Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Institute for Metabolic Disease, Fengxian Central Hospital Affiliated to Southern Medical University, Shanghai, People's Republic of China.
Diabetes. 2018 Jan;67(1):3-11. doi: 10.2337/dbi17-0013.
The incidence of type 2 diabetes (T2D) has rapidly increased over recent decades, and T2D has become a leading public health challenge in China. Compared with European descents, Chinese patients with T2D are diagnosed at a relatively young age and low BMI. A better understanding of the factors contributing to the diabetes epidemic is crucial for determining future prevention and intervention programs. In addition to environmental factors, genetic factors contribute substantially to the development of T2D. To date, more than 100 susceptibility loci for T2D have been identified. Individually, most T2D genetic variants have a small effect size (10-20% increased risk for T2D per risk allele); however, a genetic risk score that combines multiple T2D loci could be used to predict the risk of T2D and to identify individuals who are at a high risk. Furthermore, individualized antidiabetes treatment should be a top priority to prevent complications and mortality. In this article, we review the epidemiological trends and recent progress in the understanding of T2D genetic etiology and further discuss personalized medicine involved in the treatment of T2D.
近年来,2 型糖尿病(T2D)的发病率迅速上升,T2D 已成为中国主要的公共卫生挑战。与欧洲血统的人相比,中国的 T2D 患者在相对年轻的年龄和较低的 BMI 时被诊断出来。更好地了解导致糖尿病流行的因素对于确定未来的预防和干预计划至关重要。除了环境因素外,遗传因素也在 T2D 的发生中起着重要作用。迄今为止,已经确定了 100 多个 T2D 易感基因座。单独来看,大多数 T2D 遗传变异的效应量较小(每一个风险等位基因使 T2D 的患病风险增加 10-20%);然而,一种结合多个 T2D 基因座的遗传风险评分可用于预测 T2D 的风险,并识别出处于高风险的个体。此外,个体化的抗糖尿病治疗应该是预防并发症和死亡的首要任务。在本文中,我们回顾了 T2D 遗传病因学的流行病学趋势和最新进展,并进一步讨论了个体化医学在 T2D 治疗中的应用。