腰围(WC)和甘油三酯(TGs)是 FHD(+)患者胰岛素敏感性下降的独立危险因素,WC 和 TGs 的增加使胰岛素敏感性显著下降(P<0.05)。此外,糖尿病父亲的子女(PT2D)比糖尿病母亲的子女(MT2D)年龄更大,TC 更高。在调整父母的性别后,MT2D 和 PT2D 之间的胰岛素敏感性没有差异。
糖尿病遗传与胰岛素敏感性下降有关。此外,FHD(+)患者的 WC 和 TG 增加与胰岛素敏感性下降有关。