Familial early-onset type 2 diabetes in Chinese patients - Obesity and genetics have more significant roles than autoimmunity

Familial early-onset type 2 diabetes in Chinese patients - Obesity and genetics have more significant roles than autoimmunity
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DOI:
10.2337/diacare.24.4.663
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发表时间:
2001-04-01
期刊:
影响因子:
16.2
通讯作者:
Chan, JCN
Chan, JCN
中科院分区:
医学1区
文献类型:
--
作者:
Ng, MCY;Lee, SC;Chan, JCN

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目的:研究香港华人家族性早发性2型糖尿病患者中不同形式糖尿病的患病率,并将其与家族性晚发性2型糖尿病患者的临床特征进行比较。研究设计和方法:研究了145例早发性糖尿病(年龄和诊断年龄小于或等于40岁)和糖尿病家族史的年轻患者。他们被筛选编码葡萄糖激酶、肝细胞核因子(HNF)-4 α和HNF-1 α的基因突变。研究线粒体DNA A - b> G核苷酸3243 (mt3243)和amylin S20G突变,并检测GAD抗体(anti-GADs)。结果-葡萄糖激酶的推定糖尿病基因突变和自身免疫标记的患病率为4%。0%的HNF-4 α。5%用于HNF-1 α, 3%用于mt3243, 2%用于amylin S20G, 4%用于Eor抗gad。与晚发患者比较。早发性糖尿病患者的父母有糖尿病病史的患病率更高,而且通常更肥胖。当根据肥胖指数(BMI和腰围)分类时,肥胖患者,特别是早发性糖尿病患者,心血管危险因素聚集,视网膜病变和蛋白尿发生率增加。结论:在中国年轻家族性2型糖尿病患者中,遗传因素(高达14%)和肥胖(55%)比自身免疫(SB)发挥更重要的作用。肥胖相关基因以及其他基因-基因和基因-环境相互作用在这些年轻患者中的意义仍有待确定。
OBJECTIVE - We examined the prevalence of different Forms of diabetes in Hong Kong Chinese patients with familial early-onset type 2 diabetes and compared their clinical features with patients with familial late-onset type 2 diabetes.RESEARCH DESIGN AND METHODS - A total of 145 young patients with early-onset diabetes (age and age at diagnosis less than or equal to 40 years) and a family history of diabetes were studied. They were screened for mutations in the genes encoding glucokinase, hepatocyte nuclear factor (HNF)-4 alpha, and HNF-1 alpha. The mitochondrial DNA A -->G at nucleotide 3243 (mt3243) and amylin S20G mutations were studied, and antibodies to GAD (anti-GADs) were also examined.RESULTS - The prevalence of putative diabetogenic gene mutations and autoimmune markers were 4% For glucokinase. 0% for HNF-4 alpha. 5% For HNF-1 alpha, 3% for mt3243, 2% For amylin S20G, and 4% Eor anti-GAD. Compared with Late-onset patients. the patients with early-onset diabetes had a higher prevalence of a parental history of diabetes and were generally more obese. When classified by obesity indexes (BMI and waist circumference), the obese patients, especially those with early-onset diabetes, had a clustering of cardiovascular risk Factors and increased rates of retinopathy and albuminuria.CONCLUSIONS - Genetic factors (up to 14%) and obesity (55%) play more significant roles than autoimmunity (SB) in familial type 2 diabetes in young Chinese patients. The significance of obesity-related genes and other gene-gene and gene-environment interactions in these young patients remains to be determined.