Mathur S K, Chandra Piyush, Mishra Sandhya, Ajmera Peeyush, Sharma Praveen
Endocrinology Unit, S.M.S. Medical College & Hospital, 302004 Jaipur.
Indian J Clin Biochem. 2007 Sep;22(2):70-3. doi: 10.1007/BF02913317.
Asian Indians are known to be at a higher risk of developing T2DM, but the underlying genetic factor in this population is still not well understood. T2DM is a complex genetic trait and assessment of disease related intermediate phenotypic traits is an important initial step towards any systematic genomic study. Therefore, in the present study we have assessed diabetes related intermediate phenotypic traits of insulin secretion and insulin resistance in the patients belonging to this population. The study included 157 T2DM patients of either sex ranging in age from 45-80 years and 84 non-diabetic subjects with no family history of diabetes, ranging in age from 45 to 75 years served as controls. Intermediate phenotypic traits studied were BMI, W: H ratio, fasting free fatty acid level and Insulin resistance and secretion. Diabetics were found to have significantly higher W: H ratio (p<0.001), FFA (p<0.001) and HOMA-R (p<0.001) as compared to non-diabetics. However, there was no significant difference in their BMI and HOMA-β. There was a positive correlation between FFA level and HOMA-R among diabetics, but not among controls. These findings suggest that in abdominal obesity FFA mediated insulin resistance is an important causative factor underlying T2DM in this population. Moreover, comparable HOMA-β in diabetics reflects compensatory insulin hyper secretion in these subjects. There is a need to examine relative contribution and precise nature of genetic factor in their tendency for central obesity, free fatty acidemia and insulin resistance.
众所周知，亚洲印度人患2型糖尿病（T2DM）的风险较高，但该人群潜在的遗传因素仍未得到充分了解。T2DM是一种复杂的遗传性状，评估与疾病相关的中间表型性状是任何系统基因组研究的重要初始步骤。因此，在本研究中，我们评估了该人群患者中与糖尿病相关的胰岛素分泌和胰岛素抵抗的中间表型性状。该研究纳入了157例年龄在45至80岁之间的T2DM患者，男女不限，以及84例无糖尿病家族史、年龄在45至75岁之间的非糖尿病受试者作为对照。所研究的中间表型性状包括体重指数（BMI）、腰臀比（W:H）、空腹游离脂肪酸水平以及胰岛素抵抗和分泌。与非糖尿病患者相比，糖尿病患者的腰臀比（p<0.001）、游离脂肪酸（p<0.001）和稳态模型评估胰岛素抵抗指数（HOMA-R，p<0.001）显著更高。然而，他们的BMI和稳态模型评估胰岛β细胞功能指数（HOMA-β）没有显著差异。糖尿病患者中游离脂肪酸水平与HOMA-R之间存在正相关，但在对照组中不存在。这些发现表明，在腹型肥胖中，游离脂肪酸介导的胰岛素抵抗是该人群T2DM的一个重要致病因素。此外，糖尿病患者中相当的HOMA-β反映了这些受试者的代偿性胰岛素高分泌。有必要研究遗传因素在他们的中心性肥胖、游离脂肪酸血症和胰岛素抵抗倾向中的相对贡献和确切性质。
