| Objective By comparing the indexes of blood glucose and lipids,adipocytokine(leptin,adiponectin,TNF-α)and GLP-1,and other indicators of pancreatic fat infiltration in different degrees,the correlation between pancreatic fat infiltration and risk factors of T2 DM was explored.A multidimensional mass spectrometry "shotgun" method was used to qualitatively and quantitatively analyze various lipid molecules in the serum to determine differences in mass spectrometry distribution and correlation between pancreatic fat infiltration and serum lipid metabolomics in T2 DM populations,and to explore pancreatic fat infiltration and 2 The relationship between the occurrence and development of type 2 diabetes mellitus and the therapeutic effect of Yiqi Yangyin Huoxue method on pancreas fat infiltration combined with type 2diabetes.Methods 1.A total of 473 pancreatic fat infiltration patients were included in the diagnosis and exclusion criteria,and 108 healthy people in the physical examination center were selected as healthy controls.Of the 473 patients with pancreatic fatty infiltration(total NAFPD),267 were males and 206 were females.There were 382 patients with mild pancreatic fatty infiltration(mild NAFPD)and 91 patients with severe pancreatic fatty infiltration(severe NAFPD).Height and weight were measured,BMI(kg/m2)was calculated,fasting blood glucose,fasting C-peptide,HbA1 c,HOMA-IR were calculated;TG,TC,HDL,LDL were measured;LP,APN,TNF-α and fasting activity were measured by Elisa method GLP-1 level,observed changes in various indicators.2.T2 DM patients were screened for pancreatic fatty infiltration and initial hypoglycemic treatment.A total of 80 patients were observed,including 40 patients with type 2 diabetes(DM)and 40 patients with pancreatic adipose infiltration(non-DM).Another 40 healthy people were selected as the control group.The MDMS-SL method was used to qualitatively and quantitatively analyze the lipids in the serum of each group.To investigate the differences in serum lipid distribution in pancreatic fatty infiltrate and type 2 diabetes patients and their correlation.3.Eighty cases of NAFPD combined with T2 DM qi-yin deficiency and sputum syndrome were divided into traditional Chinese medicine + lifestyle intervention group and simple lifestyle intervention group,40 cases in each group.Intervention for 8 weeks,40 healthy people were selected as control.The levels of BMI,HOM1-IR,HbA1 c,blood lipids,APN,LP,TNF-α,and GLP-1 before and after treatment were measured.The changes of indexes before and after treatment were compared between the two groups.Results 1.1 Both T2 DM and NAFLD were high risk factors for increased lipid deposition in the pancreas(P<0.05).The BMI,HOMA-IR,and severe patients in NAFPD patients were higher than those in mild patients(P<0.05).The age,HbA1c,LP,APN and GLP-1 levels in severe NAFPD group were significantly different from those in healthy people(P<0.05),but there was no significant difference between mild and severe groups(P>0.05).2In patients with NAFPD,HOMO-IR,BMI,and LP levels were negatively correlated with GLP-1 levels,BMI,FBG,and LP levels,NAFLD accompanied with HOMO-IR were positively correlated,BMI and FBG and LP levels,and NAFLD were associated with positive Related.3BMI,HOMO-IR,FBG,and LP levels were positively correlated with each other.The decrease in serum GLP-1 was related to BMI,HOMO-IR,and LP levels.2.1 The glandular fatty infiltration group and diabetic group The serum total pPE content,a variety of pPE,aPE content showed a significant decline in two groups of people;serum PC analysis also showed a significant decline,especially short-chain pPC content Significantly lower.2PC,PE,LPC,and LPE decreased in different degrees,while the concentration of various HNE compounds generally increased,and the trend of DM group was more significant than that of non-DM group.3PI compounds show an upward trend.3.The levels of BMI,HOMA-IR,HbA1 c and serum TC,TG,LP,TNF-α in patients with glandular fat infiltration and T2 DM were higher than those in healthy people.APN levels were lower than those in healthy people.Patients treated with TCM + lifestyle intervention group had lower BMI,HbA1 c,serum TG,LP,and TNF-α levels after treatment,and serum APN increased.Patients with lifestyle-only intervention decreased HbA1 c and serum TG levels after treatment,and TG decreased.Less than with traditional Chinese medicine + lifestyle intervention group.Conclusions 1.Increased insulin resistance index,elevated leptin,and decreased adiponectin and GLP-1 are risk factors for the onset of pancreatic fat infiltration.Combined T2 DM and fatty liver are risk factors for aggravation of pancreatic fat infiltration.The occurrence of lipid deposition is usually multi-organ,multi-target.2.Adipokines may mediate the progression of pancreatic fat infiltration.Leptin resistance and decreased GLP-1 secretion lead to excessive lipid intake and metabolic disorders may be the factors that affect pancreatic fat infiltration.3.Pancreatic fatty infiltration is not only a more specific indicator of the onset of T2 DM,and severe patients will appear more IR and face greater risk of T2 DM.4.Serum lipid changes in pancreatic fat infiltrates are highly consistent with T2 DM populations and may therefore serve as early predictors of T2 DM.5.Fatty infiltration of the pancreas and peroxisomal function of the T2 DM population may have varying degrees of damage and increased levels of oxidative stress.It is speculated that insulin resistance may be mainly related to oxidative stress and PI3-K-mediated insulin transduction pathway.6.Yiqi Yangyin Huoxue Decoction can increase serum adiponectin and GLP-1levels and decrease HOMA-IR,TG,LP,and TNF-α levels,which may be a way to relieve pancreatic fat infiltration and chronic inflammation induced by T2 DM.One of the mechanisms to improve islet function decline and insulin resistance and leptin resistance. |
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