Warram J H, Krolewski A S, Gottlieb M S, Kahn C R
N Engl J Med. 1984 Jul 19;311(3):149-52. doi: 10.1056/NEJM198407193110304.
To examine the role of heritable factors in insulin-dependent diabetes mellitus (IDDM), we studied the incidence of IDDM in the offspring of patients with the disease who were identified by the medical records of the Joslin Diabetes Center from 1928 to 1939. We found 187 survivors who, after the diagnosis of IDDM, had produced 419 offspring for whom information about diabetes status was available. By the age of 20, 6.1 per cent of the offspring of the 88 men had diabetes; in contrast, only 1.3 per cent of the offspring of the 99 women had the disease by the age of 20 (P less than 0.05). Daughters and sons of the men with IDDM were affected equally (there were insufficient numbers of affected offspring of diabetic women to permit determination of whether the sexes were equally affected). We conclude that IDDM is transmitted less frequently to the offspring of diabetic women than to those of diabetic men. More study is required to determine whether this difference reflects a genetic mechanism or, instead, selective perinatal loss of the affected offspring of diabetic mothers.
为了研究遗传因素在胰岛素依赖型糖尿病（IDDM）中的作用，我们对1928年至1939年乔斯林糖尿病中心病历中确诊的IDDM患者后代的IDDM发病率进行了研究。我们找到了187名幸存者，他们在被诊断为IDDM后生育了419名后代，且这些后代的糖尿病状况信息可得。到20岁时，88名男性患者的后代中有6.1%患有糖尿病；相比之下，99名女性患者的后代中到20岁时只有1.3%患有该病（P小于0.05）。IDDM男性患者的女儿和儿子受影响程度相同（糖尿病女性患者的受影响后代数量不足，无法确定性别是否受到同等影响）。我们得出结论，IDDM在糖尿病女性患者后代中的遗传频率低于糖尿病男性患者后代。需要更多研究来确定这种差异是反映了遗传机制，还是相反，反映了糖尿病母亲受影响后代在围产期的选择性丢失。
