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目的:研究2型糖尿病家系非糖尿病一级亲属胰岛素抵抗和体质量指数、血脂、血糖、胰岛素、C肽等参数的关系。方法:在重庆地区选择有两个或两个以上2型糖尿病患者的103个家系进行调查。对先证者的父母、同胞、和子代进行标准口服葡萄糖耐量实验,根据糖耐量结果确定无糖尿病者125例为一级亲属组。选择糖尿病患者或糖尿病家系一级亲属的配偶83例为正常对照组。比较两组空腹血糖、空腹胰岛素、空腹C肽、血脂,及糖负荷后60,120,180min血糖、胰岛素、C肽水平,并计算体质量指数及胰岛素抵抗稳态模型评估胰岛素抵抗指数(HOMA-IR),用于评价胰岛素抵抗变化。将一级亲属组成员根据体质量指数分组。比较肥胖者(n=57)和非肥胖者(n=68)的指标改变。结果:一级亲属组收缩压、舒张压、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、HOMA-IR明显高于正常对照组(t=1.98～2.50,P<0.05～0.01)。葡萄糖负荷后60,120min的血糖及0,60min,120min的胰岛素,负荷后60min的C肽,均显著高于对照组(t=2.07～4.82,P<0.05～0.01)。一级亲属组肥胖者的三酰甘油,高密度脂蛋白胆固醇、低密度脂蛋白胆固醇空腹胰岛素水平及HOMA-IR明显高于非肥胖者t=2.03～7.56,P<0.05～0.01)。糖尿病一级亲属组HOMA-IR(与体质量指数,收缩压、舒张压、三酰甘油呈显著
Objective: To study the relationship between insulin resistance and body mass index, blood lipid, blood glucose, insulin, C-peptide and other parameters in first-degree relatives of non-diabetic type 2 diabetic families. Methods: 103 families with two or more type 2 diabetes in Chongqing were enrolled. The proband’s parents, siblings, and offspring were given standard oral glucose tolerance test. According to the results of glucose tolerance, 125 non-diabetic patients were considered as first-degree relatives. Eighty-three spouses of patients with first-degree relatives of diabetic or diabetic pedigree were selected as normal control group. The levels of fasting blood glucose, fasting insulin, fasting C-peptide, blood lipids and blood glucose, insulin and C-peptide levels at 60,120 and 180min after the glucose load were compared between the two groups. HOMA-IR was calculated by calculating the body mass index and homeostatic model of insulin resistance. Used to assess changes in insulin resistance. The first-degree relatives grouped by body mass index. The changes in the index of obese (n = 57) and non-obese (n = 68) were compared. Results: Systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterol and HOMA-IR in first-degree relatives were significantly higher than those in normal controls (t = 1.98-2.50, P <0.05-0.01). Glucose 60,120min after glucose load and 60min, 120min insulin, 60min after loading C peptide, were significantly higher than the control group (t = 2.07 ~ 4.82, P <0.05 ~ 0.01). The level of fasting insulin and HOMA-IR of triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and obesity in first-degree relatives group were significantly higher than those in non-obese group (t = 2.03-7.56, P <0.05-0.01). HOMA-IR in first-degree relatives of diabetes (compared with body mass index, systolic blood pressure, diastolic blood pressure, and triglyceride