The Influence Of Differert Backgrounds Of Heredity On Effect Of Dietary Intervention To Type 2 Diabetics

Objective To explore the influence of individual heredity diathesis on effect of dietary behavior intervention in type 2 diabetic populations,so as to provide scientific evidence for establishing more individual dietary intervention measures for type 2 diabetes patients,lessen the aimlessness in treatment,heighten effect of intervention.Methods In the research,378 new type 2 diabetes mellitus cases were selected randomly from Center of Disease Control and Prevention(CDC)of Liangshan Shandong province Aug.2005;Took down their individual information (including name,sex,age,region,et al)in detail,measuring and detecting their physical and metabolizing indexes(including stature,weight,waistline,hipline, triglycerides,total cholesterol,high density lipoprotein-cholesterol,glycosylated hemoglobin,insulin,et al)on the initial stage of the disease,then gave them healthy education on diabetes mellitus,and guided the patients treating the disease with correct dietary behavior intervention,following up the patients and measuring their fasting plasma glucose periodically during the following days;during the course of intervention,the patients were supervised by the clinicians of CDC and by their families.After implementing dietary behavior intervention for two and more than two years,378 copied of self-designed questionnaires were handed out to collect information during Aug.and Sep.of 2007,eliminated the questionnaires of patients who didn't comply well during the intervention stage,patients who took medicine or injected insulin because of heavier illness,patients who lost connection with each other because of death,moved away or other causes and patients who fill out only part of the questionnaires,and eventually we collected 342 copies of questionnaires. The subjects were divided into case and control group based on their levels of fasting plasma glucose after two years of dietary intervention,that is,the patients who with normal fasting plasma glucose were considered as cases and patients with abnormal fasting plasma glucose belonged to the control group,and in the research,there are 155 cases and 187 controls in all.After following up,we detected fasting plasma glucose,blood fat,and other indexes again,and at the same time,detected S447 polymorphism of lipoprotein lipase gene with the technique of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).χ~2 test is adopted to compare the frequency of lipoprotein lipase gene S447 mutation between the two groups;simultaneously,compare the indexes between different genotype groups before and after dietary intervention,so as to estimate the influence of LPL gene S447 polymorphism on dietary behavior intervention in type 2 diabetic population.Results In the research,we eventually collected questionnaires 342 copies, with an efficiency of 90.48%;the subjects were divided into two groups,155 cases and 187 controls in all;there is no difference between the two groups in the aspect of sex,age,race,region and compliance of dietary intervention(P＜0.05),and there is no remarkable difference between the two groups in metabolism indexes of blood sugar and fat before dietary intervention(P＜0.05).The composing of LPLS447 genotype and frequencies of alleles in the case and control group respectively is (S/S:76.13%,S/X:21.94%,X/X:1.93%;S:87.10%,X:12.90%)and(S/S: 87.70%,S/X:11.77%,X/X:0.53%;S:93.58%,X:6.42%),and there is a remarkable difference between the two groups(χ~2=7.845,P=0.005;χ~2=8.408,P=0.004);there is no remarkable differences between sex on the composing of LPLS447 genotype and frequencies of alleles(χ~2=0.093,P=0.760;χ~2=0.261,P=0.609).After dietary behavior intervention,in the S/X and X/X genotype group,levels of TG(Triglycerides),body mass index(BMI),waist-hip ratio(WHR)and GHb declined,and level of high density lipoprotein-cholesterol(HDL-C)increased remarkably(P＜0.05);but there is no remarkable difference in the S/S genotype group. Compared with genotype of S/S,patients with genotype of S/X and X/X are more susceptible to dietary intervention.After intervention,there is no remarkable difference in levels of insulin and C-P between the two groups,but the level of insulin and C-P in S/X and X/X genotype group is much lower than that of S/S genotype group(P＜0.05).Conclusion The effect of dietary behavior intervention on type 2 diabetics is not only influenced by age,sex,body-mass index and basal level of blood fat,but also affected by heredity diathesis of patients themselves.In this research,we can find that,effects of dietary behavior intervention varies with different backgrounds of heredity in type 2 diabetics,compared with genotype of LPLS/S,the effect of intervention in patients with S/X and X/X genotype group is more prominence, which indicate that S/X and X/X genotype maybe a protective factor for type 2 diabetes mellitus.This research indicates that,we need to consider the synthetic influence of factors listed above when giving dietary intervention to type 2 diabetics; Dietary intervention should be given according to conditions of patients themselves, implementing individualized intervention so that to reduce treatment blindness and to improve the effect of intervention.