摘要
目的 对2型糖尿病家系中的遗传特征、危险因素进行调查分析,为系统研究2型糖尿病及制定干预措施提供依据.方法 根据1997年美国糖尿病学会（ADA）标准,利用口服葡萄糖耐量试验确诊糖尿病,根据胰岛素功能测定和血清谷氨酸脱羧酶抗体（GADAb）、胰岛细胞抗体（ICA）和胰岛素自身抗体（IAA）检测及临床特征排除1型糖尿病,根据遗传特征及临床特点排除年轻的成年发病型糖尿病（MODY）,根据母系遗传伴耳聋等临床特征排除线粒体基因突变家系,最终筛选出2型糖尿病家系182个（实际调查865例）并进行分析.结果 182个家系中男女2型糖尿病患病率（男性42.59%、女性48.18%）、新诊断率（男性9.89%、女性1 1.82%）差异无统计学意义（P＞0.05）.家系第1代277例患者发病年龄为（63.3±12.4）岁,其中男性为（64.4±12.5）岁,女性为（62.3±10.3）岁;第2代468例患者发病年龄为（47.1 ±8.7）岁,其中男性为（48.2±9.3）岁,女性为（46.1±8.1）岁;第3代120例患者发病年龄为（29.6±10.2）岁,其中男性为（28.9 ±9.5）岁,女性为（30.0±10.4）岁.新诊断2型糖尿病组、新诊断糖调节受损（IGR）组分别与非患病亲属组比较,高血压病史、高脂血症史、吸烟史、活动量差异均有统计学意义;5年前体重、1年前体重、目前体重、腰围、腰臀比差异也有统计学意义,股围差异无统计学意义.结论 2型糖尿病发病无性别差异.肥胖、高血压病、吸烟、高脂血症、活动量较少与2型糖尿病、IGR相关.活动量较多可能是家族中的非患病亲属及IGR患者较晚进入糖尿病期的原因之一.
Objective To explore the characteristics and risk factors of type 2 diabetes mellitus （T2DM） onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test （OGTT） based on American Diabetes Association （ADA） criteria. Type 1 diabetes mellitus （T1DM） , maturity onset diabetes of the young （MODY） and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM （42. 59% in male and 48. 18% in female respectively, P ＞0. 05） , nor was the newly diagnosed rate（9. 89% in male and 11. 82%in female, P ＞ 0. 05）. The onset age was （63. 3 ± 12. 4） years old in the first generation [（64. 4 ± 12. 5）years in male and （62. 3 ± 10. 3） years in female] , （47. 1 ± 8. 7） years old in the second generation [（48. 2 ±9. 3）years in male and （46. 1 ± 8. 1） years in female] , （29. 6 ± 10. 2） years old in the third generation [（28. 9 ±9. 5）years in male and （30. 0 ± 10. 4）years in female]. Compared with normal glucose tolerance （NGT） subjects , newly diagnosed T2DM and impaired glucose regulation （IGR） subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[（68. 4 ±12. 4）kg, （69. 5 ± 11. 0）kg and （69. 1 ±9. 6）kg] and IGR[（66. 1 ±10.7）kg, （65.9 ± 10.7） kg and（65.7 ± 10.4） kg] , when compared with NGT [（61.0 ± 10.2） kg,（59. 5 ±11.0） kg and （60. 1 ± 10. 4） kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [（4. 1 ± 12. 5） cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while （89. 1 ± 10. 7） cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[（82. 5 ± 10. 1） cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第6期474-477,共4页
Chinese Journal of Internal Medicine
关键词
糖尿病
2型
系谱
危险凶素
发病特征
Diabetes mellitus, type 2
Pedigree
Risk factor
Onset characteristics
