Analysis Of TCM Syndrome Types And Correlation With Insulin Resistance In Patients With Overweight And Obesity Type 2 Diabetes Mellitus

Purpose:Experts at home and abroad in recent years,Putting forward that the proinsulin insulinogen(PI)/insulin ratio may judge islet beta cell function and judgment for insulin resistance(IR)degree is of certain reference value.In this paper,by comparing the normal weight and overweight and obese type 2 diabetes mellitus(T2DM)in patients with clinical data,Analysis the correlation of overweight and obesity with insulin resistance,And preliminary discussion on the PI/insulin ratio to evaluate the degree of IR,Analysis of overweight and obesity T2 DM patients with TCM syndrome characteristics and differences,For specific overweight and obese T2 DM patients with TCM syndrome type and correlation with IR,In as early as possible for overweight and obese patients with type 2 diabetes IR provides some references for the targeted intervention measures.Material and method:Analysis on August 1,2016 solstice November 31,in liaoning university of traditional Chinese medicine hospital endocrinology hospitalization of patients with type 2 diabetes in the hospital information.With reference to the Chinese adult overweight and obesity prevention and control guidelines of overweight and obesity in diagnostic criteria,divided into overweight,obese and normal weight group,compared between each group of the patient’s general information including age,sex,course of diseases,related parameters of islet function including fasting c-peptide,fasting insulin,blood lipids and uric acid metabolism,diabetes associated with morbidity and complications,calculation of insulin resistance(HOMA-IR)and insulin sensitivity index(ISI),PI/Fins ratio,analysis of physical and chemical indicators of differences and relations between groups.Take the grouping of TCM syndrome types,comparing the difference between the overweight and obese patients clinical characteristics,And analyze the different TCM syndrome types link between the physical and chemical index difference and correlation with IR.Application SPSS17.0 statistical software will analyze the above information,count data by chi-square test,measurement data with mean ± standard deviation(x ± s),according to satisfy the normality and homogeneity of variance using single factor analysis of variance,non-parametric test does not meet the normality is used,the measurement data with median plus or minus quartile(M±Q)said,linear correlation and rank correlation analysis used to analyze the related factors.Results:1.Included in the total number of cases of 237 cases,118 cases of male,female 119 cases,age between 24-80 years old,between 1 week-30 years duration.In age,duration,sex ratio,FBG,Hb A1 C,compare between the three groups have no significant difference(P>0.05).2.One of the highest obesity group of Fins,C peptide and PI,compared with normal-weight and overweight was statistically significant(P<0.01),the restructuring of C peptide levels higher than normal weight group(P<0.01).3.HOMA-IR values the highest obesity group,compared with normal-weight and overweight was statistically significant(P<0.01).Obese ISI value is the lowest,compared with normal-weight and overweight was statistically significant(P<0.01).Obesity group and overweight group PI/Fins ratio is higher than the normal weight group(P<0.01 or P<0.05).4.Compared with normal weight group,TG and UA levels in overweight and obese are relatively high,a relatively low level of HDL-C difference was statistically significant(P<0.05 or P<0.01),The obesity group UA level was higher than the overweight(P<0.05).5.In the case of diabetes-related complications,the highest proportion of normal weight group is the AS(52 cases,65.82%),followed by the DPN(42 cases,53.16%),and CVD(39cases,49.37%),DR(19 cases,24.05%)and DKD(10 cases,12.66%).The highest proportion of overweight is AS(73 cases,69.52%),followed by CVD(52 cases,49.52%)and DPN(46cases,43.81%),DR(21 cases,20%)and DKD(13 cases,12.38%).Obesity group for more than half of concurrent AS(32 cases,60.38%),and CVD(30 cases,56.60%),each other between the three groups was no significant difference(P>0.05).6.158 overweight and obese patients with T2 DM patients,in order to belong to Qi and Yin deficiency and blood stasis type(79 cases,50.00%)and the wet and heat trapped spleen and blood stasis type(42 cases,26.58%)is higher,Qi and Yin deficiency type times(30 cases,18.99%),Yin deficiency and blood stasis type is lowest proportion(7 cases,4.43%).7.In every syndrome model group,Qi and Yin deficiency type patients with an average age of the minimum(50.60 ± 11.16 years),the shortest duration(3.03 ± 4.09 years),fewer complications associated with diabetes mellitus;Yin deficiency and blood stasis type,the average age of the biggest(72.86±6.44 years),the longest duration(20.71 ±6.90 years),merging the proportion of all kinds of complications related to diabetes is higher,besides the DR,the comparison between the two groups was statistically significant(P<0.05);Hot and humid trapped the spleen in patients with BMI and blood stasis syndrome(29.22±3.40 kg/m2)and WC value(97.13±8.81 cm)were higher than that of Qi and Yin deficiency type and Yin deficiency and blood stasis type patients(P<0.05);Each other between different syndrome types in terms of sex ratio has no obvious difference(P>0.05).8.In every syndrome model group,Qi and Yin deficiency type Fins had the lowest levels,and hot and humid trapped spleen and blood stasis type and Yin and Yang deficiency and blood stasis type comparison was statistically significant(P<0.05);Qi and Yin deficiency and blood stasis syndrome had the lowest PI level,Yin and Yang deficiency and blood stasis type comparison was statistically significant(P<0.05).9.In every syndrome model group,Qi and Yin deficiency type HOMA-IR value is the lowest,and hot and humid trapped spleen and blood stasis type and Yin and Yang deficiency and blood stasis type comparison was statistically significant(P<0.05);Comparing with Qi and Yin deficiency and blood stasis syndrome,damp and hot trapped spleen and blood stasis type and Yin and Yang deficiency and blood stasis type was statistically significant(P<0.05).Qi and Yin deficiency type ISI the highest value,and hot and humid trapped spleen and blood stasis type and Yin and Yang deficiency and blood stasis type comparison was statistically significant(P<0.05).In terms of PI/Fins,Comparing with Qi and Yin deficiency type,Qi and Yin deficiency and blood stasis type was statistically significant(P<0.05).In terms of lipid metabolism,Yin and Yang deficiency and blood stasis type TG level the highest,with Qi and Yin deficiency and blood stasis type comparison was statistically significant(P<0.05).10.HOMA-IR was positively correlated with BMI,PI,TG,CHOL relationship(P<0.01),the ISI and BMI,PI,TG,CHOL,showed a negative correlation(P<0.01),PI/Fins were positively correlated with BMI relationship(P<0.05).Conclusion:1.The occurrence of type 2 diabetes insulin resistance may be associated with obesity;PI/Fins ratio can be roughly evaluate the extent of the IR,PI/Fins ratio,the higher the degree of IR is heavier.2.Overweight and obese patients with type 2 diabetes easier to metabolism of blood lipid and uric acid derangements.3.Overweight and obese patients with T2 DM syndrome type distribution characteristics are as follows: Qi and Yin deficiency and blood stasis type > hot and humid trapped spleen and blood stasis type > Qi and Yin deficiency type > Yin and Yang two deficiency and blood stasis type;Qi and Yin deficiency and blood stasis type is the most common in overweight and obese patients with T2 DM syndrome type of traditional Chinese medicine and closely associated with IR and TG;Hot and humid trapped spleen and blood stasis type also more common;Yin and Yang deficiency and blood stasis type merged higher percentage of various kinds of complications related to diabetes.