| Prpose of researchTo observe the relationship between 25 hydroxyvitamin D[25（OH）D] and TCM syndrome types of overweight and obese type 2diabetes mellitus（T2DM）,explore the reasons for the difference of 25（OH）D level distribution among TCM syndrome types,and analyze the related influencing factors of 25（OH）D level in different TCM syndrome types.To provide a central reference for TCM clinical syndrome differentiation in the treatment of overweight and obese T2 DM patients with vitamin D deficiencyResearch methodA total of 200 overweight and obese T2 DM patients hospitalized in the Department of Endocrinology of Yichang Hospital of Traditional Chinese Medicine between June to September 2020 and June to September 2021 were collected.Clinical data of the included patients were collected using a unified questionnaire,including general information,TCM syndrome differentiation information and relevant clinical test indicators.Excel2016 software was used to establish the database for data integration,and SPSS 24.0 software was used for data statistical analysis.Research results1.Distribution of TCM syndrome types: overweight and obesity T2 DM TCM syndrome distribution frequency from high to low were dampness-heat accumulation syndrome,spleen deficiency dampness-trap syndrome,qi and Yin deficiency syndrome,spleen and kidney Yang deficiency syndrome.2.TCM syndrome types and clinical indicators:（1）Gender: In dampness-heat syndrome type,male patients are more common;in qi-Yin deficiency syndrome type,female patients are more common.（2）Age: After pair-wise comparison,there was significant difference in age distribution between spleen and kidney Yang deficiency syndrome and dampness-heat accumulation syndrome of spleen deficiency syndrome（P < 0.05）;The difference of age distribution between qi and Yin deficiency syndrome and damp-heat accumulation syndrome is significant（P<0.05）。（3）Course of disease: By pair-wise comparison,there were differences in the course of disease distribution between spleen and kidney Yang deficiency syndrome and dampness and heat accumulation syndrome of spleen deficiency（P<0.05）;The course distribution of qi and Yin deficiency syndrome was different from that of spleen deficiency and dampness（P<0.05）（4）BMI: dampness-heat internalization syndrome had the highest BMI,followed by spleen deficiency dampness-trap syndrome and spleen and kidney Yang deficiency syndrome,and qi and Yin deficiency syndrome had the lowest BMI,which was not significant after pair-wise comparison（P>0.05）（5）FBG: From high to low,FBG includes the syndrome of dampness and dampness,deficiency of qi and Yin,dampness and heat accumulation,and deficiency of spleen and kidney Yang.There was no significant difference in FBG levels after pairwise comparison（P>0.05）.（6）Hb A1c: After pair-comparison,there was statistical difference in Hb A1 c of spleen-kidney-Yang deficiency syndrome and Qi-Yin deficiency syndrome,as well as in dampness and sleepiness syndrome of spleen deficiency and dampness and heat internalization syndrome（P<0.05）.（7）TG: After pair-wise comparison,there was statistical difference in TG level between dampness-heat internalization syndrome,Qi-Yin deficiency syndrome and spleen deficiency dampness and sleepiness syndrome（P<0.05）.（8）TC:After pair-to-pair-comparison,there was a statistical difference between the TC level of spleen and kidney Yang deficiency syndrome,dampness and sleepiness syndrome and dampness and heat accumulation syndrome（P<0.05）,and there was a statistical difference between the TC level of qi and Yin deficiency syndrome and dampness and heat accumulation syndrome（P < 0.05）.（9）LDL-C: After pair-up comparison,there was statistical difference between LDL-C level of spleen-kidney Yang deficiency syndrome and Qi-Yin deficiency syndrome and LDL-C level of spleen deficiency dampness syndrome（P<0.05）.（10）HDL-C: after comparing the two,spleen and kidney Yang deficiency syndrome,qi and Yin deficiency syndrome of the level of HDL-C and wet card trapped between the level of HDL-C pixu（spleen deficient）was statistically difference（P<0.05）,spleen and kidney Yang deficiency syndrome and humid intrinsic between was statistically significant（P<0.05）.3.The 25（OH）D level in different TCM syndromes is different.The25（OH）D level in spleen and kidney Yang deficiency syndrome is the lowest,followed by qi and Yin deficiency syndrome,damp-heat accumulation syndrome and dampness and dampness,which is consistent with the disease changes of overweight and obesity T2 DM.There were statistically significant differences in 25（OH）D of spleen and kidney Yang deficiency syndrome,qi and Yin deficiency syndrome,damp-heat internalization syndrome and spleen deficiency dampness and dampness（P < 0.05）.There was no statistical significance in 25（OH）D difference among qi-Yin deficiency syndrome,damp-heat internalization syndrome,spleen deficiency and dampness（P>0.05）.4.Correlation analysis:（1）Spleen deficiency and dampness syndrome: double correlation analysis showed that different25（OH）D levels were positively correlated with HDL-C（P<0.05）,the correlation coefficient was 0.282;It was negatively correlated with BMI,FBG and Hb A1c（P<0.05）,and the correlation coefficients were-0.507,-0.266 and-0.303,respectively.After multivariate linear regression analysis,BMI was the main factor affecting the level distribution of 25（OH）D（P < 0.05）.（2）Dampness-heat accumulation syndrome: Double correlation analysis showed that different 25（OH）D levels were negatively correlated with BMI,FBG,Hb A1 c and TG（P<0.05）,with correlation coefficients of-0.423,-0.323,-0.322 and-0.374.After multivariate linear regression analysis,abnormal BMI and TG were significant factors affecting25（OH）D level distribution（P < 0.05）.（3）Qi-Yin deficiency syndrome: Double correlation analysis showed that different vitamin D levels were positively correlated with HDL-C（P<0.05）,and the correlation coefficient was 0.378.It was negatively correlated with FBG,TG,TC and LDL-C（P<0.05）,and the correlation coefficients were-0.44,-0.538,-0.436 and-0.343,respectively.After multifactor linear regression,LDL-C was the main factor affecting 25（OH）D distribution.（4）Spleen and kidney Yang deficiency syndrome: Double correlation analysis showed that different 25（OH）D levels were positively correlated with HDL-C（P<0.05）,the correlation coefficient was 0.558;There was negative correlation with age,course of disease and Hb A1c（P<0.05）,and the correlation coefficients were-0.454,-0.577 and-0.618,respectively.After multifactor linear regression,Hb A1 c and HDL-C were the main factors affecting the level of 25（OH）D.Research conclusion1.Overweight and obese T2 DM patients are mainly characterized by dampness-heat accumulation syndrome,followed by dampness-deficiency syndrome of spleen,which is mainly characterized by spleen deficiency in the early stage.2.The TCM syndrome type distribution of overweight and obese T2 DM patients was correlated with age,course of disease,Hb A1 c,25（OH）D,TG,TC,LDL-C and HDL-C（P<0.05）,but not with gender,BMI and FBG（P>0.05）.3.In overweight and obese T2 DM patients with different TCM syndromes,the related factors affecting 25（OH）D level are different,and the main blood glucose and lipid indexes affecting25（OH）D distribution are different at different stages. |
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