| Objective: In this study,we investigated clinical cases of type 2 diabetes,analyzed and summarized the correlation between serum bile acids and glycemic control in type2 diabetes,explored the distribution and changes of serum bile acid profiles in type 2diabetes patients with different glycemic control,further analyzed the bile acid metabolic characteristics of TCM evidence elements and further screened for markers with potential diagnostic value.Methods: In this cross-sectional study,the inpatient medical records of patients with type 2 diabetes mellitus hospitalized in the Department of Endocrinology of the Affiliated Hospital of Chengdu University of Chinese Medicine from 2019 to 2021 were selected for compilation of statistics,including general information such as age,gender,ethnicity,disease duration and medical history;and laboratory information such as blood routine,C-reactive protein and glycated hemoglobin.According to the blood glucose status,they were divided into the group with blood glucose standard and the group with non-standard blood glucose,and the difference between the two groups was compared.Binary logistic regression analysis was used to assess the association between serum bile acids and blood glucose control.To explore the distribution and changes of serum bile acid profile in type 2 diabetic patients with different glycaemic control,to further analyse the bile acid metabolic characteristics of the main TCM evidence elements and to screen for markers of potential diagnostic value.Results: Correlation analysis showed that serum fasting total bile acids correlated significantly with glycosylated haemoglobin,age,ghrelin,Body Mass Index(BMI),cholesterol,creatinine,LDL,triglycerides and urea,and regression analysis found that the association between serum total bile acids and glycaemic control in type 2 diabetic patients remained after correction for major risk factors.The association between total serum bile acids and glycemic control in type 2 diabetic patients remained after correction for major risk factors.The association between total serum bile acids and glycaemic control in type 2diabetic patients remained after correction for major risk factors.The elevation of TCDCA,TCA,GCDCA,GCA,GCA and TDCA was positively correlated with glycated haemoglobin.acid(TDCA)and glycodeoxycholic acid(GDCA)were the most significant changes.The four conjugated bile acids: free bile acid ratio had a significant positive correlation with the level of glycation,whereas cholic acid(CA)in primary free bile acids,Ursodeoxycholic acid(UDCA)in secondary free bile acids,Deoxycholic acid(DCA),Lithocholic acid(No significant differences were found between the two groups of patients for Ursodeoxycholic acid(UDCA),Deoxycholic acid(DCA),Lithocholic acid(LCA)and Dehydrocholic acid(DHCA).The subjects with different syndrome types matched in concurrent syndrome were screened through propensity score,and the differences in bile acid metabolism profile between them were compared.The results showed that the levels of CA,DCA,TCDCA,TCA and LCA in type 2 diabetes patients with Qi deficiency were significantly lower than those of matched non-Qi deficiency type 2 diabetes mellitus patients,and the potential diagnostic values were DCA,TCDCA and LCA.The prominent features of yin deficiency syndrome in type 2 diabetes are CDCA,DCA,TCDCA,TCA and LCA,which are significantly higher than those of non-Yin deficiency syndrome.The potential diagnostic value is DCA,TCDCA and LCA.Compared with non-blood stasis syndrome,blood stasis syndrome of type 2 diabetes is characterized by marked increase in TCDCA and TCA,and the potential diagnostic value of type 2 diabetes is TCA.Conclusion: There was a significant association between serum bile acids and glycaemic control in type 2 diabetes.Compared with non-Qi deficiency type 2 diabetics,patients with Qi deficiency type 2 diabetes had low bile acid metabolism levels,as evidenced by significantly lower levels of CA,DCA,TCDCA,TCA and LCA,of which DCA,TCDCA and LCA were of potential diagnostic value.The prominent feature of the Yin deficiency element of type 2 diabetes was high bile acid metabolism,as evidenced by significantly higher levels of CDCA,DCA,TCDCA and LCA.Compared to the non-blood stasis elements,the blood stasis elements in type 2 diabetes mellitus are characterized by significantly higher TCDCA and TCA,of which TCA is of potential diagnostic value. |
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