Newman B, Selby J V, King M C, Slemenda C, Fabsitz R, Friedman G D
Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland.
Diabetologia. 1987 Oct;30(10):763-8. doi: 10.1007/BF00275741.
Concordance for Type 2 (non-insulin-dependent) diabetes was determined in 250 monozygotic and 264 dizygotic white male twin pairs who participated in the National Heart, Lung, and Blood Institute Twin Study. These twins were born between 1917 and 1927 and were identified from military records without regard to disease status. We examined surviving members of the cohort twice--at mean ages of 47 and 57 years--and obtained 1-h post-load glucose tests and medication histories. Diagnostic criteria for Type 2 diabetes included a glucose value greater than or equal to 13.9 mmol/l or current use of antidiabetic medication; possible Type 1 (insulin-dependent) diabetic twins were excluded. A strong genetic predisposition to Type 2 diabetes was suggested by 3 lines of evidence from the second examination: (1) 58% of monozygotic co-twins of diabetic twins were themselves diabetic compared with an expected prevalence of 10%; (2) only 1 of 15 originally disease-discordant, monozygotic twin pairs remained discordant for diabetes; and (3) 65% of non-diabetic monozygotic co-twins of diabetic twins had elevated glucose values. Because concordance for diabetes was less than 100% for twins aged 52-65 years and because twins varied in age at onset of disease, non-genetic factors may also influence diabetes development. Among the 19 monozygotic twins pairs discordant for diabetes, diabetic twins did not differ from their non-diabetic co-twins in obesity, diet, alcohol consumption, or education. However, compared with unrelated non-diabetic twins of the same ages, non-diabetic co-twins of diabetic twins gained more weight as adults (p less than 0.02) and had higher glucose levels (p less than 0.03).
在参与美国国立心肺血液研究所双胞胎研究的250对同卵和264对异卵白人男性双胞胎中，确定了2型（非胰岛素依赖型）糖尿病的一致性。这些双胞胎出生于1917年至1927年之间，是从军事记录中识别出来的，未考虑疾病状况。我们对该队列的存活成员进行了两次检查，平均年龄分别为47岁和57岁，并获得了负荷后1小时血糖测试和用药史。2型糖尿病的诊断标准包括血糖值大于或等于13.9 mmol/l或目前正在使用抗糖尿病药物；可能患有1型（胰岛素依赖型）糖尿病的双胞胎被排除在外。第二次检查的三条证据表明2型糖尿病有很强的遗传易感性：（1）糖尿病双胞胎的同卵双胞胎中有58%自己患有糖尿病，而预期患病率为10%；（2）15对最初疾病不一致的同卵双胞胎中，只有1对在糖尿病方面仍不一致；（3）糖尿病双胞胎的非糖尿病同卵双胞胎中有65%的血糖值升高。由于52至65岁双胞胎的糖尿病一致性低于100%，且双胞胎发病年龄不同，非遗传因素也可能影响糖尿病的发展。在19对糖尿病不一致的同卵双胞胎中，糖尿病双胞胎在肥胖、饮食、饮酒或教育方面与非糖尿病的同卵双胞胎没有差异。然而，与相同年龄的无关非糖尿病双胞胎相比，糖尿病双胞胎的非糖尿病同卵双胞胎成年后体重增加更多（p<0.02），血糖水平更高（p<0.03）。
