Cost and benefit of the genetic diagnosis for diabetes mellitus as a screening test.

最近已经确定了几个糖尿病易感基因，并有望用于糖尿病和/或糖尿病并发症的筛查试验。建立了糖尿病的马尔可夫决策分析模型（计算机模拟模型），以评估基因谱检测作为糖尿病筛查方法之一对健康的影响。该模型纳入了发生糖尿病和/或糖尿病并发症的可能性、费用、生存年和生活质量。由于关于遗传诊断对健康的益处的文献很少，并且模型结构本身存在缺陷，因此模拟过程需要进一步改进以达到目的。通过MEDLINE和日本医学中心（Ichushi）检索，我们检索并回顾了有关糖尿病遗传易感性、基因谱检查对健康益处的有效性以及基因诊断的决策和经济分析的英文和日语文章。许多文章通过生物学和分子技术处理遗传问题。但是，很少有证据表明，对生活方式相关疾病（如糖尿病）进行基因检测对健康有益。一些类型的基因谱检测在糖尿病领域已经有了创新。糖尿病基因诊断对健康的益处还需要从生活质量、生物伦理学和健康经济学等几个角度进行研究。

Several diabetes susceptibility genes have been identified recently and expected to be used as screening tests for diabetes and/or diabetic complications.1.A Markov decision analytic model (computerized simulation model) of diabetes mellitus was constructed to evaluate the health implications of examining gene profiles as one of the screening tests for diabetes. The model incorporated the likelihood of developing diabetes and/or diabetic complications, costs, survival year and quality of life. Because of scarce published literature about the health benefits of genetic diagnosis and the weakness of the model structure itself, the simulation process needs further amelioration to accomplish the purpose.2.Through MEDLINE and Japna Centra Revuo Medicina (Ichushi) searches, we retrieved and reviewed English-language and Japanese-language articles about the genetic predisposition to diabetes mellitus, the effectiveness of gene profile examination on health benefits, and the decision and economical analyses of the genetic diagnosis. A lot of articles have dealt with the genetic problems through biological and molecular techniques. But scarce evidence has been reported about the health benefits of the genetic tests for lifestyle related disease such as diabetes mellitus. Some kinds of genetic profile examinations have already been innovated in diabetes fields. Health benefits of genetic diagnosis of diabetes remains to be investigated from several viewpoints such as quality of life, bioethics, and health economics.