非胰岛素依赖型糖尿病的病例对照研究

非胰岛素依赖型糖尿病的病例对照研究张青献１施侣元２非胰岛素依赖型糖尿病（ＮＩＤＤＭ）占糖尿病的９０％以上，其确切病因及发病机制尚不十分清楚。为此，我们采用１∶１配比病例对照研究来探讨ＮＩＤ－ＤＭ的危险因子。１材料与方法１．１调查对象病例为１９９５年３...     

非胰岛素依赖型糖尿病遗传基因的研究进展

非胰岛素依赖型糖尿病遗传基因的研究进展马灵筠１宋友民１苏琳２糖尿病是影响人类健康的常见病之一，黄种人的发病率约为１～３％，白种人达５％，而在比马印地安人等遗传隔离的群体中高达４０％。非胰岛素依赖型糖尿病（ＮＩＤＤＭ）在糖尿病中占９０％以上，但其病因及...     

城市人群非胰岛素依赖型糖尿病危险因素的病例对照研究

「目的」了解城市人群非胰岛素依赖型糖尿病（ＮＩＤＤＭ）的危险因素,为该病适宜的社区干预对策与措施的制订提供依据。「方法」对１１５例非胰岛素依赖型糖尿病患者进行了１：２个体配比例对照研究。「结果」糖尿病家族史、体重超重、高血压史和低体力活动是ＮＩＤＤＭ的危险因素,ＯＲ值分别为３．７１、１．８９、３．６２和１．６９。各因素的人群病因分值分别为１９．８５％、２８．４３％、１０．２４％和２８．３１％。「结     

高血压,年龄与Ⅱ型糖尿病患病率的关系研究

对湖北省部分地区２５岁及以上的９４５０名居民进行了高血压、年龄与Ⅱ型糖尿病——非胰岛素依赖型糖尿病（ＮＩＤＤＭ）及糖耐量低减（ＩＧＴ）患病率关系的流行病学研究。结果表明：２５岁及以上的ＮＩＤＤＭ患病率为２．６２％，ＩＧＴ患病率为４．４８％，男女性的ＮＩＤＤＭ与ＩＧＴ患病率差别无统计学意义（Ｐ＞０．０５），高血压患者中，ＮＩＤＤＭ和ＩＧＴ患病率分别为６．７５３％和９．６３３％，非高血压者ＮＩＤＤＭ和ＩＧＴ患病率仅为２．３４８％和３．７９０％，前者分别为后者的２．９倍和２．５倍，二者的标准化患病率差别仍有统计学意义。     

北京城区居民非胰岛素依赖型糖尿病人视网膜病变特征

北京城区居民非胰岛素依赖型糖尿病人视网膜病变特征吴升平１孙醒明２李明瑞３糖尿病性视网膜病变是由于糖尿病所致的严重微血管病变之一。在社区人群中有关非胰岛素依赖型糖尿病人眼底视网膜病变分布特征的报道甚少。为此本文将北京天坛地区居民中，非胰岛素依赖型糖尿病...     

洛阳市成人NIDDM危险因素研究

采用分层整群抽样的方法,对洛阳市２０～７４岁常住人口１８００人进行了成人ＮＩＤＤＭ（非胰岛素依赖型糖尿病）流行病学调查。分析结果表明,洛阳市成人ＮＩＤＤＭ患病率为３．２２％,男性２．６７％,女性３．７３％,性别差异无显著性（χ２＝１．８５,Ｐ＞０．０５）;年龄组ＮＩＤＤＭ患病率差异有显著性（（χ２＝６６．０７,Ｐ＜０．０１）,并且患病率有随年龄增长而增高的趋势。研究因素经ｍ∶ｎ的病例对照分层分析,结果发现人体质量指数大,腰／臀比大,月均收入高,Ｅｎｇｅｌ指数小,阳性糖尿病家族史,阳性巨胎史６个因素是ＮＩＤＤＭ的危险因素     

