Bjerregaard-Andersen Morten, Hansen Lone, da Silva Leontina I, Joaquím Luis C, Hennild Ditte E, Christiansen Lene, Aaby Peter, Benn Christine S, Christensen Kaare, Sodemann Morten, Jensen Dorte M, Beck-Nielsen Henning
Corresponding author: Morten Bjerregaard-Andersen,
Diabetes Care. 2013 Nov;36(11):3549-56. doi: 10.2337/dc12-2653. Epub 2013 Aug 15.
Twins in Africa may be at increased risk of metabolic disorders due to strained conditions in utero, including high exposure to infections. We studied metabolic syndrome (MS) and diabetes mellitus (DM) among young twins and singletons in Guinea-Bissau.
The study was cross-sectional and occurred from October 2009 until August 2011 at the Bandim Health Project, a demographic surveillance site in the capital Bissau. Twins and singleton controls between 5 and 32 years were visited at home. Fasting blood samples for metabolic measurements were collected. Zygosity was established genetically for a subset. DM was defined as HbA1c ≥6.5% (48 mmol/mol) and MS by the International Diabetes Federation criteria.
HbA1c was available for 574 twins and 463 singletons. Mean age was 15.3 years versus 15.8 years, respectively. Eighteen percent of twins were monozygotic. There were no DM cases among twins but one among singletons. A total of 1.4% (8 of 574) of twins had elevated HbA1c (6.0-6.4%, 42-46 mmol/mol) compared with 2.4% (11 of 463) of singletons (P = 0.28). Mean HbA1c was 5.3% (34 mmol/mol) for both groups. MS data were available for 364 twins and 360 singletons. The MS prevalence was 3.0% (11 of 364) among twins and 3.6% (13 of 360) among singletons (P = 0.66). The prevalence of fasting blood glucose (F-glucose) ≥5.6 mmol/L was 34.9% (127 of 364) for twins versus 24.7% (89 of 360) for singletons (P = 0.003). Median homeostasis model assessment-insulin resistance did not differ (P = 0.34).
The MS and DM prevalences among young individuals in Guinea-Bissau were low. Twins did not have a higher MS and DM burden than singletons, though elevated F-glucose was more common among twins.
由于子宫内环境紧张，包括高感染暴露风险，非洲双胞胎患代谢紊乱疾病的风险可能更高。我们对几内亚比绍的年轻双胞胎和单胎进行了代谢综合征（MS）和糖尿病（DM）的研究。
本研究为横断面研究，于2009年10月至2011年8月在首都比绍的一个人口监测点班迪姆健康项目开展。对年龄在5至32岁之间的双胞胎和单胎对照进行了家访。采集空腹血样进行代谢指标检测。对一部分双胞胎进行了基因分型以确定其合子类型。糖尿病定义为糖化血红蛋白（HbA1c）≥6.5%（48 mmol/mol），代谢综合征依据国际糖尿病联盟标准诊断。
共获得574对双胞胎和463名单胎的HbA1c数据。平均年龄分别为15.3岁和15.8岁。18%的双胞胎为同卵双胞胎。双胞胎中无糖尿病病例，单胎中有1例。共有1.4%（574例中的8例）的双胞胎HbA1c升高（6.0 - 至6.4%，42 - 46 mmol/mol），而单胎中这一比例为2.4%（463例中的11例）（P = 0.28）。两组的平均HbA1c均为5.3%（34 mmol/mol）。获得了364对双胞胎和360名单胎的代谢综合征数据。双胞胎中代谢综合征患病率为3.0%（364例中的11例），单胎中为3.6%（360例中的13例）（P = 0.66）。双胞胎中空腹血糖（F - 葡萄糖）≥5.6 mmol/L的患病率为34.9%（364例中的127例），单胎中为24.7%（360例中的89例）（P = 0.003）。稳态模型评估 - 胰岛素抵抗中位数无差异（P = 0.34）。
几内亚比绍年轻人中代谢综合征和糖尿病的患病率较低。双胞胎的代谢综合征和糖尿病负担并不高于单胎，不过空腹血糖升高在双胞胎中更为常见。
