Dubrey S W, Reaveley D R, Seed M, Lane D A, Ireland H, O'Donnell M, O'Connor B, Noble M I, Leslie R D
Department of Academic Medicine, Charing Cross and Westminster Medical School, London, U.K.
Diabetes. 1994 Jun;43(6):831-5. doi: 10.2337/diab.43.6.831.
Patients with insulin-dependent diabetes mellitus (IDDM) have an excess mortality, predominantly attributable to cardiovascular disease. To determine the effect of IDDM on potential risk factors for cardiovascular mortality, we studied subjects from the British Diabetic Twin Study Group. Forty-five identical twin pairs discordant for IDDM were recruited in addition to 45 matched nondiabetic singleton control subjects. All were selected to be normotensive and to have normal albumin excretion rates. Four variables differed significantly between the diabetic twins and their nondiabetic identical co-twins: diabetic twins had higher systolic blood pressure (sBP) ([mean +/- SD] 127 +/- 17 vs. 123 +/- 18 mmHg, P < 0.05), high-density lipoprotein (HDL) cholesterol (1.36 +/- 0.31 vs. 1.25 +/- 0.29 mM, P < 0.05) and fibrinogen (3.23 +/- 0.81 vs. 2.98 +/- 0.71 mg/ml, P < 0.05) but lower factor VII (114 +/- 34 vs. 122 +/- 31%, P < 0.05). All four of these risk factors were significantly correlated (P < 0.001) within the identical twin pairs, as were the other risk factors. These significant correlations within twins for the risk factors studied reflects the impact of shared genetic and environmental influences. IDDM affects sBP, HDL cholesterol, fibrinogen, and factor VII, but only sBP and fibrinogen are affected adversely.
胰岛素依赖型糖尿病（IDDM）患者死亡率较高，主要归因于心血管疾病。为了确定IDDM对心血管疾病死亡潜在风险因素的影响，我们对英国糖尿病双胞胎研究组的受试者进行了研究。除了45名匹配的非糖尿病单卵对照受试者外，还招募了45对IDDM不一致的同卵双胞胎。所有受试者均被选择为血压正常且白蛋白排泄率正常。糖尿病双胞胎与其非糖尿病同卵双胞胎之间有四个变量存在显著差异：糖尿病双胞胎的收缩压（sBP）较高（[平均值±标准差]127±17 vs. 123±18 mmHg，P<0.05）、高密度脂蛋白（HDL）胆固醇较高（1.36±0.31 vs. 1.25±0.29 mM，P<0.05）、纤维蛋白原较高（3.23±0.81 vs. 2.98±0.71 mg/ml，P<0.05），但凝血因子VII较低（114±34 vs. 122±31%，P<0.05）。在同卵双胞胎对中，所有这四个风险因素均显著相关（P<0.001），其他风险因素也是如此。双胞胎中所研究的风险因素之间的这些显著相关性反映了共同遗传和环境影响的作用。IDDM会影响sBP、HDL胆固醇、纤维蛋白原和凝血因子VII，但只有sBP和纤维蛋白原受到不利影响。
