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目的探讨糖尿病家族史对代谢综合征组分及胰岛β细胞功能和胰岛素抵抗的影响。方法选取新诊断空腹血糖受损者,根据糖尿病家族史(FH)的有无各入选30例患者,并选取年龄、性别相匹配的正常组30例作对照,分别观察体质指数(BMI)、测定空腹血糖(FBG)、空腹血胰岛素(FINS)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及尿酸(UA)水平,通过OGTT测餐后2 h血糖(2hBG)、餐后2 h血胰岛素(2hINS)、询问高血压病史。结果与FH-组相比,FH+组发病年龄早于FH-组(56.36±12.50vs62.63±12.24),FH+组与FH-组相比BMI、UA、TC、LDL-C、TG、FINS、2hINS、HOMA-β(36.62±14.21vs44.61±19.73)、HOMA-IR(2.48±1.40vs2.83±1.37)均降低,而HDL-C增高。FH+组与正常对照组相比BMI、UA、TC、LDL-C、TG、HOMA-IR(2.48±1.40vs2.16±1.21)仍高,HDL-C、HOMA-β(36.62±14.21vs48.32±13.26)低,经年龄校正后,差异有统计学意义(P<0.05)。结论有糖尿病家族史者由于遗传缺陷导致胰岛β细胞功能差,糖尿病发病年龄轻,虽胰岛素抵抗及代谢综合征成分不及无糖尿病家族史者,但与正常对照组相比仍高。
Objective To investigate the influence of family history of diabetes on the components of metabolic syndrome, islet β-cell function and insulin resistance. Methods Thirty newly diagnosed patients with impaired fasting glucose were enrolled in this study. According to the presence or absence of family history of diabetes mellitus (FH), 30 patients were enrolled in this study. Thirty healthy adults and 30 normal controls were selected as controls. Body mass index (BMI) Fasting blood glucose (FBG), fasting blood insulin (FINS), cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and uric acid ) Level, 2 h blood glucose (2 hBG) and 2 h postprandial insulin (2 hINS) were measured by OGTT and asked about the history of hypertension. Results Compared with FH group, the onset age of FH group was earlier than that of FH group (56.36 ± 12.50 vs 62.63 ± 12.24). Compared with FH group, BMI, UA, TC, LDL-C, TG, FINS, 2hINS, HOMA-β (36.62 ± 14.21vs44.61 ± 19.73) and HOMA-IR (2.48 ± 1.40vs2.83 ± 1.37) both decreased and HDL-C increased. The levels of BMI, UA, TC, LDL-C, TG and HOMA-IR in FH + group were still higher than those in normal control group (2.48 ± 1.40 vs 2.16 ± 1.21), while those in HDL-C and HOMA-β were 36.62 ± 14.21 vs 48.32 ± 13.26). After age correction, the difference was statistically significant (P <0.05). Conclusion The family history of diabetes mellitus is characterized by poor function of pancreatic β cells due to genetic defects and age of onset of diabetes. Although the components of insulin resistance and metabolic syndrome are less than those without family history of diabetes, they are still high compared with the normal control group.