| Part One: A Study on the Association of KCNQ1 Polymorphism with Type 2 Diabetes MellitusObjective: To study the relationship between polymorphism of KCNQ1 (rs2283228, rs151290, rs2237897) and Type 2 Diabetes Mellitus (T2DM).Methods: Case-control design was used in this study. 239 samples were selected. Each of the subjects received physical examination and laboratory test, such as WHR, BMI, SBP, DBP, TC, TG, HDL-C, LDL-C and FPG. KCNQ1 rs2283228 and rs151290 polymorphisms were genotyped using PCR-RFLP (the Polymerase Chain Reaction Restriction Fragment Length Polymorphisms) method,and the KCNQ1 rs2237897 polymorphism was genotyped by HRM (High Resolution Melt). All the data were analyzed by SPSS 18.0.Results:1 Age and sex was no statistical difference between the cases and the controls (P>0.05). T2DM patients had higher SBP, BMI, WHR, TG, FPG, LDL-C than normal controls (P<0.05). T2DM patients had lower HDL-C than normal controls (P<0.05). DBP and TC was no statistical difference between the cases and the controls (P>0.05). Genotypic and allelic frequencies of KCNQl rs2283228 rs151290 rs2237897 polymorphisms were in Hardy-Weinberg equilibrium, there was no statistical difference between the actual genotype frequencies and the expected genotype frequencies (P>0.05).2 Distribution of genotype and allele of KCNQ1- rs2283228A/C: The distribution of genotype (AA, AC, CC) and allele (A, C) frequencies was statistical difference in both groups (P<0.05). The frequency of AA genotype (65.4%) and the frequency of A allele (80.5%) in case group was higher than those in control group (31.1%, 59.9%), there was statistical difference (P<0.05). The prevalence rate of AA genotype (65.4%) was higher than AC, CC genotype (30.1%, 4.5%) in case group, there was statistical difference (P<0.05). The prevalence rate of A allele carrying (95.5%) was higher than CC genotype (4.5%) in case group, there was statistical difference (P<0.05). The risk of A allele carrying in patients was 2.702 times than that of patients with CC genotype (OR=2.702, 90%CI 1.210-8.173).3 Distribution of genotype and allele of KCNQ1- rs151290C/A: The distribution of genotype (CC, CA, AA) and allele (C, A) frequencies was statistical difference in both groups (P<0.05). The frequency of CC genotype (32.3%) and the frequency of C allele (56.4%) in case group was higher than those in control group (16.0%, 44.3%), there was statistical difference (P<0.05). The prevalence rate of CC genotype (32.3%) was higher than AA genotype (19.5%) in case group, there was statistical difference (P<0.05). The prevalence rate of C allele carrying (80.5%) was higher than AA genotype (19.5%) in case group, but there was no statistical difference (P>0.05).4 Distribution of genotype and allele of KCNQ1- rs2237897C/T: The distribution of genotype (CC, CT, TT) and allele (C, T) frequencies was statistical difference in both groups (P<0.05). The frequency of CC genotype (52.6%) and the frequency of C allele (76.3%) in case group was higher than those in control group (24.5%, 62.3%), there was statistical difference (P<0.05). The prevalence rate of CC genotype (52.6%) was higher than CT genotype (47.4%) in case group, there was statistical difference (P<0.05).Conclusions:1 KCNQ1- rs2283228 is associated with T2DM, and the A allele may serve as a genetic risk factor of T2DM.2 KCNQ1- rs151290 is associated with T2DM, and the C allele may serve as a genetic risk factor of T2DM.3 KCNQ1- rs2237897 is associated with T2DM, and the C allele may serve as a genetic risk factor of T2DM. Part Two: Evaluation of Intervention Effect in Middle-Aged and Elderly Type 2 Diabetes Mellitus Patients and Impaired Glucose Regulation Populations in Community of Bao Ding CityObjective: To evaluate the effects of community-based intervention among patients with type 2 diabetes mellitus (T2DM) and patients with impaired glucose regulation (IGR) in middle-aged and elderly residents from Baoding city and explore effective measures to improving T2DM patients'and diabetic patients'treatment.Methods: A randomized controlled trail study was conducted in two community residents which were selected randomly from three community. They were divided into control group and intervention group based on the baseline survey of type 2 diabetes mellitus (T2DM) prevalence among middle-aged and elderly residents from Bao Ding city. The intervention group, in addition to diabetic health education, was supplemented by dietary therapy, exercise therapy and drug therapy, while the control group was only by general health education, and the intervention was carried out by doctors of The First Central hospital in Baoding city. After six months'intervention, the survey was conducted by trained investigators using a standardized questionnaire, each of the subjects both received physical examination and laboratory test, such as height, weight, WC, HC, SBP, SDP, TC, TG, LDL-C, HDL-C, WHR, FBG, 2hPG and BMI. All the data were entered into computer by Epidata 3.1 and analyzed by SPSS 18.0.Results:1 The basic information of samples(1) T2DM patients included 87 cases of intervention group, which has 49 male and 38 female, the average age was (62.43±10.45) years, and 79 cases of control group, which has 44 male and 35 female, the average age was (63.81±9.96) years. There were no significant differences about the sex and age between the two groups (P>0.05) and so were the SBP, DBP, weight, BMI, WC, HC, WHR, TC, TG, FPG, 2hPG, HDL-C, FINS (P>0.05). The awareness rate of the range of normal blood glucose, the IGR, the prevention knowledge of DM risk factors, the inheritance, and the relationship between eating habit or proper exercise, or emotional control, and the importance of blood glucose self-monitoring has no significant differences between two groups (P>0.05). In conclusion, the two groups have comparability before intervention.