Matsuda A, Kuzuya T
Division of Pathological Physiology, Jichi Medical School, School of Nursing, Tochigi-ken, Japan.
Diabetes Res Clin Pract. 1994 Dec 16;26(2):137-43. doi: 10.1016/0168-8227(94)90151-1.
In order to analyse the relationship of genetic factors and the role of obesity in the pathogenesis of Type 2 (non-insulin-dependent) diabetes mellitus, we compared body mass index (BMI) and other parameters in 71 monozygotic and 17 dizygotic twins (MZT and DZT) with Type 2 diabetes, and analysed the relationship of maximal BMI in the past (max BMI) with the concordance and discordance for diabetes. Data were collected by mail from the members of the Japan Diabetes Society. Concordance rate for diabetes was higher in MZT than in DZT (72% vs. 41%, P = 0.017). Concordance rate in MZT varied in relation to the max BMI of the index twins who developed diabetes earlier. It was higher in non-obese and slightly obese groups (82% and 80% for those with max BMI < 24 and 24-27.9, respectively) than in obese group (36%, max BMI > or = 28) (P = 0.003). In MZT, diabetic twins of discordant pairs were significantly more obese at the survey and in the past than index twins of concordant pairs (mean BMI: 23.9 vs. 21.7, P = 0.007; mean max BMI, 27.7 vs. 24.3, P = 0.001). A similar tendency of differences in BMI was also observed in DZT. Intrapair comparison in discordant MZT and DZT pairs showed that diabetic twins were more obese than non-diabetic cotwins (mean max BMI, 27.7 vs. 24.7, P = 0.004 for MZT; and 27.3 vs. 23.9, P = 0.002 for DZT). In concordant DZT pairs, index twins with earlier onset of diabetes had been less obese than cotwins (mean max BMI, 23.6 vs. 26.0, P = 0.004). In conclusion, the comparison of the max BMI in twins suggests that the degree of diabetogenic role of obesity varies in heterogeneous genetic background. The index twins of discordant pairs had been more obese than those of concordant pairs, suggesting that obesity plays a more important role in those with weaker genetic susceptibility for diabetes.
为了分析遗传因素与肥胖在2型（非胰岛素依赖型）糖尿病发病机制中的作用之间的关系，我们比较了71对同卵双胞胎和17对异卵双胞胎（MZT和DZT）患2型糖尿病的体重指数（BMI）及其他参数，并分析了过去的最大BMI（max BMI）与糖尿病一致性和不一致性之间的关系。数据通过邮件从日本糖尿病学会成员处收集。MZT中糖尿病的一致性率高于DZT（72%对41%，P = 0.017）。MZT中的一致性率因较早患糖尿病的索引双胞胎的max BMI而异。非肥胖和轻度肥胖组（max BMI < 24和24 - 27.9者分别为82%和80%）高于肥胖组（36%，max BMI≥28）（P = 0.003）。在MZT中，不一致对中的糖尿病双胞胎在调查时和过去比一致对中的索引双胞胎明显更肥胖（平均BMI：23.9对21.7，P = 0.007；平均max BMI，27.7对24.3，P = 0.001）。在DZT中也观察到类似的BMI差异趋势。对不一致的MZT和DZT对进行配对比较显示，糖尿病双胞胎比非糖尿病的孪生同胞更肥胖（MZT的平均max BMI为27.7对24.7，P = 0.004；DZT的为27.3对23.9，P = 0.002）。在一致的DZT对中，糖尿病发病较早的索引双胞胎比孪生同胞肥胖程度低（平均max BMI，23.6对26.