胰岛素抵抗在非胰岛素依赖型糖尿病患者继发冠心病中的作用

为研究冠心病（ＣＨＤ）的发病危险因素，对１０２例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）继发ＣＨＤ病例进行多个配比病例对照研究。通过条件Ｌｏｇｉｓｔｉｃ回归分析，发现胰岛素抵抗及高血糖症是ＮＩＤＤＭ继发ＣＨＤ的危险因素，ＯＲ分别为２．５６（９５％ＣＩ１．２７～５．１６）、４．３２（９５％ＣＩ２．５６～７．２８），高胰岛素血症增加ＮＩＤＤＭ继发ＣＨＤ的危险性，ＯＲ为１．６０（１．０３～２．４７）。     

河北省糖尿病流行病学研究

为探索河北省城乡非胰岛素依赖型糖尿病（ＮＩＤＤＭ）流行趋势和患病的危险因素，对６个城乡进行了抽样调查和分析。结果表明，抽样人口ＮＩＤＤＭ患病率为２．７９％，标化率２．３４％；城市人口患病率３．０３％，农村为２．５６％；人均收入高的城乡，ＮＩＤＤＭ患病率亦高。高龄、肥胖、阳性家族史者是ＮＩＤＤＭ的高危人群。经多因素分析，人均收入高及饮食开支大、家族史、肥胖及肉、蛋、油、奶类的大量摄入是ＮＩＤＤＭ高发的危险因素，玉米等粗粮摄入、体育锻练和职业体力劳动是保护因素。提示营养过剩、运动缺乏、教育不足是ＮＩＤＤＭ发病的主要原因。     

老年糖尿病人饮食与保健指导

老年糖尿病人饮食与保健指导兰景轩糖尿病在老年人群中很常见。它是因体内胰岛素绝对或相对缺乏引起的全身性、进行性、消耗性疾病。糖尿病临床上可分为两种类型，即胰岛素依赖型和非胰岛素依赖型。老年人糖尿病多属非胰岛素依赖型。临床资料表明，我国糖尿病的发病率达１...     

浅谈非依赖型糖尿病的药物治疗

１糖尿病患者增加引起全社会关注随着经济发展和生活方式的改变,糖尿病患病率正呈逐渐上升趋势。世界卫生组织负责糖尿病的卫生官员指出,二十世纪发展中国家糖尿病患者占全世界的６０％,到２０２５年预计将占７５％。随着肥胖儿童的增多,青少年中非胰岛素依赖型糖尿病...     

2型糖尿病的遗传流行病学研究

目的 探讨遗传因素在2型糖尿病发生中的作用及其一般遗传模式。方法 对21个2型糖尿病先证者进行家系调查，应用Falconer同归法估算遗传度，Penrose’s法、Li-Mantel-Gait法及江三多的阈值模型理论估计2型糖尿病分离比、遗传模式等。结果 2型糖尿病先证者一级亲属患病率为7．6％，高于一般人群患病率；2型糖尿病遗传度为46．8％；Penrose’s法计算同胞患病率（s）/人群患病率（q）为3．312，接近1／q^1/2；简单分离分析结果显示，分离率P为0．131，低于0．25；阈值模型理论推算出2型糖尿病一级亲属的理论发病率为8．0％，实际发病率为7．6％。结论 2型糖尿病有明显遗传倾向，但不符合单基因遗传模式，具有多基因遗传特征。     

浙江省815例白癜风患者遗传流行病学研究

目的探讨白癜风可能的遗传模式。方法通过调查表得到浙江地区815例白癜风患者及其一、二级亲属的数据。815例白癜风患者中男411例（50．43％），女404例（49．57％），年龄2月龄至71岁。由于缺乏当地白癜风患病率普查数据，因此设立对照组以方便遗传模式及遗传度的计算。468名对照组性别及各年龄段比例与病例组具有可比性。应用Penrose法、Falconer回归法及SAGE—REGTL软件对白癜风患者进行遗传方式分析，遗传度计算及复合分离分析。结果所调查的815例白癜风先证者中，有家族史者128例，无家族史者687例，遗传率15．70％。Penrose法计算出同胞患病率（s）／人群患病率（q）为41．76，不接近1／2q（260．42），也不接近1／4q（130．21），而接近1／√q（22182），提示白癜风符合一种多基因遗传模式。白癜风患者一、二级亲属遗传度分别为59．61％和55．20％，加权遗传度为58．7％。复合分离分析显示孟德尔显性、隐性、加性主基因模型假设均被接受；单纯环境与非传递模型被拒绝；以AIC值判断，显性模型拟合程度最好。结论遗传因素在白癜风发病中占有重要作用，白癜风符合一种多基因或多因子遗传模式，存在主基因效应。     

