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中国天津一项横断面研究:2 型糖尿病发病年龄与不同糖尿病家族史及性别关联性分析。

Association Analysis Between Different Diabetic Family History and Gender with Diagnosed Age of Type 2 Diabetes Mellitus: A Cross-Sectional Study in Tianjin, China.

机构信息

Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, The 4th Central Hospital Affiliated to Nankai University, 159424The 4th Center Clinical College of Tianjin Medical University, Tianjin, China.

NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.

出版信息

Inquiry. 2022 Jan-Dec;59:469580221086364. doi: 10.1177/00469580221086364.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) was previously considered a common disease in middle-aged and older people, but the age of diagnosis of T2DM is advancing every year, and the trend toward a younger age is obvious. Early-onset T2DM is a clinical syndrome caused by genetic and environmental factors. This study aimed to investigate the association between diabetic family history and gender with the diagnosed age of T2DM.

METHODS

The newly diagnosed T2DM patients admitted to the diabetes identification center of Tianjin 4th Central Hospital (TJ4thch) from October 2017 to June 2020 were registered. According to whether the diagnosis age is over 40 years old, patients were divided into 2 groups (early-onset T2DM group and late-onset T2DM group). In the study, the T2DM family history was divided into 5 types: () Father T2DM: father with T2DM, but not the mother; () Mother T2DM: mother with T2DM, but not the father; () Both parents with T2DM; () Another relative(s) (other than the parents) with a history of T2DM; and () Without a family history of T2DM. The diagnosed age with different genders and diabetic family history was compared. Multivariate logistic regression analysis was used to investigate the association factors of early-onset T2DM.

RESULTS

A total of 3725 patients completed the survey. There were 589 patients (15.8%) with early-onset T2DM, and 2469 patients (66.3%) had a diabetic family history. The T2DM-diagnosed age in males was lower than in females (51.7 ± 11.2 vs 54.0 ± 10.2, P = .000). The result was also reflected in the different T2DM family histories (with Both parents T2DM, 46.7 ± 11.1 vs 48.5 ± 10.3, = .271; with Father T2DM, 46.8 ± 10.8 vs 49.8 ± 11.3, = .005; with Mother T2DM, 50.4 ± 10.6 vs 52.3 ± 10.2, = .019; with Other T2DM family history, 54.0 ± 10.8 vs 55.7 ± 9.5, = .008; with no T2DM family history, 53.0 ± 11.0 vs 55.9 ± 9.3, = .000). The order of the T2DM-diagnosed age in the different groups was Both parents T2DM (47.5 ± 11.0) and Father T2DM (47.9 ± 11.1) family history < that with Mother T2DM family history (51.1 ± 10.5) < that with Other T2DM family history (54.7 ± 10.3) and no T2DM family history (54.1 ± 10.5). Logistic regression analysis indicated that gender (OR, 1.733; = .000), Father T2DM history (OR, 2.738; = .000), Mother T2DM history (OR, 1.536; = .001), Both parents T2DM (OR, 2.866; = .000) and body mass index (OR, 1.108, = .000) were correlated with early-onset T2DM.

CONCLUSION

Patients with early-onset T2DM tend to have a more obvious T2DM family history in China. This survey shows that when a parent has a T2DM family history, especially the father with T2DM, male patients are diagnosed with T2DM earlier. We need more intensive screening for diabetes in children with a family history of diabetes, especially in male children.

摘要

背景

2 型糖尿病(T2DM)以前被认为是中老年人的常见病,但 T2DM 的诊断年龄每年都在提前,呈年轻化趋势。早发 T2DM 是一种由遗传和环境因素引起的临床综合征。本研究旨在探讨糖尿病家族史和性别与 T2DM 诊断年龄的关系。

方法

登记 2017 年 10 月至 2020 年 6 月期间在天津市第四中心医院糖尿病鉴定中心新诊断的 T2DM 患者。根据诊断年龄是否超过 40 岁,将患者分为 2 组(早发 T2DM 组和晚发 T2DM 组)。在研究中,将 T2DM 家族史分为 5 种类型:()父亲 T2DM:父亲患有 T2DM,但母亲没有;()母亲 T2DM:母亲患有 T2DM,但父亲没有;()父母双方均患有 T2DM;()其他亲属(除父母外)有 T2DM 病史;()无 T2DM 家族史。比较不同性别和糖尿病家族史患者的诊断年龄。采用多因素 logistic 回归分析探讨早发 T2DM 的相关因素。

结果

共 3725 例患者完成了调查。其中 589 例(15.8%)为早发 T2DM,2469 例(66.3%)有糖尿病家族史。男性 T2DM 诊断年龄低于女性(51.7±11.2 岁比 54.0±10.2 岁,P=.000)。不同 T2DM 家族史也反映了这一结果(父母双方均有 T2DM 史者 46.7±11.1 岁比 48.5±10.3 岁,=.271;父亲有 T2DM 史者 46.8±10.8 岁比 49.8±11.3 岁,=.005;母亲有 T2DM 史者 50.4±10.6 岁比 52.3±10.2 岁,=.019;其他 T2DM 家族史者 54.0±10.8 岁比 55.7±9.5 岁,=.008;无 T2DM 家族史者 53.0±11.0 岁比 55.9±9.3 岁,=.000)。不同组 T2DM 诊断年龄的顺序为父母双方均有 T2DM 史(47.5±11.0)和父亲有 T2DM 史(47.9±11.1)<母亲有 T2DM 史(51.1±10.5)<其他 T2DM 家族史(54.7±10.3)和无 T2DM 家族史(54.1±10.5)。logistic 回归分析表明,性别(OR,1.733;=.000)、父亲有 T2DM 史(OR,2.738;=.000)、母亲有 T2DM 史(OR,1.536;=.001)、父母双方均有 T2DM 史(OR,2.866;=.000)和体重指数(OR,1.108,=.000)与早发 T2DM 相关。

结论

中国早发 T2DM 患者往往有更明显的 T2DM 家族史。本调查显示,当父母一方有 T2DM 家族史,尤其是父亲有 T2DM 时,男性患者 T2DM 的诊断年龄更早。我们需要对有糖尿病家族史的儿童进行更密集的糖尿病筛查,尤其是男性儿童。

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