Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Diabetes Care. 2013 Jan;36(1):13-9. doi: 10.2337/dc12-0884. Epub 2012 Aug 28.
To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors.
We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top and bottom score quartiles received individual genetic counseling before being enrolled with untested control participants in a 12-week, validated, diabetes prevention program. Middle-risk quartile participants were not studied further. We examined the effect of this genetic counseling intervention on patient self-reported attitudes, program attendance, and weight loss, separately comparing higher-risk and lower-risk result recipients with control participants.
The 108 participants enrolled in the diabetes prevention program included 42 participants at higher diabetes genetic risk, 32 at lower diabetes genetic risk, and 34 untested control subjects. Mean age was 57.9 ± 10.6 years, 61% were men, and average BMI was 34.8 kg/m(2), with no differences among randomization groups. Participants attended 6.8 ± 4.3 group sessions and lost 8.5 ± 10.1 pounds, with 33 of 108 (30.6%) losing ≥5% body weight. There were few statistically significant differences in self-reported motivation, program attendance, or mean weight loss when higher-risk recipients and lower-risk recipients were compared with control subjects (P > 0.05 for all but one comparison).
Diabetes genetic risk counseling with currently available variants does not significantly alter self-reported motivation or prevention program adherence for overweight individuals at risk for diabetes.
研究糖尿病遗传风险检测和咨询是否能改善糖尿病预防行为。
我们对超重且有 2 型糖尿病表型高风险的患者进行了糖尿病遗传风险咨询的随机试验。参与者被随机分配接受基因检测或不接受检测。遗传风险通过累加与 2 型糖尿病相关的 36 个单核苷酸多态性来计算。在参加为期 12 周、经验证的糖尿病预防计划之前，处于最高和最低得分四分位的参与者接受了个体遗传咨询，而未接受测试的对照组参与者则与处于中间风险四分位的参与者一起参加。我们分别比较了高风险和低风险结果接受者与对照组参与者，研究了这种遗传咨询干预对患者自我报告的态度、计划参与度和体重减轻的影响。
参加糖尿病预防计划的 108 名参与者包括 42 名糖尿病遗传风险较高的参与者、32 名糖尿病遗传风险较低的参与者和 34 名未接受测试的对照组参与者。平均年龄为 57.9 ± 10.6 岁，61%为男性，平均 BMI 为 34.8kg/m²，随机分组之间无差异。参与者参加了 6.8 ± 4.3 次小组会议，体重减轻了 8.5 ± 10.1 磅，108 人中的 33 人（30.6%）体重减轻了≥5%。当高风险接受者和低风险接受者与对照组比较时，自我报告的动机、计划参与度或平均体重减轻率差异不大（除了一次比较外，所有比较 P>0.05）。
目前可用的变异体进行糖尿病遗传风险咨询并不能显著改变超重且有糖尿病风险个体的自我报告动机或预防计划依从性。