腰/臀比值与糖、脂代谢相关性研究

测定２２６例ＮＩＤＤＭ、３８９例ＩＧＴ患者体质指数（ＢＭＩ）及腰／臀比值（ＷＨＲ），并与１５３例糖耐量正常对照组作了比较。结果显示：ＮＩＤＤＭ组、ＩＧＴ组ＢＭＩ、ＷＨＲ均显著高于对照组（Ｐ＜０．０１）；ＮＩＤＤＭ组ＷＨＲ显著高于ＩＧＴ组（Ｐ＜０．０１），两组间ＢＭＩ无显著性差异（Ｐ＞０．０５）。另外，ＮＩＤＤＭ组、ＩＧＴ组的ＦＩｎｓ、２ｈＢＧ、２ｈＩｎｓ、ＴＧ、ＳＢＰ、ＤＢＰ及高血压患病率均显著高于正常组（Ｐ＜０．０１）；ＮＩＤＤＭ组ＦＢＧ、ＦＩｎｓ、２ｈＢＧ、ＴＧ及高血压患病率显著高于ＩＧＴ组（Ｐ＜０．０１），而ＩＤ１、２ｈＩｎｓ、ＩＤ２显著低于ＩＧＴ组（Ｐ＜０．０１）。ＮＩＤＤＭ组Ｃｈ明显高于对照组（Ｐ＜０．０５），而ＩＧＴ组Ｃｈ与对照组相比无显著性差异（Ｐ＞０．０５）。相关分析结果示ＷＨＲ与ＩＤ１、ＩＤ２、Ｃｈ、ＴＧ、ＳＢＰ、ＤＢＰ，均呈正相关。提示ＷＨＲ是体脂分布对糖、脂及胰岛素代谢影响较重要的指标。     

原发性肝癌的遗传流行病学研究

目的　研究原发性肝癌的遗传模式 ,探讨本病的遗传与环境的交互作用。方法　采用Penrose法、简单分离分析和Falconer法对乙型肝炎表面抗原 (HBsAg)阳性队列中的 10 0例原发性肝癌家系资料进行遗传流行病学研究。先证者样本来自同地区 9万名 8年随访队列人群 ,分析遗传模式并将队列中家系样本发病情况分别与队列人群和一般人群的发病情况进行比较 ,计算遗传度。结果　先证者家系一级亲属肝癌发生率为 4 .0 % ,高于一般人群发生率 (0 .4 4 % ) ,也高于队列人群的肝癌发生率 (1.0 3% )。HBsAg阳性在先证者家系中存在聚集 ,且HBsAg阳性与肝癌的发生有强相关(OR =8.4 4 ,95 %CI :3.37～ 2 0 .0 6 ,P <0 .0 0 1) ;应用Penrose法计算 ,同胞肝癌发生率 一般人群肝癌发生率 (s q)接近 1 q1 2 ;简单分离分析提示不符合单因子遗传模式 ;与一般人群遗传度相比 (5 9%±7% ) ,队列人群遗传度h2 =4 2 %± 6 % ,P <0 .0 5。在控制了HBsAg后 ,一般人群遗传度下降为4 7%± 7% ,队列人群遗传度下降为 2 9%± 8%。结论　肝癌不符合单基因遗传模式 ,为一多因子疾病 ,受遗传与环境的综合影响。     

常州市城乡居民高血压病流行特征及其与糖尿病关系的研究

目的：了解常州市城乡居民高血压病流行特征及其与2型糖尿病的关系。方法：对该市20岁以上自然人群的高血压病流行特征进行调查，并对其与糖尿病的关系进行研究。结果：常州市20岁以上城镇自然人群确诊高血压患病率为23．6％(男性23．0％，女性23．9％)，乡村为10．1％(男性12．1％，女性8．8％)，均高于全国城乡平均患病率水平。确诊和临界高血压合计的患病率城镇为33．9％，乡村为18．2％。无论城市和乡村，高血压患者中的血糖水平和糖尿病的患病率均显著高于非高血压患者。城市人群确诊高血压患者中糖尿病的患病率男、女分别为14．8％和23．6％，显著高于临界高血压患者中糖尿病的患病率(男、女分别为8．0％和13．6％)以及正常血压者中的糖尿病患病率(男、女分别为3．5％和7．4％)。结论：高血压病与糖尿病可能具有共同的致病因素，两者之间的关系值得进一步研究。     

