Deng Liling, Liu Songfang, Gong Yuan, Tian Haoming, Liu Yuanyuan, Song Jie, Ran Xingwu, Yu Honglin, Zhang Xiangxun, Long Yang, Ren Yan
1 Development of Endocrinology and Metabolism, West China Hospital of Sichuan University , Chengdu, China .
2 Division of Endocrinology and Metabolism, Ninth Hospital of Xi'an , Xi'an, China .
Metab Syndr Relat Disord. 2016 Nov;14(9):431-436. doi: 10.1089/met.2016.0002. Epub 2016 Sep 30.
To compare the metabolic status and pancreatic β-cell function in first-degree relatives (FDRs) of type 2 diabetic patients with normal glucose tolerance (NGT).
Three hundred twelve subjects, who were NGT-FDR of type 2 diabetic patients and 1348 subjects, who were NGT individuals with no family history of diabetes, were defined as NGT-FDRs and NGT-controls (NGT-C), respectively. Blood pressure, body weight, waist circumference, plasma glucose, lipid profile, and insulin levels were measured in all subjects. Homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-β, insulin sensitivity index (ISI), and disposition index (DI) was used to evaluate insulin resistance and insulin sensitivity.
The HOMA-IR and HOMA-β indices were significantly higher in the NGT-FDR group relative to the NGT-C, while the ISI, DI, and ΔI/ΔG were lower (P < 0.05). The prevalence rate of greater than or equal to three metabolic disorders was higher in the NGT-FDR group compared to the NGT-C (P < 0.05). In the NGT-FDR group, compared to people with normal metabolism, HOMA-β decreased when there was only one metabolic disorder, increased slightly when there were two to three metabolic abnormalities, and decreased again when there were four or more metabolic abnormalities. The data also indicated that having a family history of type 2 diabetes maybe an independent risk factor of β-cell dysfunction.
Metabolic disorders developed frequently in the NGT-FDRs of type 2 diabetic patients. As the number of coexisting metabolic disorders increased, pancreatic β-cell secretory ability and insulin sensitivity decreased. Therefore, it is necessary to provide early preventive interventions and monitoring of metabolic indices for NGT-FDRs of type 2 diabetic patients.
比较糖耐量正常的2型糖尿病患者一级亲属（FDRs）的代谢状况和胰岛β细胞功能。
分别将312名2型糖尿病患者的糖耐量正常一级亲属（NGT-FDRs）和1348名无糖尿病家族史的糖耐量正常个体（NGT-controls，NGT-C）作为研究对象。测量所有受试者的血压、体重、腰围、血糖、血脂谱和胰岛素水平。采用胰岛素抵抗稳态模型评估（HOMA-IR）、HOMA-β、胰岛素敏感指数（ISI）和处置指数（DI）评估胰岛素抵抗和胰岛素敏感性。
与NGT-C组相比，NGT-FDR组的HOMA-IR和HOMA-β指数显著更高，而ISI、DI和ΔI/ΔG更低（P < 0.05）。与NGT-C组相比，NGT-FDR组中三种及以上代谢紊乱的患病率更高（P < 0.05）。在NGT-FDR组中，与代谢正常者相比，仅有一种代谢紊乱时HOMA-β降低，有两到三种代谢异常时略有升高，有四种及以上代谢异常时再次降低。数据还表明，2型糖尿病家族史可能是β细胞功能障碍的独立危险因素。
2型糖尿病患者的NGT-FDRs中代谢紊乱频发。随着并存代谢紊乱数量的增加，胰岛β细胞分泌能力和胰岛素敏感性降低。因此，有必要对2型糖尿病患者的NGT-FDRs进行早期预防性干预并监测代谢指标。
