Research On Clinical Features And TCM Syndromes Of Overweight/obesity Combined With Impaired Glucose Tolerance

Research purposes:To compare the differences of general information,diet and exercise habits,moods,physical measurement indexes,and laboratory examination indexes among overweight/obese subjects with impaired glucose tolerance(IGT),overweight/obese subjects with normal glucose tolerance(NGT),and normal-weight subjects with normal glucose tolerance(NGT),explore the clinical characteristics of overweight/obesity with IGT.At the same time,to compare the distribution differences of TCM syndrome types between overweight/obese with IGT and overweight/obese with NGT,reveal the distribution characteristics of TCM syndrome types of overweight/obesity with IGT,explore the relationship between each syndrome type and related indicators,which included physical measurement indexes and laboratory examination indexes,and laid the foundation for the prevention and treatment of the overweight/obese subjects with IGT by the combination of disease differentiation and syndrome differentiation.Methods:In this study,cross-sectional study method was used.The subjects who were normal-weight with normal glucose tolerance,overweight/obesity with normal glucose tolerance and overweight/obesity with impaired glucose tolerance were preliminarily screened in the endocrinology clinic of Guang’anmen Hospital of China Academy of Chinese Medical Sciences and Xinjiekou community health service center of Xicheng District in the past three months,and those who meet the requirements were included in the group through appointment,oral glucose tolerance test(OGTT)was carried out again,at the same time,height and weight were also measured and BMI was calculated.129 subjects were finally enrolled,70 overweight/obese subjects with impaired glucose tolerance,29 overweight/obese subjects with normal glucose tolerance and 30 normal-weight subjects with normal glucose tolerance were included in the study.The trained personnel completed physical examination on the subjects,filled in epidemiological questionnaire and TCM symptom and sign questionnaire.Moreover,the blood samples of the subjects were taken for laboratory biochemical tests,including blood glucose,blood lipid,and blood uric acid.The data were statistically analyzed by IBM SPSS v.25.0 software and plotted by Microsoft Excel v.2010 software.To comparing the differences of general information,diet and exercise habits,moods,physical measurement indexes,and laboratory examination indexes of three groups,explore the clinical characteristics of overweight/obesity with IGT.According to my tutor’s mature theoretical understanding on obesity with impaired glucose tolerance,combined with the TCM symptom and sign questionnaire and clinical practice.The TCM syndrome types were divided into liver and stomach stasis type,spleen deficiency and phlegm dampness type,spleen and kidney deficiency type.By using statistical methods,to compare the distribution differences of TCM syndrome types between overweight/obesity with IGT and overweight/obesity with NGT,and explore the relationship between each syndrome type and related indicators,which included physical measurement indexes(BMI,waist circumference,WHR,waist height ratio)and laboratory examinations(HbA1c,FPG,2hPG,FINS,HOMA-β,HOMA-IR,TC,TG,HDL-C,LDL-C,and UA).Results:1.Differences in general informationThe age of the overweight/obesity with IGT group(62.50(8.00))was higher than that of the overweight/obesity with NGT group(57.00(16.00)),and the difference was statistically significant(P<0.05).The proportion of history of previous comorbidity in the overweight/obesity with IGT group(75.71%)>overweight/obesity with NGT group(34.48%),and normal-weight with NGT group(36.67%),and the difference was statistically significant(P<0.0001).The proportion of family history of diabetes mellitus in the overweight/obesity with NGT group(55.17%)>overweight/obesity with IGT group(27.14%),and normal-weight with NGT group(23.33%),and the difference was statistically significant(P<0.05).There was no statistical difference in nationality and educational level among the three groups.In addition,in overweight/obesity with IGT group,the proportion of family history of overweight/obesity and family history of diabetes mellitus in females were higher than that in males,and the both differences were statistically significant(P<0.05).2.Differences in living habits and emotionsThe proportions of oily taste and irritable mood in the overweight/obesity with IGT group were higher than that in normal-weight with NGT group,and the difference was statistically significant(P<0.05).In the overweight/obesity with IGT group,salty