2,5-己二酮对坐骨神经及运动神经元瘤细胞VSC4.1神经生长因子水平的影响

目的 研究2,5-己二酮(2,5-hexanedione,2,5-HD)对大鼠坐骨神经和运动神经元神经生长因子(nerve growth factor,NGF)水平的影响.方法 应用随机数字表法将50只Wistar大鼠分为400 mg·kg~(-1)·d~(-1),5-HD染毒0、7、14、21-,28 d组,每组10只,采用免疫组织化学显色和荧光定量PCR检测不同时间坐骨神经横断面NGF水平和坐骨神经NGF mRNA水平.选用0、2.5、5.0、10.0、20.0 mmol/L 2,5-HD染毒神经元瘤细胞VSCA.1,应用免疫荧光法观察NGF水平的改变;并选用10.0 mmol/L2,5-HD作染毒剂量,观察0、1、3、6、12、24、48 h NGF水平的变化.结果 随染毒时间延长,坐骨神经NGF呈先增高后降低的趋势;坐骨神经NGF mRNA水平在染毒14 d(2~(-△△Ct)=3.46)、21 d(2~(-△△Ct)=5.28)和28 d(2~(-△△Ct)=3.10)高于染毒0d(2~(-△△Ct)=1)和7 d(2~(-△△Ct)=0.78),差异有统计学意义.各染毒剂量组VSCA.1细胞NGF水平差异有统计学意义(F=188.88,P<0.01);5.0、10.0、20.0 mmol/L组NGF平均荧光强度值(分别为43.24±7.52、43.48±10.86、63.13±10.68)高于0 mmol/L组(16.32±4.20)(q值分别为19.92、19.72、32.78,P值均<0.01)和2.5 mmol/L组(19.78±2.66)(q值分别为17.50、17.42、30.63,P值均<0.01);20.0 mmol/L组高于5.0、10.0 mmol/L组(q值分别为13.04、11.71,P值均<0.01).10.0 mmol/L 2,5-HD染毒不同时间VSCA.1细胞NGF水平差异有统计学意义(F=75.69,P<0.01);染毒6、12、24、48 h NGF平均荧光强度值(分别为18.66±2.89、23.14±6.08、27.66±6.11、17.25±3.05)高于染毒0 h(10.18±1.81)(q值分别为9.64、15.74、21.76、8.50,P值均<0.01)、染毒1 h(9.31±1.28)(q值分别为10.28、16.17、21.95、9.20,P值均<0.01)和染毒3 h(10.44±2.13)(q值分别为9.25、15.24、21.17、8.10,P值均<0.01);染毒12、24 h NGF平均荧光强度值高于染毒6 h(q值分别为5.24、10.77,P值均<0.01)和染毒48 h(q值分别为7.31、13.26,P值均<0.01).结论一定时间内,2,5-HD可导致大鼠坐骨神经和运动神经元NGF的水平升高,有剂量(时间)依赖关系.     

Trends in the prevalence and incidence of diabetes: non-insulin-dependent diabetes mellitus

The revision of the classification of diabetes mellitus, to differentiate clearly between insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM), and the provision of unambiguous guidelines for diagnosis (1) constitute important recent developments in diabetes epidemiology. However, our knowledge even of the prevalence of NIDDM remains surprisingly incomplete for many areas of the world. Whilst NIDDM may still be uncommon in rural Africa, prevalence has been reported as approximately 10% in blacks in the United States, indicating a need for more information regarding the prevalence of NIDDM in urban Africa. There is also little information with regard to urban communities in Latin America. The highest prevalence of NIDDM is found in certain indigenous North American and Western Pacific societies. In extreme cases approximately one-third of the adult population now suffers from the disease. NIDDM is also common (prevalence approximately 5%) in Europe and in communities of European origin. Data from the United States suggest that approximately one-fifth of white North Americans can expect to develop NIDDM if they live to the seventh decade of life. Of populations of South-East Asian ethnicity, Indians appear to be the most susceptible. Indian migrants to Fiji, South Africa and South America all demonstrate prevalence of NIDDM of 10% or more. Whilst it was formerly believed that Chinese were rarely affected by NIDDM, recent reports cast some doubt on this. Prevalence of NIDDM in the Western Pacific varies widely. However, with the possible exception of certain Melanesian populations, prevalence is high in all communities which have abandoned their traditional lifestyle.(ABSTRACT TRUNCATED AT 250 WORDS)     

Management of diabetic patients requiring nutritional support.

