·糖尿病临床研究·

　　【摘要】 目的 了解T2DM家系中非糖尿病一级亲属MS及主要组分的患病率。 方法 选取恩施地区符合条件的土家族T2DM家系128个行OGTT，去除家系组中的二级亲、配偶组中有糖尿病家族史和T2DM患者，将剩余成员分为T2DM组322例、非糖尿病一级亲(FDR)组298例和非糖尿病且无糖尿病家族史的配偶(Con)组102名。比较各组人体测量学参数、血糖、BP、血脂、胰岛素等指标的差别，及MS和主要组分的患病率。 结果 校正年龄因素后，FDR组WC和WHR高于Con组(P<0.05，P<0.01)。校正年龄和BMI后，与Con组比较，FDR组SBP、OGTT2 hPG、FIns和HOMA-IR升高，HDL-C降低(P<0.05或P<0.01)。FDR组肥胖、腹型肥胖、IGR、高血压、高TG血症、低HDL-C血症、MS(MCEP-ATPIII标准)和MS(IDF标准)的患病率均高于Con组(P<0.05或P<0.01)，但低于T2DM组(P<0.05或P<0.01)。校正年龄和性别后，FDR组患IGR的风险是Con组的13.2倍，肥胖、腹型肥胖和低HDL-C血症的风险是Con组的2倍左右，MS的患病风险是Con组的2.5倍左右(P<0.01或P<0.05)。 结论 T2DM及相关的代谢异常如肥胖、高血压、脂代谢紊乱等存在明显的家族聚集性。T2DM家系中非糖尿病一级亲属已表现出不同程度的代谢紊乱。

　　【关键词】 2型糖尿病;代谢综合征;一级亲

　　【Abstarct】 Objective To understand the prevalence of metabolic syndrome and its main components in non-diabetic first-degree relatives in families with T2DM. Methods 128 Enshi Tujia families with T2DM were enrolled and carried out OGTT. Anthropometry, blood pressure,lipid levels and OGTT were examined. Except second degree relatives and spouses who had diabetic relatives or who per se were diabetic, All the subjects were divided into three groups: T2DM group(n=332), FDR group(n=298) and control group(n=102). The clinical and metabolic characteristics and the prevalence of MS and its main components were compared among three groups. Results After adjusted for age, waist circumferences and WHR in FDR group were higher than in control group (P<0.05, P<0.01). After adjusted for age and BMI, the levels of SBP,OGTT 2 hPG, FIns and HOMA-IR in FDR group were higher than in control group, but HDL-C was lower (P<0.05 or P<0.01). In FDR group, the prevalence of IGR, hypertension, hypertriglyceridemia, decreased blood HDL-C, MS(MCEP-ATPIII criterion) and (IDF criterion) were higher than in control group, but lower than in T2DM group (P<0.05 or P<0.01). After adjusted for age and sex, the risk of FDR group with IGR was 13.2 times higher than in control group, obesity, central obesity and decreased blood HDL-C were about 2 times higher than in control group, and MS was 2.5 times higher than in control group(P<0.01 or P<0.05). Conclusion There is significant familial aggregation of T2DM and related phenotypes as obesity, hypertension and dyslipidaemia. There are metabolic disorder in different degree in the non-diabetic FDR.

　　【Key Words】 Diabetes mellitus,type 2;Metabolic syndrome;First-degree relatives