The Association Between Syndrome Differentiation Of Traditional Chinese Medicine And Insulin Resistance In Type 2 Diabetes Mellitus With Non-alcoholic Fatty Liver Disease

OBJECTIVE:To study the association between syndrome differentiation of traditional Chinese medicine(TCM) and insulin resistance(IR) in type 2 diabetes mellitus(T2DM) with non-alcoholic fatty liver disease(NAFLD).MATERIALS AND MATHODS:143 patients of T2DM with NAFLD were selected.The syndromes were typed and height,body weight,FPG,FINS,TG,TC,HDL-C,HbAlc were measured.The relationship between the indexes and syndrome differentiation of TCM were analyzed.RESULTS:1.Among T2DM with NAFLD patients,syndrome of damp-heat stagnating in the spleen was maximum,then is syndrome of extreme heat with YIN asthenia,next is syndrome of QI-YIN deficiency,syndrome of blood stasis were minmum.2.The comparison of course of disease among all TCM syndromes showed that syndrome of extreme heat with YIN asthenia was significantly shorter than other three groups (p＜0.01).The course of disease of syndrome of blood stasis was significantly longer than that of syndrome of damp-heat stagnating in the spleen and QI-YIN deficiency(p＜0.01).3.ISI of all TCM syndromes were lower than that of healthy control group(p＜0.01).ISI of syndrome of damp-heat stagnating in the spleen was significantly lower than other three groups(p＜0.01 or p＜0.05).4.BMI,HbAlc of T2DM with NAFLD were also higher than those of healthy control group, and the contrast in all TCM syndromes showed that BMI,HbAlc of syndrome of damp-heat stagnating in the spleen were highest(p＜0.01),these was no statistical significance in comparison of other three groups.5.The level of CHOL and TG was increased by turns from healty control group,syndrome of blood stasis,syndrome of extreme heat with YIN asthenia,syndrome of QI-YIN deficiency, syndrome of damp-heat stagnating in the spleen.The level of HDL-C was decreased by turns from healthy control group,syndromes of blood stasis,syndrome of QI-YIN deficiency,syndrome of extreme heat with YIN asthenia,syndrome of damp-heat stagnating in the spleen.There was significant difference between syndrome of damp-heat stagnating in the spleen and other syndromes(p＜0.01).6.These was negative relation between ISI and BMI,FPG,FINS,HbAlc,CHOL and TG(p＜0.01).There was positive relation between ISI and HDL-C,and these was no relation between ISI and age,course of disease. CONCLUSIONS:1.TCM syndromes of T2DM with NAFLD had the tendency of development from the syndrome of extreme heat with YIN asthenia to the syndrome of damp-heat stagnating in the spleen and QI-YIN deficiency and eventually to syndrome of blood stasis.The level of IR was increased firstly and then decreased with the development of disease.2.Among T2DM with NAFLD,the degree of IR in the syndrome of damp-heat stagnating in the spleen is most severe.3.The chaos of metabolism of lipid played an important role in the course of the development of IR and the chaos of metabolism of lipid on syndrome of damp-heat stagnating in the spleen was most severe.