A retrospective analysis was performed on 70 patients with diabetes mellitus who required nutritional support over the 10-yr period 1979-1989. Information was available for 65 patients, of whom 55 had non-insulin-dependent diabetes mellitus (NIDDM). Enteral nutrition (EN, 750-2200 kcal/day) was given to 40 NIDDM patients (group A) and 6 insulin-dependent diabetic (IDDM) patients (group B), and parenteral nutrition (PN, 1600-2400 kcal/day) was given to 18 NIDDM patients (group C) and 4 IDDM patients (group D). Three NIDDM patients required both types of feeding. Preadmission diabetes treatment remained the same during feeding for 31% of the total group (38% of group A, 33% of group B, 23% of group C, and 0% of group D). The NIDDM patients in group C who received insulin during PN required a high daily dose of approximately 100 U. The IDDM patients on PN required an increase of 225% from their preadmission daily dose. The likelihood of a patient requiring a major change from preadmission diabetes therapy depended mainly on the severity of the underlying illness and on the type of feeding (greater with PN) but not on preadmission therapy, age of patient, or type of EN (cyclic vs. continuous). Hypoglycemic episodes were uncommon in all groups. There were no significant differences between the prefeeding and feeding blood glucose levels and HbA1c results.     

Homocysteinaemia and degenerative complications in non insulin dependent diabetes mellitus

Type 2 diabetes mellitus (non insulin-dependent diabetes mellitus: NIDDM) is known to be associated with degenerative complications. Although, the pathophysiology of such complications is well known, the role of homocysteine (Hcy) is still discussed. The aim of the present study was to evaluate the relationship between the homocysteine levels and the NIDDM related complications in a group of NIDDM patients. Our study population consisted of 41 NIDDM patients including 13 subjects (G1) without complications (group controls), 17 patients (G2) with microangiopathy and 11 patients (G3) with coronary deficiency. Plasmatic homocysteine, glycemia, glycated haemoglobin (HbA1C) and lipidic parameters were essessed in all patients. Our results showed that mean levels of plasmatic homocysteine were within the normal range (10.4 +/- 3.3 micromol/l, 9.9 +/- 5.5 micromol/l and 14.8 +/- 10.4 micromol/l in G1, G2 and G3 respectively). Nevertheless, moderate hyperhomocysteinaemia was found in 36% in the coronary group (G3), 17.3% in patients with microangiopathy (G2) and 7.7% in controls. These preliminary results showed that cardiovascular complications in NIDDM patients may be related to high levels of homocysteine.     

Diabetes and its Long-term Complications in General Practice: a Survey in a Well-defined Population

The aim of this study was to assess the prevalence of long-termcomplications in all patients with non-insulin-dependent diabetesmellitus, who were known to their general practitioners (GPs).During one year 19 GPs in the area of Hoogeveen in the Netherlandsexamined their non-insulin-dependent (NIDDM) patients, includingthose under specialist's care. A detailed protocol was used;the GPs were trained in the diagnostic procedures. Complicationswere either already known from the records or newly discoveredduring screening. In a population of 41940 14.5/1000 patientswith diabetes were identified: 12/1000 NIDDM and 2.5/1000 insulin-dependent-diabetesmellitus (IDDM). Of the 509 NIDDM patients, 387 (76%) couldbe screened for late complications. Signs and symptoms of latecomplications were found in many patients: retinopathy (14%),nephropathy (57%), neuropathy (68%) and macroangiopathy (53%).The prevalence of serious complications was: proliferative retino-and maculopathy (3.3%); diabetic foot (2.6%); renal failure(2.5%). The systemic screening revealed a high number of previouslyunknown cases. It is concluded that many patients with NIDDMdevelop signs and symptoms of late complications. Most casesare identified by systemic screening only. More long-term studiesof the prognosis of late com plications in NIDDM are needed.