Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan.
J Diabetes Res. 2020 Dec 14;2020:8822135. doi: 10.1155/2020/8822135. eCollection 2020.
We tested the hypothesis that family history of type 2 diabetes (FHD) is associated with reduced birth weight and reduced insulin secretion later in life.
Birth weight, body composition by whole-body dual-energy X-ray absorptiometry, and homeostasis model assessment-insulin resistance were compared between Japanese women aged 20 years with positive ( = 73) and negative ( = 258) FHD. A subsample of 153 women (57 with positive FHD) underwent a 75 g oral glucose tolerance test. Multivariate logistic regression analyses were used to identify the most important determinants of FHD.
Women with positive as compared with negative FHD had lower birth weight (3132 ± 364 vs. 3238 ± 418 g, = 0.04). However, the current fat mass index and trunk/leg fat ratio, sophisticated measures of general and abdominal fat accumulation, respectively, did not differ. Women with positive FHD had a lower insulinogenic index (2.4 ± 7.3 vs. 6.2 ± 16, = 0.007) and higher area under the glucose curve (217 ± 47 vs. 198 ± 36 mg/dL/2 h, = 0.006). However, fasting and postload insulinemia, homeostasis model assessment-insulin resistance, and Matsuda index did not differ. In multivariate logistic regression analysis, birth weight was marginally associated with FHD (odds ratio, 0.999; 95% confidential interval, 0.98-1.00000; = 0.0509).
FHD was associated not only with reduced birth weight but also with decreased early-phase insulin secretion and increased postload glucose concentrations in Japanese women aged 20 years. These findings may be in keeping with the fetal insulin hypothesis and provide some evidence that FHD can alter size at birth, probably through genetic and shared environmental components, which consequently resulted in decreased early-phase insulin secretion and increased glucose excursion in the early twenties. FHD was not related to sophisticated measures of general and abdominal adiposity and insulin resistance/sensitivity.
我们检验了这样一个假设，即 2 型糖尿病家族史（FHD）与出生体重降低和生命后期胰岛素分泌减少有关。
比较了 20 岁日本女性中 FHD 阳性（n=73）和阴性（n=258）的出生体重、全身双能 X 射线吸收法测定的身体成分以及稳态模型评估胰岛素抵抗。153 名女性中的一个亚组（57 名 FHD 阳性）接受了 75g 口服葡萄糖耐量试验。采用多变量 logistic 回归分析来确定 FHD 的最重要决定因素。
与 FHD 阴性的女性相比，FHD 阳性的女性出生体重较低（3132±364 vs. 3238±418g，=0.04）。然而，当前的脂肪质量指数和躯干/腿部脂肪比例，分别是衡量全身和腹部脂肪积累的复杂指标，没有差异。FHD 阳性的女性胰岛素生成指数较低（2.4±7.3 vs. 6.2±16，=0.007），血糖曲线下面积较高（217±47 vs. 198±36mg/dL/2h，=0.006）。然而，空腹和餐后胰岛素血症、稳态模型评估胰岛素抵抗和 Matsuda 指数没有差异。在多变量 logistic 回归分析中，出生体重与 FHD 呈边缘相关（比值比，0.999；95%置信区间，0.98-1.00000；=0.0509）。
FHD 不仅与出生体重降低有关，而且与 20 岁日本女性的早期胰岛素分泌减少和餐后血糖浓度升高有关。这些发现可能与胎儿胰岛素假说一致，并提供了一些证据表明 FHD 可以改变出生时的大小，可能通过遗传和共同的环境因素，从而导致早期胰岛素分泌减少和二十多岁时血糖波动增加。FHD 与全身和腹部肥胖的复杂指标以及胰岛素抵抗/敏感性无关。
