Poulsen P, Vaag A A, Kyvik K O, Jensen D M, Beck-Nielsen H
Odense Universitetshospital, endokrinologisk afdeling M.
Ugeskr Laeger. 1998 Apr 13;160(16):2382-7.
Previous studies have demonstrated an association between low weight at birth and risk of later development of non-insulin dependent diabetes mellitus (NIDDM). It is unknown whether this association may be due to an impact of intrauterine malnutrition per se, or whether it may be due to a coincidence between the putative "NIDDM susceptibility genotype" and a genetically determined low weight at birth. We traced original midwife birthweight record determinations in a group of monozygotic (n = 14 pairs) and dizygotic (n = 14 pairs) twins who phenotypically appeared discordant for NIDDM at a mean age of 67 and 64 years respectively. Birthweights were lower in the NIDDM twins compared with both their identical and non-identical non-diabetic co-twins respectively (p < 0.02 both). Using a similar approach in twin pairs discordant for impaired glucose tolerance (IGT) per se, no significantly decreased birthweight was detected in the IGT twins compared with their non-diabetic co-twins. However, when a larger group of twins with different glucose tolerances were considered, birthweights were lower in twins with abnormal glucose tolerance including both NIDDM and IGT. Furthermore, the twins with the lowest birthweights among the two co-twins had the highest plasma glucose concentrations 120 min after the 75 g oral glucose load (n = 86 pairs, p = 0.02). The study supports the hypothesis that low birthweight and a non-genetically determined intrauterine component such af malnutrition may play a role for the development of NIDDM in twins.
以往的研究表明,出生时体重偏低与日后患非胰岛素依赖型糖尿病(NIDDM)的风险之间存在关联。目前尚不清楚这种关联是由于宫内营养不良本身的影响,还是由于假定的“NIDDM易感基因型”与遗传决定的低出生体重之间的巧合。我们追踪了一组单卵双胞胎(n = 14对)和双卵双胞胎(n = 14对)的原始助产士出生体重记录测定情况,这些双胞胎在平均年龄分别为67岁和64岁时,在NIDDM表型上表现出不一致。与他们的同卵和异卵非糖尿病双胞胎相比,NIDDM双胞胎的出生体重分别较低(两者p < 0.02)。在本身糖耐量受损(IGT)不一致的双胞胎对中采用类似方法,未发现IGT双胞胎的出生体重与他们的非糖尿病双胞胎相比有显著降低。然而,当考虑一大组具有不同糖耐量的双胞胎时,包括NIDDM和IGT在内的糖耐量异常的双胞胎出生体重较低。此外,在86对双胞胎中,两个双胞胎中出生体重最低的那些在75克口服葡萄糖负荷后120分钟时血浆葡萄糖浓度最高(p = 0.02)。该研究支持这样的假设,即低出生体重和非遗传决定的宫内因素如营养不良可能在双胞胎NIDDM的发生中起作用。