diet accounted for 31.43%of the taste preference,but there was no statistical difference compared with the other two groups.There was no statistical difference in tobacco and alcohol addiction,exercise frequency,and sedentary habit among the three groups.Furthermore,in overweight/obesity with IGT group,the proportion of smoking and drinking habits in males were higher than that in females,and the both differences were statistically significant(P<0.05).3.Differences in physical measurement indexesThe waist circumference of the overweight/obesity with IGT group(94.00(13.00))>the overweight/obesity with NGT group(88.00(17.00))>normal-weight with NGT group(80.00(12.00)),and the difference was statistically significant(P<0.05).The differences were not statistically significant in BMI,waist hip ratio,and waist height ratio between overweight/obesity with IGT group and overweight/obesity with NGT group4.Differences in laboratory examination indexesThe UA of the overweight/obesity with IGT group(337.00(116.00))>normal-weight with NGT group(303.00(109.00)),and the difference was statistically significant(P<0.05).The HDL-C of normal-weight with NGT group(1.44±0.29)>the overweight/obesity with IGT group(1.24±0.23),and the overweight/obesity with NGT group(1.29±0.22),and the difference was statistically significant(P<0.05).There was no statistical difference in TC,TG,and LDL-C among the three groups.5.Differences in TCM syndrome typesThe spread of TCM syndrome type of overweight/obesity with IGT is liver and stomach stasis type(47.76%)>liver and stomach stasis type(28.36%)>spleen deficiency and phlegm dampness type(23.88%),and the liver and stomach stasis is the main type in the overweight/obesity with IGT group.While the spread of TCM syndrome type of overweight/obesity with NGT is spleen deficiency and phlegm dampness type(55.56%)>liver and stomach stasis type(25.92%)>liver and stomach stasis type(18.52%),and the spleen deficiency and phlegm dampness type is the main type in the overweight/obesity with NGT group.The differences in the distribution of TCM syndrome types between the two groups were statistically significant(P<0.05).in the overweight/obesity with IGT group,spleen and kidney deficiency mainly occurred in male(41.93%)and liver and stomach stasis mainly occurred in female(61.11%),the difference was statistically significant(P<0.05);In overweight/obesity with IGT group,BMI of spleen deficiency and phlegm dampness type was higher than spleen and kidney deficiency type,the difference was statistically significant(P<0.05).The waist circumference and waist height ratio of spleen deficiency and phlegm dampness type were higher than those liver and stomach stasis type,as well as spleen and kidney deficiency type,the difference was statistically significant(P<0.05).There were no statistical differences in blood glucose metabolism index(HbAlc,FPG,2hPG,and FINS),HOMA steady-state model(HOMA-β,HOMA-IR),blood lipid metabolism index(TC,TG,HDL-C,and LDL-C)and uric acid(UA)among the three TCM syndrome types.Conclusions:1.The incidence of overweight/obesity complicated with impaired glucose tolerance increased with age,and the obesity with unhealthy metabolism,especially abdominal obesity,was more likely to cause overweight/obesity complicated with impaired glucose tolerance.Compared with the normal weight with NGT group,the overweight/obesity with IGT group had statistically significant in oily taste,irritable mood,and UA level.In the overweight/obese patients with impaired glucose tolerance,there were more salty taste,and sedentary and exercise habits,there were no statistically significant compared with the other two groups.2.The differences in the distribution of TCM syndrome types between overweight/obesity with IGT and overweight/obesity with NGT were statistically significant.In overweight and obese population with impaired glucose tolerance,the change of metabolism in the body has an effect on the TCM syndrome type.Liver and stomach stasis is the main TCM syndrome type.To a certain extent,it has enriched the theoretical understanding that stasis is the key to the onset of overweight/obesity with impaired glucose tolerance,which provides a reference for focusing on the state of obesity and abnormal blood glucose when preventing and treating overweight/obesity with impaired glucose tolerance by the combination of disease differentiation and syndrome differentiation.However,the spleen deficiency and phlegm dampness is the main type in the overweight/obesity with NGT.3.There was no statistically significant in laboratory examination indexes(HbAlc,FPG,2hPG,FINS,HOMA-β,HOMA-IR,TC,TG,HDL-C,LDL-C,and UA)among TCM syndrome types in overweight/obesity with IGT group.