Study On The Correlation Between TCM Synd-romes And Islet β-cell Function In Newly Dia-gnosed Type 2 Diabetes Mellitus With Non-al-coholic Fatty Liver Disease

Objective: Through the combination of four Traditional Chinese Medicine(TCM)diagnosis and according to TCM different syndromes in type 2 diabetes patients with non-alcoholic fatty liver,We are going to analysis risk factors of non-alcoholic fatty liver disease and study the distributing regulation of their syndromes,reveal their the pathology,and combine with the modern medical examination results,and observe correlation of different syndromes of Islet β–cell function,In order to provide the Chinese medicine clinical classification quantitative indicators,make Chinese type more impressive and provide the basis for prescription under the theory of TCM.To provide a theoretical basis for early prevention,diagnosis and treatment of diseases.Method: According to the diagnostic criteria we collected 162 patients,Which was divided into two groups according to whether they were combined with nonalcoholic fatty liver,89 patients belong to type 2 diabetic patients with non-alcoholic fatty liver,The other 73 patients were part of a group of people with type 2 diabetes who were not associated with nonalcoholic fatty liver disease.We made four diagnosis by TCM to distributing regulation of their syndromes.Recorded age,height,weight,and the body mass index(BMI),Blood lipid four items(TC 、 TG、 HDL-C 、 LDL-C)、 alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum uric acid(SUA),fasting blood glucose(FBG),2 hours postprandial blood glucose(2hFBG),glycosylated hemoglobin(HbA1c).To analysis risk factors of non-alcoholic fatty liver disease and to explore the relationship between the two groups of TCM syndromes and islet β-cell function,and analyzed the SPSS19.0 statistical software.Results:(1)Compared without fatty liver group,T2 DM with NAFLD patients who BMI,FINs,FC-P,TG,ALT,SUA,were significantly higher(P<0.05)(2)Multivariate logistic regression analysis showed that the independent risk factors of NAFLD were: BMI,SUA,TG,HOMA-IR.(3)By counting the frequency of TCM syndromes of the two groups of patients,the TCM syndromes of the combined NAFLD group were: temper deficiency syndrome(n=40,accounting for 44.9%),Qi and Yin deficiency(n=25,accounting for 28.2%),lung and stomach heat syndrome(n=15,accounting for 16.8%)and phlegm and blood stasis syndrome(n= 9,accounting for 10.1%);the TCM syndromes of the N-NAFLD group were: lung and stomach heat syndrome(n=28,accounting for 38.3%);Qi and Yin deficiency(n=19,accounting for 26.2%),Liver qi stagnation(n= 16,accounting for 21.9%)and temper deficiency syndrome(n=10,accounting for 13.6%);Through the χ2 test,we can see that the combined NAFLD group: phlegm,internal wetness,qi deficiency,blood stasis accounted for a higher proportion(P <0.05);N-NAFLD group: the proportion of Jin deficiency,heat and qi stagnation(P <0.05),the difference was statistically significant.(4)The various syndromes and islet beta cell indices were analyzed by multiple Logistic regression analysis: as temper deficiency syndrome for a reference,the HOMA-β 、△I30/△G30、HOMA-IR regression coefficients of the lung and stomach heat syndrome were:-0.550、-2.194,0.156,the HOMA-β、△I30/△G30、HOMA-IR regression coefficients of the Liver qi stagnation were:-0.476,-1.158,0.147,The HOMA-β、△I30/△G30、HOMA-IR regression coefficients of the Qi and Yin deficiency were: 0.089,0.006,-0.074,The HOMA-β、△I30/△G30、HOMA-IR regression coefficients of the phlegm and blood stasis syndrome were: 0.253,0.008,-0.937.All the data shows that HOMA-IR is positively correlated with the lung and stomach heat syndrome and Liver qi stagnation,HOMA-β、△I30/△G30 is positively correlated with the Qi and Yin deficiency and phlegm and blood stasis syndrome;the larger of HOMA-β、△I30/△G30,the lower probability of the lung and stomach heat syndrome and Liver qi stagnation,for the same reason,the larger of HOMA-IR,the lower probability of the Qi and Yin deficiency and phlegm and blood stasis syndrome.(5)Insulin resistance was prevalent in both groups,and the HOMA-IR index was higher in patients with NAFLD(P <0.05);The level of HOMA-β and △I30/△G30 in No-NAFLD patients was higher than that in patients with NAFLD(P <0.05).Conclusions:(1)newly diagnosis of T2 DM with NAFLD patients with overweight or obesity,abnormal lipid metabolism,hyperuricemia,insulin resistance;BMI,TG,SUA,IR are important risk factors for NAFLD(2)Combination of NAFLD group of TCM syndromes to temper deficiency and the TCM syndromes of N-NAFLD group were dominated by lung and stomach heat syndrome.(3)Lung and heat syndrome,liver qi stagnation card,temper deficiency syndrome to the main insulin resistance;Qi and Yin Deficiency,phlegm and blood stasis syndrome to reduce the function of islet β cells.(4)Insulin resistance was prevalent in both groups,and HOMA-IR was higher in patients with NAFLD.