Department of Endocrinology, Emergency General Hospital, Beijing, China.
Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
J Diabetes Res. 2021 Jan 4;2021:8822702. doi: 10.1155/2021/8822702. eCollection 2021.
The current study aims to explore if a family history of diabetes can influence the efficiency of lifestyle intervention on insulin secretion and study the insulin resistance in Chinese men and women with metabolic syndrome in a cohort with a 2-year follow-up.
151 individuals (90 individuals did not have a family history of diabetes (DMFH (-)) and 61 with a family history of diabetes (DMFH (+)) with metabolic syndrome participated in the lifestyle intervention program at baseline and finished with 1-year follow-up. 124 individuals have two-year follow-up data. A family history of diabetes was ascertained by self-report. Lifestyle interventions were individual sessions on lifestyle changes.
During the 1-year follow-up, Ln Insulinogenic index (Δ = 0.29 ± 0.65, = 0.001) and 30-min glucose (Δ = -0.41 ± 1.71, = 0.024) changed significantly in the DMFH(-) group; in the DMFH(+) group, Ln ISIm (Δ = -0.22 ± 0.60, = 0.022) and 30-min glucose (Δ = 0.53 ± 1.89, = 0.032) changed significantly, and there was no significant change of other parameters. The change of 30 min glucose during a 1-year intervention has shown a significant difference between the two groups ( = 0.002). During the 2 years intervention, Ln Insulinogenic index changed significantly in the DMFH(-) group (Δ = 0.33 ± 0.66, < 0.001 and Δ = 0.43 ± 1.17, = 0.034). Fasting insulin (Δ = 2.95 ± 8.69, = 0.034), 2 h insulin (Δ = 23.75 ± 44.89, = 0.002), Ln HOMA-B (Δ = 0.43 ± 1.02, = 0.009), Ln HOMA-IR (Δ = 0.53 ± 1.04, = 0.002), Ln ISIm (Δ = 0.52 ± 0.95, = 0.004), and Ln Insulinogenic index (Δ = 0.66 ± 1.18, = 0.047) changed significantly after 2 years of intervention, compared to the baseline in the DMFH(+) group. The change of Ln ISIm ( = 0.023), fasting ( = 0.030), and 2 h insulin ( = 0.007) during the 2-year intervention has shown a significant difference between the two groups. Family history of diabetes was related with a 0.500 unit increase in 2-year ISIm ( = 0.020) modified by lifestyle intervention adjusted for age, baseline BMI, sex, and baseline waist circumference and a 0.476 unit increase in 2-year ISIm ( = 0.027) with extra adjustment for weight change.
Patients with a family history of diabetes benefit more from lifestyle intervention in regard to insulin resistance than those without a family history of diabetes adjusting for age, baseline BMI, sex, baseline waist circumference, and weight change.
本研究旨在探讨糖尿病家族史是否会影响生活方式干预对胰岛素分泌的效果，并在具有 2 年随访的队列中研究中国代谢综合征男性和女性的胰岛素抵抗。
151 名个体（90 名个体没有糖尿病家族史（DMFH（-）），61 名有糖尿病家族史（DMFH（+））患有代谢综合征，在基线时参加了生活方式干预计划，并完成了 1 年随访。124 名个体有两年的随访数据。糖尿病家族史通过自我报告确定。生活方式干预是针对生活方式改变的个别会议。
在 1 年随访期间，DMFH（-）组的胰岛素原指数的自然对数值（Δ=0.29±0.65， =0.001）和 30 分钟血糖（Δ= -0.41±1.71， =0.024）有显著变化；在 DMFH（+）组中，胰岛素敏感指数的自然对数值（Δ= -0.22±0.60， =0.022）和 30 分钟血糖（Δ= 0.53±1.89， =0.032）有显著变化，其他参数没有显著变化。1 年干预期间 30 分钟血糖的变化在两组之间存在显著差异（ =0.002）。在 2 年干预期间，DMFH（-）组的胰岛素原指数变化显著（Δ=0.33±0.66， <0.001 和 Δ=0.43±1.17， =0.034）。空腹胰岛素（Δ=2.95±8.69， =0.034）、2 小时胰岛素（Δ=23.75±44.89， =0.002）、HOMA-B 胰岛素敏感指数的自然对数值（Δ=0.43±1.02， =0.009）、HOMA-IR 胰岛素抵抗指数的自然对数值（Δ=0.53±1.04， =0.002）、胰岛素敏感指数的自然对数值（Δ=0.52±0.95， =0.004）和胰岛素原指数的自然对数值（Δ=0.66±1.18， =0.047）在干预 2 年后与基线相比有显著变化，而 DMFH（+）组则无显著变化。在 2 年干预期间，胰岛素敏感指数的自然对数值（ =0.023）、空腹胰岛素（ =0.030）和 2 小时胰岛素（ =0.007）的变化在两组之间有显著差异。糖尿病家族史与 2 年胰岛素敏感指数的 0.500 单位增加有关（ =0.020），调整因素为年龄、基线 BMI、性别、基线腰围和体重变化；与 2 年胰岛素敏感指数的 0.476 单位增加有关（ =0.027），额外调整了体重变化。
与没有糖尿病家族史的患者相比，有糖尿病家族史的患者在接受生活方式干预时，胰岛素抵抗的改善更为显著，调整因素为年龄、基线 BMI、性别、基线腰围和体重变化。
