Correlation Of TCM Syndrome Types With Insulin Resistance And Islet β-cell Function In Newly Diagnosed T2DM Patients

Objective:In this study,through the investigation of T2DM(Type 2 diabetes mellitus,T2DM)TCM syndrome types,the distribution characteristics of TCM syndrome types of newly diagnosed T2DM-were analyzed,and the correlation between each TCM syndrome type and insulin resistance and isletβ-cell function was studied.TCM diagnosis and treatment of T2DM provides a new diagnosis and treatment idea.Methods:A total of 203 newly diagnosed T2DM patients from January 1,2021 to December 31,2021 in the Endocrinology Department of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine or inpatient department were.selected.Index detection,calculation of insulin resistance index(HOMA-insulin resistance index HOMA-IR)and pancreaticβ cell function index(HOMA-pancrea β cell function index HOMA-β).Statistically analyze the relationship between TCM syndrome types and basic information of gender,age,body mass index(BMI)in newly diagnosed T2DM patients,and experimental indicators fasting blood glucose(FBG)and 2 hours postprandial blood glucose(2 hours postprandial blood glucose).2hPG),fasting insulin(fasting insulin FINS),etc.;to analyze the correlation of TCM syndrome types with insulin resistance and islet β-cell function in newly diagnosed T2DM patients.SPSS26.0 was used to establish a database for statistical analysis,to study the distribution of T2DM TCM syndrome types newly diagnosed,and to explore the correlation between each TCM syndrome type and HOMA-IR and HOMA-β.Results:1.The distribution of TCM syndrome types in 203 newly diagnosed T2DM patients was as follows:damp-heat trapping the spleen(34.5%)>qi and yin deficiency syndrome(25.6%)>liver and stomach stagnation and heat syndrome(22.2%)>yin and yang deficiency syndrome(17.7%).2.There were significant differences in age,body mass index,FBG,FINS,glycated hemoglobin HbAlc,triglyceride TG,HOMA-IR and HOMAβ among the four newly diagnosed T2DM syndromes(P<0.05),while gender,2hPG,total cholesterol(total cholesterol TC),high density lipoprotein cholesterol(high density lipoprotein cholesterol HDL-C),and low density lipoprotein cholesterol(low density lipoprotein cholesterol LDL-C)were not significantly different(P>0.05).3.The average age of yin and yang deficiency syndrome is higher than that of the other three syndrome types(P<0.05).The BMI of the syndrome was significantly lower than that of the other three syndromes(P<0.05);the FBG of the syndrome of deficiency of qi and yin was higher than that of the syndrome of damp-heat trapping the spleen(P<0.05)and the syndrome of deficiency of yin and yang(P<0.05).There was no significant difference in FBG between liver-stomach stagnation-heat syndrome and the other three syndromes(P>0.05),the HbAlc of liver-stomach stagnation-heat syndrome was not significantly different from the other three syndromes(P>0.05);the FINS level of qi-yin deficiency syndrome was significantly lower than the other three syndromes(P<0.05),liver-stomach stagnation-heat The level of FINS in the syndrome was lower than that in the syndrome of damp-heat trapping the spleen(P<0.05).4.The size of HOMA-IR of each TCM syndrome type in newly diagnosed T2DM patients was:damp-heat trapping spleen syndrome>yin-yang deficiency syndrome>liver-stomach stagnation-heat syndrome>qi and yin deficiency syndrome.Among them,the syndrome of damp-heat trapping the spleen and deficiency of both qi and yin(P<0.05),the syndrome of damp-heat trapping the spleen and the syndrome of liver and stomach stagnation(P<0.05),the syndrome of damp-heat trapping the spleen and the deficiency of both yin and yang(P<0.05),the difference in HOMA-IR between the two syndromes was statistically significant.5.Taking HOMA-IR=2.69 as the cut point,the patients were divided into group A(HOMA-IR≥2.69)and group B(HOMA-IR<2.69).The syndrome of damp-heat trapping the spleen was the main type in group A,accounting for 91.4%,while the syndrome of deficiency of both qi and yin was the main type in group B,accounting for 45.8%.There were significant differences in BMI,FBG,FINS,2h PG,HOMA-β,TG and HDL-C between the two groups(P<0.05).Group A BMI(P<0.05),FBG(P<0.05),FINS(P<0.05),2hPG(P<0.05),HOMA-β(β<0.05),TG(P<0.05)higher than group B;HDL-C(P<0.05)level was lower than group B.6.In group A,64 cases(41.3%)of damp heat trapped the spleen>34 cases of stagnant heat in the liver and stomach(21.9%)>30 cases(19.4%)of deficiency of both qi and yin>27 cases of deficiency of both yin and yang(17.4%),and group B had qi and yin deficiency in 27 cases(17.4%).There were 22 cases(45.8%)of deficiency of both sides,11 cases(22.9%)of stagnant heat in the liver and stomach,9 cases(18.8%)of deficiency of both yin and yang,and 6 cases(16.6%)of damp-heat trapping the spleen.7.Taking the TCM syndrome type of newly diagnosed T2DM patients as independent variable and HOMA-IR grouping as dependent variable,further logistic regression analysis showed that the probability of HOMA-IR≥ 2.69 in the syndrome of damp-heat trapping the spleen was 3.556 times that of non-damp-heat trapping the spleen,which was statistically significant(P<0.05).Compared with patients with non-Qi-yin deficiency syndrome,the probability of HOMA-IR≥ 2.69 in patients with Qi-yin deficiency syndrome was 0.455 times higher than that in non-Qi-yin deficiency syndrome patients.That is,the risk of HOMA-IR ≥ 2.69 in patients with non-Qi-yin deficiency syndrome was 2.25 times higher than that in patients with Qi-yin deficiency syndrome,which was statistically significant(P<0.05).8.The size of HOMA-β of each TCM syndrome type in newly diagnosed T2DM patients was:damp-heat trapping spleen syndrome>yin-yang deficiency syndrome>liver-stomach stagnation-heat syndrome>qi-yin deficiency syndrome,qi-yin deficiency syndrome and liver-stomach stagnation-heat syndrome(P<0.05),qi-yin deficiency syndrome and damp-heat trapping spleen syndrome(P<0.05),qi-yin deficiency syndrome and yin-yang deficiency syndrome(P<0.05),liver-stomach stagnation-heat syndrome and damp-heat trapping spleen syndrome(P<0.05),the difference of HOMA-β between the two syndromes is statistically significant,and the HOMA-β of the syndrome of liver and stomach stagnation and heat is 15.869 times that of the syndrome of qi and yin deficiency;19.862 times that of yin-yang deficiency syndrome HOMA-β is 10.521 times that of liver-stomach stagnation-heat syndrome.Conclusion(s):1.The common syndromes of newly diagnosed T2DM are damp-heat trapping the spleen,followed by deficiency of both qi and yin.2.The syndrome of damp-heat trapping the spleen is dominated by insulin resistance,and the syndrome of deficiency of both qi and yin is dominated by insulin deficiency.Clinically,the treatment of patients with damp-heat trapping spleen syndrome focuses on improving insulin resistance,while patients with qi and yin deficiency syndrome are mainly treated with insulin.3.HOMA-IR,HOMA-β and other indicators are correlated with the TCM syndrome types of newly diagnosed T2DM,and can be used as a reference for the syndrome differentiation of newly diagnosed T2DM.