[The disease characteristics and risk factors of type 2 diabetes mellitus in pedigrees].

OBJECTIVE: To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. METHODS: A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM), maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. RESULTS: No gender difference was found in the prevalence of T2DM (42.59% in male and 48.18% in female respectively, P > 0.05), nor was the newly diagnosed rate (9.89% in male and 11.82% in female, P > 0.05). The onset age was (63.3 ± 12.4) years old in the first generation [(64.4 ± 12.5) years in male and (62.3 ± 10.3) years in female], (47.1 ± 8.7) years old in the second generation [(48.2 ± 9.3) years in male and (46.1 ± 8.1) years in female], (29.6 ± 10.2) years old in the third generation [(28.9 ± 9.5) years in male and (30.0 ± 10.4) years in female]. Compared with normal glucose tolerance (NGT) subjects, newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM [(68.4 ± 12.4) kg, (69.5 ± 11.0) kg and (69.1 ± 9.6) kg] and IGR [(66.1 ± 10.7) kg, (65.9 ± 10.7) kg and (65.7 ± 10.4) kg], when compared with NGT [(61.0 ± 10.2) kg, (59.5 ± 11.0) kg and (60.1 ± 10.4) kg, all P < 0.05]. The same results were obtained with waist circumference and waist-hip ratio [(4.1 ± 12.5) cm and 0.92 ± 0.36 in newly diagnosed T2DM while (89.1 ± 10.7) cm and 0.90 ± 0.64 in IGR], when compared with NGT [(82.5 ± 10.1) cm and 0.82 ± 0.25], all P < 0.05. CONCLUSIONS: No gender difference was found in the onset characteristics of T2DM. High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.

[Study on abnormal glucose and lipid metabolism among 771 in-patients with ischemic stroke].

OBJECTIVE: To study the epidemiological characteristics of abnormal glucose and lipid metabolism in in-patients with ischemic stroke. METHODS: A total number of 771 in-patients with ischemic stroke, hospitalized in the Department of Neurology/Endocrinology from Changzhou No. 2 Hospital from April 2007 to April 2008 were enrolled in this study. After identifying the condition of glucose metabolism, all diagnosis-undetermined patients received oral glucose tolerance test. RESULTS: Among in-patients with ischemic stroke, 41.8% of the patients were finally diagnosed as diabetes, with 23.4% classified as 'impaired glucose tolerance'. The prevalence of 'abnormal glucose metabolism' was 65.2% in total. If diabetes in the in-patients with ischemic stroke was diagnosed only by fast plasma glucose instead of oral glucose tolerance test, 58.5% diabetic patients would have been misdiagnosed. Abnormal lipid metabolism existed in inpatients with cerebral ischemic stroke were noticed. These abnormalities of lipid metabolism were mainly consisting of increased triglyceride and decreased HDL-C cholesterol. CONCLUSION: The majority of in-patients with ischemic stroke appeared to have had abnormal glucose and lipid metabolism. It seemed necessary to promptly and correctly diagnose these patients with abnormal glucose metabolism by oral glucose tolerance test to reduce the chances of developing the recurrence of stroke.

[Relationship between polymorphism of urotensin II gene and type 2 diabetes in pedigrees].

OBJECTIVE: To investigate the association between a polymorphism (rs228648) of urotensin II (UT-II) gene and type 2 diabetes in pedigrees. METHODS: Patients and controls with/without familial history were enrolled in the same place. RESULTS: Carriers with AG or AA genotype from pedigrees had higher disease risk than those with GG genotype (OR=1.98, 95% CI:1.19-3.29,OR=2.46,95% CI:1.39-4.34), the frequency of A allele was higher in the patients from pedigrees than inner controls and patients who had no familial history (P=0.01). The frequency of A allele was higher in the inner controls than outer ones (P=0.001). The insulin resistance index, insulin sensitivity index and pancreatic secretion index of inner controls with AG genotype were higher than those with GG genotype (All P < 0.05). CONCLUSION: This polymorphism of UT-II gene might be a risk to type 2 diabetes, the insulin function of people from pedigrees is associated with the mutation.

[A study on risk factors among 125 type 2 diabetes mellitus with familial tendency].

OBJECTIVE: To study the risk factors regarding heredity and environment in familial incident type 2 diabetes mellitus (DM). METHODS: To compare the difference of environmental risk factors between type 2 DM, impaired glucose tolerance (IGT) and normal persons through study on familial information and environmental risk factors in 125 familial incident type 2 DM in-patients and out-patients from 1999 to 2001. Falconer was used to estimate heritability. Penrose was used to study the heredity damagers by polygene analysis. RESULTS: There was a significant constituent ratio diversity (P < 0.01) in triglyceride, body mass index, waist to hip ratio, hypertension history and physical activities history among 3 groups, while no significant diversity in blood lipids and history of coronary heart disease. 83.42% +/- 5.84% heritability of type 2 DM in 125 familial predigree indicated that dominant major gene might exist in these familiar pedigrees. Analysis of polygene in these groups showed type 2 DM might conform to the model of polygene heredity. CONCLUSION: This study suggested that type 2 DM had significant heritability and genetic heterogeneity, which generally appeared to be a disease of multi-factorial inheritance. Environmental risk factors, genetic factors and their interactions were due to type 2 DM.

[Study on the relationship between sulfonylurea receptor 1 gene polymorphism and type 2 diabetes mellitus].

To study whether the 3c/t polymorphism of the sulfonylurea receptor 1 (SUR1) gene exon16 increased the risk of type 2 diabetes mellitus in type 2 diabetes mellitus pedigrees in Han population in south area of China. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used in 46 type 2 diabetes mellitus pedigrees. The polymorphism in SUR1 was tested and analyzed by Mantel-Haenszel chi(2) test. Frequencies of SUR1-3c/t polymorphism had no significant difference between type 2 diabetes mellitus and normal relatives (genotypes chi(2)=3.224, P=0.199; frequency of allele chi(2)=1.250, P=0.264). In all subjects, type 2 diabetes mellitus and normal relatives, SUR1-3c/t genotypes were listed (cc: 29.3%, 30.2%, 28.3%; ct: 50.7%, 53.8%, 47.2%; tt: 20%, 16.0%, 24.5% respectively). The frequencies of c were 54.7%, 57.1% and 51.9% respectively. The frequency of c is lower than Han population in northern China. The results show that SUR1 exon16-3c/t polymorphism is not associated with type 2 diabetes mellitus in the population.

[Studies on genetic model in familial type 2 diabetes mellitus].

This study is to explore the genetic model of type 2 diabetes mellitus (type 2 DM) among the hereditary family. One hundred and thirty-six pedigrees of familial type 2 DM were studied. The heritability of type 2 DM was estimated according to Falconer's method and the multi-factorial inheritance analyzed according to Penrose's method. Complex segregation analysis was performed using S.A.G.E-REGD. The heritability of familial type 2 DM was 94 07%-/+5.84%. Dominant major gene might influence the genesis of type 2 DM. Analysis of multi-factorial inheritance indicated that there be two genetic patterns respectively in male and female populations. By complex segregation analysis,environment,non-transmitted and co-dominant inheritance were rejected. Autosomal dominant (AD) inheritance and autosomal recessive (AR) inheritance was accepted but AR inheritance was the best pattern. This study suggested that type 2 DM had significant heritability and genetic heterogeneity,which appeared to be a disease of multi-factorial inheritance generally and autosomal dominant (AD) inheritance in part of pedigrees.