Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
Department of Endocrinology and Metabolism, China Meitan General Hospital, Beijing, China.
J Diabetes Investig. 2021 Mar;12(3):434-445. doi: 10.1111/jdi.13360. Epub 2020 Aug 16.
AIMS/INTRODUCTION: To investigate the differential effects of maternal versus paternal history of diabetes on the risks for diabetes and prediabetes, as well as on insulin secretion and resistance in Chinese individuals.
From the 2007 to 2008 China National Diabetes and Metabolism Disorders Study, 39,244 participants were included and divided into four categories: negative parental history, paternal history only (PH), maternal history only (MH), and both paternal and maternal history.
The age- and sex-standardized prevalence rates of diabetes in the negative parental history, PH, MH, and both paternal and maternal history groups were 8.59, 12.56, 15.86 and 29.81%, respectively. The prevalence rates of impaired glucose metabolism were 24.13, 25.41, 31.13 and 50.80%, with the prevalence in the MH group being significantly higher than that in the PH group. Compared with that in the FH0 group, the risks of diabetes in the PH, MH, and both paternal and maternal history groups were 2.01-, 2.67- and 6.37-fold greater, and the risks of impaired glucose metabolism were 1.28-, 1.65- and 3.45-fold greater. In addition, MH had a significantly greater impact on impaired glucose metabolism than PH (P = 0.0292). Regression analyses suggested MH was associated with homeostatic model assessment for β-cell function (β[SE] = -0.0910[0.0334], P = 0.0065), insulinogenic index (-0.1866[0.0550], P = 0.0007), homeostatic model assessment for insulin resistance (0.0662[0.0227], P = 0.0036) and Matsuda Index [-0.0716(0.0203), P = 0.0004]. PH was specifically associated with homeostatic model assessment for insulin resistance (0.1343[0.0267], P < 0.0001) and Matsuda Index (-0.1566[0.0243], P < 0.0001), but the effects were stronger than those of MH (P = 0.0431, 0.0054).
MH and PH differentially influence the risks for diabetes, insulin secretion, and insulin resistance in the Chinese population, suggesting they participate in the pathogenesis of diabetes through different mechanisms.
目的/引言:本研究旨在探讨父母双方糖尿病史和仅父亲或母亲糖尿病史对中国人群糖尿病和糖尿病前期风险的差异影响,以及对胰岛素分泌和抵抗的影响。
本研究纳入了 2007 年至 2008 年中国国家糖尿病和代谢紊乱研究中的 39244 名参与者,并将其分为四组:无父母糖尿病史、仅父亲糖尿病史(PH)、仅母亲糖尿病史(MH)和父母双方均有糖尿病史。
在无父母糖尿病史、PH、MH 和父母双方均有糖尿病史组中,年龄和性别标准化的糖尿病患病率分别为 8.59%、12.56%、15.86%和 29.81%。葡萄糖代谢受损的患病率分别为 24.13%、25.41%、31.13%和 50.80%,其中 MH 组明显高于 PH 组。与 FH0 组相比,PH、MH 和父母双方均有糖尿病史组的糖尿病风险分别增加了 2.01 倍、2.67 倍和 6.37 倍,葡萄糖代谢受损的风险分别增加了 1.28 倍、1.65 倍和 3.45 倍。此外,MH 对葡萄糖代谢受损的影响明显大于 PH(P=0.0292)。回归分析表明,MH 与稳态模型评估的β细胞功能(β[SE]=-0.0910[0.0334],P=0.0065)、胰岛素生成指数(-0.1866[0.0550],P=0.0007)、稳态模型评估的胰岛素抵抗(0.0662[0.0227],P=0.0036)和 Matsuda 指数[-0.0716(0.0203),P=0.0004]相关。PH 仅与稳态模型评估的胰岛素抵抗(0.1343[0.0267],P<0.0001)和 Matsuda 指数(-0.1566[0.0243],P<0.0001)相关,但其作用强于 MH(P=0.0431,0.0054)。
MH 和 PH 对中国人群的糖尿病、胰岛素分泌和胰岛素抵抗风险有不同的影响,这表明它们通过不同的机制参与糖尿病的发病机制。