| Objective:This study aimed to observe the changes of serum free fatty acid, lipid profile in first-degree relatives with different glucose tolerance of type 2 diabetes, and to expore the action of them in the incidence of type 2 diabetes mullitus, and to analyze the correlation. To investigate the relationship between free fatty acid and insulin resistance, beta cell function, and it is very important for the early prevention of diabetes incidence and the treatment for the disorders of lipid metabolism in diabetes are of great significance.Materials and Methods:The first-degree relatives of type 2 diabetes(all for patients children) were selected randomly from courtyard geriatric ward and outpatient service of people's hospital of LinYi as research object, All undertook oral glucose tolerance test,20 cases with normal glucose tolerance impaired glucose tolerance were selected for NGT group, and 21 cases with impaired glucose tolerance were involved in IGT group, and 18 patients with diabetes mellitus were involved in DM group by 1999 WHO diabetes diagnostic criteria, The impaired glucose tolerance and diabetes were first diagnosed, and did not make any treatment. All subjects were recorded general clinical data(including name, sex, age, height, weight, blood pressure, waistline and hip circumference) and receiving oral 75 grams glucose tolerance and insulin release test. Fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and 2h postprandial plasma glucose (2hPG) were observed. At the same time, return serum to uninfied detect fasting serum free fatty acid (FFA), fasting insulin (FINS) and 2h postprandial free fatty acid (2hFFA) and 2h postprandial insulin (2hINS). And calculated body mass index (BMI), waist to hip ratio (WHR), Insulin resistance index (HOMA-IR), beta cell function index (HOMA-B), insulin sensitivity index (ISI) were calculated by homeostasis model assessment. Clinical and experimental data were completely input into computer, all data were aprocessed by SPSS10.0 statistical software. Homa-IR, HOMA-B, ISI showed skewness distribution, taking natural logarithms converted to meet normal distribution, and did statistical analysis. Counting material were tested byχ2 inspection, measuring data were tested by t-test, numerical value were showed by mean±standard deviations (x±s), P< 0.05, P< 0.01 were considered as statistically differences.Results:(1)In the first-degree relatives of type 2 diabetics, compared with NGT group, DBP, WHR, LDL-C were significantly increased in IGT group and DM group (P< 0.01), SBP, TC were increased in DM group (P<0.05). BMI, TG were obviously increased in DM group (P< 0.01), BMI was increased in IGT group (P<0.05).(2)In the first-degree relatives of type 2 diabetics, HOMA-IR rose successively in NGT group, IGT group, DM group three groups (P<0.05), but HOMA-B rend to decrease in the three groups:compared with type NGT group, it had no statistical difference in IGT group (P>0.05), but significantly reduced in DM group (P<0.01); compared with IGT group, it had no statistical difference in DM group (P>0.05). HOMA-B tended to decrease in the three groups:compared with type NGT group, it remarkably reduced in IGT group and DM group (P<0.01), compared with IGT group, it decreased in DM group (P<0.05).(3)In the first-degree relatives of type 2 diabetics, compared with type NGT group, FINS,2h FFA and 2h INS significantly creased in IGT group and DM group (P<0.01), FFA rose in IGT group and DM group (P<0.05). Compared with IGT group, FINS rose in DM group (P<0.05),2hPG significantly creased in DM group (P<0.01).(4)Compared with FFA,2h FFA were significantly lower in the three groups (P<0.01). The linear correlation analysis between FFA and other parameters showed that, FFA positively correlated with BMI, WHR, TG, HOMA-IR and FPG(r were 0.349,0.305,0.250,0.309,0.201, respectively,P<0.05); but significant negatively correlated with HDL-C(r was-0.27, P<0.01), FFA only negatively correlated with HOMA-B, ISI, but had no statistical differences (r were-0.114,-0.097, P>0.05).(5)The linear correlation analysis between 2hFFA and other parameters showed that,2hFFA positively correlated with FFA(r was 0.349, P<0.05); but only positively correlated with DBP,2hINS, HOMA-IR, but had no statistical differences (r were 0.221,0.325,0.206, respectively, P>0.05), significant negatively correlated with HOMA-B, ISI (r were-0.129,-0.241, P<0.05).Conclusions:(1)The fasting serum FFA and TG levels elevated, and there were obvious insulin resistance and beta cell function defects In type 2 diabetes with family history of type 2 diabetes.(2)FFA (2 hours after sugar load) also rose in first-degree relatives with type 2 diabetes, it was suggested that long-term rise of FFA was worsen insulin resistance and injured the function of beta cell.(3)It existed lipid metabolism disorders, and had insulin resistance and impaired beta cell function in the first-degree relatives with abnormal glucose tolerance of type 2 diabetes patients. It is proved that high-risk groups with family history of type 2 diabetes mellitus had the basic of the development of type 2 diabetes mellitus, and also showed that insulin resistance. Beta-cell function defects and lipid metabolism disorders all participated in the development of type 2 diabetes high-risk groups with family history of type 2 diabetes. And the rise of serum FFA and TG levels was the main performance of this kind of crowd of the lipid metabolism disorders. FFA increasing may be the result of abnormal adjustment of sugar and lipid metabolism disorders working together, also may be the results of insulin resistance and beta-cell function defects. The hypertension of FFA and TG may be risk factors of this population to develope type 2 diabetes mellitus.(4) We should pay attention to early interventional treatment on lipid metabolism disorders and insulin resistance in first-degree relatives with type 2 diabetes patients, and detected the early changes of free fatty acid and take active measures, this may be one of important means to prevent or delay the development of type 2 diabetes in the high-risk groups of this kind. |
PDF Full Text Request