| Type2diabetes mellitus (T2DM) has the nature of the incidence of familial aggregation, their first-degree relatives (first degree relatives, FDRs) is a high risk of diabetes. High mortality of diabetes morbidity has been concern, and as a complication, cardiovascular disease (cardiovascular disease, CVD) is the main cause. Thus, for high-risk populations T2DM,assess the cardiovascular risk and take early intervention is of great significance.Objective:Discuss cardiovascular risk factors intervention methods for FDRs of T2DM patients with normal glucose tolerance, and provide early references for the prophylaxis of T2DM CVD.Methods:Collected70T2DM trios206cases of first-degree relatives (parents, children, siblings) who have been treatment in Zaozhuang Municipal Hospital from October2010to June2011. Select60cases of first-degree relatives with normal glucose tolerance to study entry by oral administration of "75g glucose tolerance test"(OGTT test), that28males and32females, age (40.2±6.8) years of age. Through randomly selected,40patients are in the group of nutrition therapy intervention,20patients are in the control group. Normal glucose tolerance diagnosed using WHO (1999year) diagnostic criteria:fasting blood glucose (FBG)<6.1mmol/L, OGTT glucose2h after the experiment (P2hBG)<7.8mmol/L. Exclusion criteria:exclude cardiovascular and cerebrovascular disease, severe liver and kidney dysfunction, cancer and other chronic wasting disease. Exclude primary familial hyperlipidemia, thyroid and other endocrine diseases, as well as related autoimmune diseases. Rule out acute infection, trauma, stress, pregnancy and secondary DM. Assessments all the objects of whom into the group and create the file, including general demographic data (gender, age), tobacco history, health status, CVD family history, work and physical activity, and so on. Measure height, weight, waist circumference (WC), hip circumference (HC), then calculate WHR and BMI.Measure blood pressure (systolic blood pressure, diastolic blood pressure), heart rate. Detect FBG and P2hBG, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), uric acid (UA) by enzyme linked immunosorbent assay.Detect fasting insulin (FINS) by photochemical luminescence determination. Detect of CRP by immune nephelometry. Collecct urine from10pm to6am, detect urinary albumin by radioimmunoassay, then calculate UAER per minute.Calculate the HOMA-IR. Examine liver by high-resolution ultrasound.According to ischemic cardiovascular disease (ICVD)10year incidence risk assessment table established by Task Force of China’s "fifteen" key "study of coronary heart disease and stroke risk assessment and comprehensive intervention program" ICVD risk score for all subjects before and after intervention. And assess risk of its10-year ICVD. Both groups were regularly given to health lectures of diabetes (DM) and cardiovascular disease. To reasonable exercise guidance, periodic outpatient and telephone follow-up, risk factor surveillance, information analysis;the nutritious meals are provided for dynamic intervention group based on the above, and individualized intervention. Follow-up at6,12,and24months after intervention, and record and estimate changes of the metabolic indicators in the two groups and ICVD danger.Conclusion:After intervention, compared with the control group, multiple risk factors significantly improved of the intervention group at6months,12months,24months. Cardiovascular absolute risk level significantly lower (P<0.01).Results: T2DM with normal glucose tolerance FDRs exist multiple risk factors for CVD. Right nutrition comprehensive intervention can benefit maximization CVD. Long-term primary prevention for cardiovascular risk groups should be strengthen, and individualized prevention program should be selected. |
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