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2型糖尿病家系一级亲属非糖尿病同胞血糖 胰岛素和C |
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吴松华 项坤三 林辛 赵红华 李杰 陆俊茜
【摘要】 目的 研究2型糖尿病(DM)一级亲属(一级亲)成员中有关胰岛素(INS)作用和分泌的8个参数水平的变化。方法 以320个2型DM家系中347名一级亲非DM非糖耐量低减(IGT)同胞为观察组，326名非DM非IGT的同胞配偶为对照组，比较两组口服葡萄糖耐量试验(OGTT)中空腹和2小时血糖，INS、C-肽及胰岛素抵抗稳态模型评估(HOMA-IR)和胰岛β-细胞功能稳态模型评估(HOMA-B)。结果 总组比较，一级亲的HOMA-B降低，空腹血浆葡萄糖(FPG)增高(P分别为0.002 6和0.000 2)。进一步发现差异表现在≥40岁亚组，除HOMA-B和FPG有类似总组比较所见的变化外尚 可见到在给于 75 克葡萄糖负荷后血 糖、INS和C-肽 水平均高于对照 组(P分别为0.019、0.030和0.037)。尤其表现在40～60岁和BMI 22～27亚组。结论 2型DM一级亲非DM、非IGT同胞，尤其超过40岁的成员在出现明显的糖耐量减退前已存在INS作用和分泌的轻度减退。
【关键词】 糖尿病，非胰岛素依赖型； 系谱； 胰岛素； C肽； 一级亲
Changes of glucose、insulin and C-peptide levels in non-diabetic siblings of first degree relatives in type 2 diabetes mellitus families
WU Songhua XIANG Kunsan LIN Xin et al
（Department of Endocrinology and Metabolism,Shanghai Sixth People Hospital,Shanghai Diabetes Research Institute,Shanghai 200233）
【Abstract】 Objective To investigate the changes of 8 parameters related to insulin (INS) action and secretion in non-diabetes (non-DM) siblings of first degree relatives (FDRs) in type 2 DM families. Methods 1986 individuals out of the 320 families from Shanghai, Jiangsu and Zhejiang provinces, were investigated and blood sampled. 347 siblings among FDRs who were not DM and IGT patients were selected as FDR group and 326 subjects of their spouses as control group. The oral glucose tolerance test (OGTT) was conducted, 8 parameters including homostasis model assessment (HOMA)-insulin resistance (IR), HOMA-β-cell function (HOMA-B) reflecting INS action and INS secretion were compared. Two groups were further divided into subgroups according to age and body mass index (BMI). Analysis of covariance with adjustment of these two factors was used in comparison between groups and subgroups. Results There were statistically significant differences of HOMA-B and fasting plasma glucose (FPG) in comparison between two whole groups. HOMA-B of FDR group was lower, whreas FPG higher than [1] [2] [3] 下一页
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