Henninger Josefin, Rawshani Araz, Hammarstedt Ann, Eliasson Björn
The Lundberg Laboratory for Diabetes Research, Department of Molecular and Clinical Medicine, the Sahlgrenska Academy at the University of Gothenburg, 413 45, Gothenburg, Sweden.
BMC Endocr Disord. 2017 Jul 14;17(1):40. doi: 10.1186/s12902-017-0191-5.
Type 2 diabetes (T2D) is associated with substantial morbidity and mortality. Individuals with a family history of T2D are at an increased risk of developing the disease. The aim of this study was to assess metabolic differences between first-degree relatives (FDR) of T2D patients and persons with no known family history of T2D (non-FDR).
In 200 FDR and 73 non-FDR, we compared anthropometrics, glucose tolerance status, different measurements of insulin secretion, insulin resistance, as well as blood lipids and other blood analyses.
In the FDR group, 30 individuals had impaired glucose tolerance or T2D. Among the non-FDR, two individuals had impaired glucose tolerance. In unadjusted data, the FDR were older, had stronger heredity for coronary heart disease, lower body mass index and weight, higher OGTT plasma glucose concentrations, and impaired insulin secretion (all p < 0.05). Using propensity score, we matched the groups, resulting in significantly stronger heredity of coronary heart disease, higher OGTT plasma glucose at 60 and 90 min, larger glucose area under curve during the OGTT and higher serum creatinine among the FDR. Using least squares means, OGTT glucose at 60 and 120 min, as well as the area under curve, and OGTT insulin levels at 60 min were significantly higher. Body mass index was negatively correlated with insulin sensitivity (MI) and positively correlated with HOMA-β, a measurement of insulin secretion.
We show that FDR are more likely to have impaired glucose tolerance and display higher OGTT plasma glucose and insulin, indicating an unfavorable metabolic profile. We conclude that OGTT is a simple and yet informative metabolic assessment in the FDR group. In both groups, we saw a negative correlation between body mass index and MI, confirming the role of body mass index in insulin resistance.
2型糖尿病（T2D）与较高的发病率和死亡率相关。有T2D家族史的个体患该病的风险增加。本研究的目的是评估T2D患者的一级亲属（FDR）与无T2D家族史者（非FDR）之间的代谢差异。
我们比较了200名FDR和73名非FDR的人体测量学指标、糖耐量状态、胰岛素分泌的不同测量值、胰岛素抵抗以及血脂和其他血液分析指标。
在FDR组中，30人糖耐量受损或患有T2D。在非FDR组中，2人糖耐量受损。在未校正的数据中，FDR年龄更大，冠心病遗传倾向更强，体重指数和体重更低，口服葡萄糖耐量试验（OGTT）血浆葡萄糖浓度更高，胰岛素分泌受损（所有p<0.05）。使用倾向评分，我们对两组进行匹配，结果显示FDR的冠心病遗传倾向显著更强，OGTT 60分钟和90分钟时的血浆葡萄糖更高，OGTT期间的葡萄糖曲线下面积更大，血清肌酐更高。使用最小二乘均值法，OGTT 60分钟和120分钟时的葡萄糖以及曲线下面积，以及OGTT 60分钟时的胰岛素水平显著更高。体重指数与胰岛素敏感性（MI）呈负相关，与胰岛素分泌测量指标HOMA-β呈正相关。
我们发现FDR更有可能糖耐量受损，且OGTT血浆葡萄糖和胰岛素水平更高，表明代谢状况不佳。我们得出结论，OGTT在FDR组中是一种简单而又信息丰富的代谢评估方法。在两组中，我们都观察到体重指数与MI之间存在负相关，证实了体重指数在胰岛素抵抗中的作用。
