| Background:Diabetes is a group of syndrome because of the relative or absolute lack of insulin,as well as varying degrees of insulin resistance,caused by carbohydrates,fat and protein metabolism disorder.Diabetes mellitus in patients with morbid obesity almost have fatty liver,and the majority of obese type 2 diabetes at the early fatty liver had occurred.NAFLD and T2DM independently related to their common foundation for the pathogenesis of insulin resistance(IR);we found that the majority of insulin resistance in patients with low serum bilirubin level.The latest research shows that a certain concentration of bilirubin in the human body with antioxidant,can eliminate free radicals,inhibit lipid and lipoprotein peroxidation,changes in certain enzyme activities, block DNA molecules,reducing oxidative damage;the present study indicated that the majority of bilirubin in the body with injury and the protection of the dual role.Clinical research has shown that serum bilirubin concentrations independently associated with insulin resistance.TCM perspective from experience found that the clinical type 2 diabetes mellitus with non-alcoholic fatty liver disease in patients are more vulnerable to damp-disturbed disorder due to deficiency in spleen than the clinical type 2 diabetes mellitus without fatty liver disease.Objective:According to the analysis and summarization of the clinical type 2 diabetes mellitus with nonalcoholic fatty liver in patients study the risk factors related to insulin resistance.Previous study found that the majority of risk factors related to insulin resistance mainly refer to obesity,lipid metabolic disorders and hyperinsulinemia;With previous studies difference is,this article selected risk factors of insulin resistance related to this indicator will also be involved in bilirubin and statistical analysis of the relevant Syndrome differentiation together with Symptoms factor. Methods:The subject used a retrospective clinical research methods. Retrospective analysis of 180 cases of Endocrinology ward patients with type 2 diabetes medical records in Xiyuan hospital in 2007, in accordance with the case inclusion criteria and exclusion criteria should be screened for the design of completing the form, and relevant data were statistically analyzed.A case-control study methodology observed 180 cases of type 2 diabetes mellitus with nonalcoholic fatty liver and without fatty liver in patients with age,height,weight,body mass index,fasting plasma glucose,C peptide,glycosylated hemoglobin,bilirubin,triglycerides,total cholesterol,high density lipoprotein,low density lipoprotein, 2h-glucose,2h-C peptide,bilirubin and so on.Type 2 diabetes according to Syndrome differentiation,statistics combined alcoholic fatty liver in patients with type proportional share.And statistics of the two groups of bilirubin levels and insulin resistance whether or not related to each other.Results:The general information and laboratory tests of two groups comparing indicators:Tests including Age,height,total cholesterol,fasting venous blood glucose,glycosylated hemoglobin, TC,LDL-ch in two groups was no significant difference(P＞0.05). Tests about Body weight,BMI,fasting and 2 hours postprandial C-peptide,TG,HDL-ch have significant difference(P＜0.01 or P＜0.05).The Statistical comparison of Syndrome differentiationand Symptoms factor in TCM.:the Syndrome of Lung-dryness stomach-heat,Deficiency in lung-qi,Deficiency in Spleen-qi, deficiency of kidney-yin and deficiency of both yin and yang,blood stasis was no significant difference(P＞0.05).For two groups of patients,the syndrome of phlegm and moebid fluid have significant difference(P＜0.05).Conclusions:The results suggest that obesity,lipid metabolic disorders and hyperinsulinemia in diabetic patients become important factor in the pathogenesis of NAFLD.The level of bilirubin may be play the important role of protection for the type 2 diabetes mellitus with nonalcoholic fatty liver in patients.Based on diabetes,in accordance with the analysis of Symptoms factor,statistics found that type 2 diabetes mellitus with fatty liver and without fatty liver all occupied the more proportion of Spleen Qi Deficiency Syndrome up to 40%,by four table X2 test,phlegm syndrome at the fatty liver and without fatty liver patients have P value＜0.05, and other Symptoms factor all have P value＞0.05.The result prove phlegm syndrome is the key certificate relative to other Symptoms factor for combined fatty liver patients with diabetes... |
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