The study of insulin resistance in NGT first-degree relatives of type 2 diabetic patients and the resistance associating risk factors

( views:167, downloads:0 )
Journal Title:
Volume 12, Issue 01, 2004
Key Word:

Abstract: ObjectiveTo study insulin resistance in the NG T first-degree relatives of type 2 diabetics and the relationship of anthropometr ic, blood lipids, TNF-α, FFA and leptin with insulin resistance.Meth odsA total of 58 NGT first-degree relatives of type 2 diabetics and 3 4 sex-, age- and BMI-matched control subjects without a family history of dia betics were joined, All subjects underwent a 75 g OGTT for determinations of 0, 60, 90, 120 minutes glucose, insulin and C-peptide, and baseline blood lipids, TNF-α, FFA, leptin. Insulin resistance was estimated using the homeostasis as sessment (HOMA).The relationship between HOMA-IR and the other variables was as sessed.Results(1) TC and TG were higher in relatives than in controls (P<0.05,P<0.01). Ins and CP at 0 minute and glucose at 60, 90, 12 0 minutes after OGTT were significantly higher in relatives (P<0 01). The m ean glucose(AUC) in relatives was higher than that in controls(P<0.01),an d the mean Ins(AUC) had no difference between the relatives and the controls . T he HOMA-IR in relatives (3.70±1.94)was higher than that in controls (2.73 ±0.59)(P<0.01). The mean TNF-α concentration in relatives was higher tha n that in controls (P<0.01). (2) The first-degree relatives were classified three subgroups according to BMI<23, 23≤BMI<25, BMI≥25. With BMI increasing , TG, 0, 60, 90, 120 minutes glucose, Ins, CP, HOMA-IR , leptin were signifi cantly increased (P<0.001).(3) HOMA-IR is significantly correlated with BMI , WHR, TG, Glu0, Ins 0, CP 0, Glu(AUC), Ins(AUC) (P<0.001). A significant co rrelation can be found between FFA and Glu(AUC)(r=0.31, P=0.019). ConclusionsHyperinsulinemia and insulin resistance could appear early in normoglycemic first-degree relatives of type 2 diabetics. With BMI increasin g, the severities of insulin resistance and dyslipidemia are increased in the fi rst-degree relatives. Circulating TNF-α is correlated with insulin resistance . FFA is correlated with deteriorated glucose tolerance.

  • [1]Martin BC,Warram JH, Krolewski AS, et al. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet,1992,17: 925-929.
  • [2]Groop L, Forsblom L, Lehtovirta M. Characterization of the prediabetic state. Am J Hypertens,1997,10(9 pt 2):172s-180s.
  • [3]Shaw JT, Levy JC, Turner RC. The relationship between the insulin resistance syndrome and insulin sensitivity in the first-degree relatives of subjects with non-insulin dependent diabetes mellitus. Diabetes Res Clin Pract,1998,42:91-99.
  • [4]Camps I, Biarnes J, Fernandez-Real JM, et al. Insulin resistance and metabolic syndrome in first-degree relatives of patients with NIDDM. Med Clin, 1999,112:281-284.
  • [5]Humphriss DB, Stewart MW, Berrish TS, et al. Multiple metabolic abnormalities in normal glucose tolerant relatives of NIDDM families. Diabetologia, 1997,40:1185-1190.
  • [6]Costa A, Rios M, Casamitjana R, et al. High prevalence of abnormal glucose tolerance and metabolic disturbances in first degree relatives of NIDDM patients. A study in Catalonia, a mediterranean community. Diabetes Res Clin Pract,1998,41:191-196.
  • [7]Amoah AG, Owusu SK, Ayittey OM, et al. Minimal model analyses of beta cell secretion, insulin sensitivity and glucose effectiveness in glucose tolerant, non-diabetic first-degree relatives of Ghanaian patients with type 2 diabetes and healthy control subjects. Ethn Dis, 2001,11:201-210.
  • [8]Volk A, Renn W, Overkamp D, et al. Insulin action and secretion in healthy, glucose tolerant first degree relatives of patients with type 2 diabetes mellitus. Influence of body weight. Exp Clin Endocrinol Diabetes, 1999,107:140-147.
  • [9]Jensen CC, Cnop M, Hull RL, et al. Beta-cell function is a major contributor to oral glucose tolerance in high-risk relatives of four ethnic groups in the U.S. Diabetes,2002,51:2170-2178.
  • [10]Paolisso G, Tagliamonte MR, Rizzo MR, et al. Lowering fatty acids potentiates acute insulin response in first degree relatives of people with type II diabetes. Diabetologia, 1998, 41:1127-1132.
  • [11]Peraldi P, Spiegelman B. TNF-α and insulin resistance: Summary and future prospects. Mol and Cell Biochem,1998,182:169-175.
  • [12]Zinman B, Hanley AJ, Harris SB, et al. Circulation tumor necrosis factor-α concentrations in a native Canadian Population with high rate of type 2 diabetes mellitus. J Clin Endocr and Metab,1999,84:272-278.
  • [13]Smith U, Axelsen M, Carvalho E, et al. Insulin signaling and action in fat cells: associations with insulin resistance and type 2 diabetes. Ann N Y Acad Sci, 1999,18:119-126.
  • [14]徐一甄. 胰岛素抵抗与血脂异常. 国外医学内科学分册, 1998, 25:12-13.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615