2型糖尿病家系胰岛素抵抗及危险因素分析
Analysis on risk factors of insulin resistance clustering in type 2 diabetes mellitus families
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摘要:目的 研究2型糖尿病(T2DM)家系人群的胰岛素抵抗与心血管疾病危险因素聚集的关系。方法 选取2型糖尿病家系115个, 共计570人, 其中268例糖尿病患者为病例组, 非糖尿病一级血缘亲属302人为内对照组, 健康者161人为外对照组, 应用χ2检验以及二项分类Logistic回归方法。结果 3组的心血管危险因素聚集程度与胰岛素抵抗程度有关(均P < 0.05)。随着胰岛素抵抗指数(HOMA-IR)的增高, 3组人群的心血管疾病危险因素聚集的风险均增加。内对照组的胰岛初期分泌功能指数的平均水平高于T2DM人群和外对照人群(P=0.018, 0.000)。结论 健康人群在未发生糖尿病之前均有胰岛素抵抗, 因胰岛β细胞代偿性分泌增加, 故不发病; 当其失代偿时, 则导致糖尿病发生。胰岛素抵抗为心血管疾病危险因素聚集的基础, 心血管疾病危险因素聚集则是导致家系2型糖尿病高发的原因之一。Abstract:Objective To explore the relationship between insulin resistance and the clustering of Cardiovascular Disease (CVD)among relatives of T2DM family and health people.Methods 115 T2DM families were selected, which contained 268 cases as the case group, 302 relatives but nondiabetic individuals from these families as the inner control group and 161 healthy ones as outer control group that contained 570 subjects in all.Chi-test and binary logistic reg ression were used.Results Insulin resistance and risk-factor clustering had association among these three groups(All P < 0.05).Then what insulin resistance was the base of clustering of CVD in multiple familial type 2 diabetes mellitus was uncovered.The value of OR increased with the value of HOMA-IR growing.The mean of insulin secretion in inner-group was higher than that of both T2DM group and outer-group(P=0.018, 0.000).Conclusion Whether the individuals in relative group in families with type 2 diabetes orin the health group all have severe insulin resistance before getting CVD.However, their Bcells could secrete instead of dysfunct ion of insulin resistance as a prevention.And cardiovascular risk factors clustering may be the reason of type 2 diabetes mellitus.Insulin resistance may be the basis of multiple familial type 2 diabetes mellitus.
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