Effects Of Age And Family History On Islet β Cell Function And Insulin Sensitivity In Residents With Normal Glucose Tolerance In Shanghai

Objective:Diabetes is a chronic disease the pancreas can’t secrete enough insulin or the body can’t utilize insulin effectively.According to Global report on diabetes by World Health Organization in 2016,the amount of diabetic patients has risen from 108 million in 1980 to 422 million in 2014,as well as the prevalence rate from 4.7% to 8.5%.Among all the diabetic patients,type 2 diabetes is the most common one characterized by hyperglycemia、insulin resistance and insulin insufficiency.The prevalence rate of type 2 diabetes increases with age and at the peak at 60-74 years old.The development of diabetes is the results of inheritance、behavior and life style,almost one third of the aged have diabetes and three fourths have prediabetes.Our study researches the βcell function and insulin sensitivity of Shanghai residents with different age and inheritance background.This may help us to evaluate the pancreatic function and find the features of people with high risk.Methods:Our research is an observational study,the objects are from the key project of Three Year Action plan for Public Health of Shanghai Municipal Health and Family Planning Commission《Screening and evaluation system of autoimmune thyroid disease(AITD)in adults in Shanghai》.We picked five communities both in urban and rural areas of Shanghai,then 10 different neighborhood committees in every community chose 344 people in total as our objects.In the process we excluded pregnant women,people diagnosed as diabetes or prediabetes,with any diseases that may infect glucose tolerance,with bone fracture、severe mental disease、hepatitis、tuberculosis、HIV or infectious diseases as well as those taking any medicines that may infect glucose tolerance.During the investigation,we gathered the information of family history、height、weight、lipid level、fasting glucose and insulin concentration、glucose and insulin concentration 2h after OGTT.We use HOMA-β、HOMA-IS、HOMA-IR、GUTT-ISI to evaluate the β cell function and insulin sensitivity.B y dividing all the objects into groups according to age and inheritance background,the difference were tested by Student-Newman-Keuls test.Results:According to WHO diabetes expert committee report standard in 1999,there are 37 people diagnosed with diabetes,4 with impaired fasting glucose,26 with impaired glucose tolerance and 277 with normal glucose regulation.Among all the 292 objects with the information of family history,90 of them have positive family history,202 have negative,40 have paternal inheritance,31 have maternal inheritance and 11 have parental inheritance.We divided all the objects into 8 groups by age:18 to 24 years old(group YrA)、25 to 30 years old(group YrB)、31 to 36 years old(group YrC)、37 to 42 years old(group YrD)、43 to 48 years old(group Yr E)、49 to 54 years old(group YrF)、55 to 60 years old(group YrG)、61 to 65 years old(group YrH).After adjusting BMI and triglyceride level,we analyzed the difference between groups by SNK test and found the HOMA-βof group YrA、group YrB、group YrC is statistically higher than group YrF、group YrG、group YrH,while the GUTT-ISI of group YrB is statistically higher than other groups except group Yr C.The HOMA-IS has a downward trend with age but without statistical significance.According to the family history of T2 DM and the genetic intensity,we divided all the subjects with NGR into group FH+(positive family history)、FH-(negative family history),group FHF(paternal inheritance)、group FHM(maternal inheritance)、group FHB(parental inheritance)、group FH1(mild intensity)、groupFH2(moderate intensity)、groupFH3(severe intensity).We used the Student’s t test to test HOMA index and GUTT-ISI and found no statistically difference among these groups.Conclusion:1.With comparing different factors with indexes representing pancreatic function,age is statistically related with β-cell function and insulin sensitivity.2.The βcell function of normal glucose regulation with positive T2 DM family history is better than that with negative family history.There is no other significant statistically difference between inheritance background、lineage or intensity and β-cell function or insulin sensitivity.The insulin secretion and sensitivity have a downtrend by age in the subjects with normal glucose tolerance and positive family history.