| Diabetes is one of the common chronic diseases with increasing in frequency. WHO reports showed 30 million persons suffered from various kinds of diabetes in the world in 1985 and the number was 151 million by 2000. The number of patients will reach to 300 million up to 2025 and 95 percent among them is type 2 diabetes (T2DM). The diabetic in China has already been up to 30 million people at present, accounts for the one fifth of whole world. The proportion of T2DM is probably 95%. The etiology of T2DM is intricate; many studies have suggested that environmental and genetic factors may play important roles. So it is important for prevention and therapy to find out T2DM etiology, and to carry out the study of susceptible gene single nucleotide polymorphism (SNPs) especially. Our study was conducted in Changzhou, which was based on population pedigrees.Part I Epidemiological study of risk factors in type 2diabetes pedigreesThe type 2 diabetes pedigrees were collected to study T2DM genetic and environmental risk factors. A questionnaire and laboratory tests were carried out to get the detail information of the subjects. Their characteristics and the risk factors of T2DM were analyzed based on population pedigrees. The main results were as follows:1. After getting rid of T1DM, MODY, mitochondria heredity positive pedigrees with immunology method, pedigree analysis and molecular biology method, 115 eligible pedigrees had been collected, include 578 persons. At the same time, 177 controls had been collected also.2. The appearing rate newly of T2DM in normal kin-relatives and spouses were 10.29% and 3.08%, the appearing rate newly of IGT were 20.58% and 26.15. There was not significant difference between the two groups (x~2T2dm=3.33 , P=0.068; X~2IGT=0.94, P=0.333, respectively). The prevalence rate of T2DM of male and female in kin-relatives were 59.82% and 54.54% respectively. There also was no significant difference between male and female (X~2= 1.405, P=0.236).3. The result of univariate analysis on T2DM and population-based -control showed that high systolic blood pressure, high diastolic blood pressure, overweight, visceral obesity, hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol and high low-density lipoprotein cholesterol were risk factors. Multivariate Logistic regression analysis showed that age, visceral obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol and high low-density lipoprotein cholesterol were independent risk factors , and the odds ratio(95%CI) were 1.12(1.09-1.16) , 4.84(2.48-9.45) , 2.83(1.47-5.48) , 5.79(2.40-13.99) and 4.86(2.29-10.29).4. The result of univariate analysis on T2DM and family-based-control showed that high systolic blood pressure, high diastolic blood pressure, overweight, visceral obesity, hypercholesterolemia, hypertriglyceridemia and low high-density lipoprotein cholesterol were risk factors. Multivariate Logistic regression analysis showed that age, low high-density lipoprotein cholesterol were independent risk factors, and the odds ratio(95%CI) were 1.06(1.04-1.08) and 1.91(1.17-3.14).5. In comparison of the population-based-control , the family-based-control, IGT and T2DM were significant difference in proportions of risk factors, groups of IGT and T2DM were discovered having 3 or more risk factors (X~2=138.72, P= 0.000). The rate of riskfactors clustering was becoming higher and higher among the population-based-control, the family-based-control, IGT group and T2DM group in file. The trend had statistical significance(x~2趋势 =108.18, P= 0.000).6. Clustering of risk factors had been observed in the T2DM pedigrees, and insulin resistance was the risk factor. Subjects of kin-relatives were divided into four groups according to the quartile of HOMA-IR index. The rate of risk factors clustering were 46.8%, 69.8%, 79.4%, and 91.3% , which increased with the level of HOMA-IR index, the trend had statistical significance (x~2趋势=63.41, P= 0.000).7. Level of insulin, H...
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