(2) IGR patients included 33 cases of intervention group, which has 24 male and 9 female, the average age was (62.03±8.35) years, and 30 cases of control group, which has 16 male and 14 female, the average age was (64.80±9.41) years. There were no significant differences about the sex and age between the two groups (P>0.05) and so were the SBP, DBP, weight, BMI, WC, HC, WHR, TC, TG, FPG, 2hPG, HDL-C, FINS (P>0.05). Thus, the two groups have comparability before intervention.2 The result of intervention in T2DM patients,(1) Compare with the effects before and after program of intervention groupThe weight and BMI declined significantly, while HDL-C, FINS increased, and the differences had statistical significance before and after intervention (P<0.05). There were no significant differences about the 2hPG, SBP, DBP, WC, HC, WHR, TC, FPG and TG, though 2hPG declind (P>0.05). There were significantly differences about the awareness rate of the range of normal blood glucose, the IGR, the prevention knowledge of DM risk factors, the inheritance, the relationship between eating habit or proper exercise and DM, and the importance of blood glucose self-monitoring (P<0.05), except the awareness rate of the relationship between emotional control and DM (P>0.05).(2) Compare with the effects before and after program of control groupThe WC, HC, WHR, TG increased and the differences had statistical significance before and after intervention (P<0.05), while WC, FPG, FINS, SBP, DBP, BMI, TC, 2hPG, HDL-C had no statistical significance (P>0.05). There were significantly differences about the awareness rate of the inheritance, the relationship between eating habit or proper exercise and DM, the relationship between emotional control and DM, and the importance of blood glucose self-monitoring (P<0.05), except the awareness rate of the range of normal blood glucose, the IGR, the prevention knowledge of DM risk factors (P>0.05).(3) Compare with the effects between intervention and control group after interventionThere were significantly differences about WC, FPG, and FINS between intervention and control group after intervention, as the WC, FPG are lower than control and FINS is higher (P<0.05). There were no significantly differences about the BMI and HC (P>0.05). The SBP, DBP, WHR, TC, TG, 2hPG, HDL-C, weight had no statistical significance (P>0.05). There were significantly differences about the awareness rate of the range of normal blood glucose, the IGR, as the intervention group was both higher than control group (P<0.05). The awareness rate of the prevention knowledge of DM risk factors, the inheritance, the relationship of eating habit or proper exercise and DM, the relationship between emotional control and DM, and the importance of blood glucose self-monitoring had no statistical significance (P>0.05).3 The result of intervention in IGR population(1) Compare with the effects before and after program of intervention groupThe BMI and FPG declined significantly, while HDL-C, TG increased, and the differences had statistical significance before and after intervention (P<0.05). There were no significant differences about the weight, 2hPG, SBP, DBP, WC, HC, WHR, TC, FPG and TG, though weight and 2hPG declind(P>0.05).(2) Compare with the effects before and after program of control groupThe HC, TG increased and the differences had statistical significance before and after intervention (P<0.05) while WC, SBP, DBP, weight, BMI, WHR, TC, FPG, 2hPG, HDL-C, FINS had no statistical significance (P>0.05).(3) Compare with the effects between intervention and control group after intervention.There were significant differences about HC, BMI between intervention and control group after intervention. Though the weight, WC, 2hPG of intervention group declined and HDL-C increased than the control group, there were still no statistical significance (P>0.05). There were no significant differences about the SBP, DBP, WHR, TC, TG, FPG, FINS (P>0.05).Conclusions:1 The intervention effect of comprehensive intervention including diabetic health education, dietary therapy, exercise therapy and drug therapy is better than general health education intervention.2 The weight, BMI, HDL-C, FINS of T2MD patients have improved and the BMI, FPG, HDL-C of IGR population have also improved, after intervention.3 The health knowledge about DM of T2DM patients increased significantly.
|
PDF Full Text Request