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© 2001 by the American Diabetes Association, Inc.
Epidemiology/Health Services/Psychosocial Research |
Familial Early-Onset Type 2 Diabetes in Chinese Patients
Obesity and genetics have more significant roles than autoimmunity
1 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR
2 Diabetes Research Laboratories, Radcliffe Infirmary, University of Oxford, Oxford
3 Department of Medicine, University of Birmingham, Birmingham, U.K.
4 Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia
OBJECTIVE—We examined the prevalence of different forms of diabetes in Hong Kong Chinese patients with familial early-onset type 2 diabetes and compared their clinical features with patients with familial late-onset type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 145 young patients with early-onset diabetes (age and age at diagnosis 
40 years) and a family history of diabetes were studied. They were screened for mutations in the genes encoding glucokinase, hepatocyte nuclear factor (HNF)-4
, and HNF-1. The mitochondrial DNA A
G at nucleotide 3243 (mt3243) and amylin S20G mutations were studied, and antibodies to GAD (anti-GADs) were also examined.
RESULTS—The prevalence of putative diabetogenic gene mutations and autoimmune markers were 4% for glucokinase, 0% for HNF-4, 5% for HNF-1, 3% for mt3243, 2% for amylin S20G, and 4% for anti-GAD. Compared with late-onset patients, the patients with early-onset diabetes had a higher prevalence of a parental history of diabetes and were generally more obese. When classified by obesity indexes (BMI and waist circumference), the obese patients, especially those with early-onset diabetes, had a clustering of cardiovascular risk factors and increased rates of retinopathy and albuminuria.
CONCLUSIONS—Genetic factors (up to 14%) and obesity (55%) play more significant roles than autoimmunity (4%) in familial type 2 diabetes in young Chinese patients. The significance of obesity-related genes and other gene-gene and gene-environment interactions in these young patients remains to be determined.
Abbreviations: ACR, albumin-to-creatinine ratio • anti-GAD, antibody to GAD • BP, blood pressure • HDL-C, HDL cholesterol • LDL-C, LDL cholesterol • HOMAIR, homeostasis model assessment for insulin resistance • HNF, hepatocyte nuclear factor • MODY, maturity-onset diabetes of the young • PCR, polymerase chain reaction • PWH, Prince of Wales Hospital • RFLP, restriction fragment–length polymorphism • TC, total cholesterol • TG, triglyceride
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