Study On Dyslipidemia And TCM Syndrome Differentiation In Patients With Type 2 Diabetes Mellitus Complicated With NAFLD

Objective:To analyze the risk factors of type 2 diabetes mellitus with non-alcoholic fatty liver and BMI,blood glucose,blood lipids,uric acid,etc.,and to explore the relationship between dyslipidemia and TCM syndromes in patients with type 2 diabetes mellitus complicated with NAFLD.Methods: From November 2016 to November 2018,158 patients diagnosed as type 2diabetes mellitus in the Department of endocrinology of Yunnan Traditional Chinese Medicine Hospital were investigated.According to the images of fatty liver detected by B-mode ultrasound,the patients were divided into two groups.The general data(gender,age),body mass index(BMI),biochemical data and blood sugar of the two groups were statistically analyzed.Comparing the differences of different indicators in each group,TCM syndrome differentiation and typing were divided into Qi-Yin deficiency syndrome,Qi-Yin deficiency and blood stasis syndrome,liver-kidney Yin deficiency syndrome,spleen-stomach dampness-heat syndrome,Qi-deficiency and blood stasis syndrome,lung-heat-body injury syndrome.Statistical analysis was used for the measurement data obeying normal distribution,t-test was used for intra-group comparison,t-test for single sample was used for intra-group comparison,and t-test for independent sample was used for inter-group comparison.The results were expressed as x ±s,non-parametric test was used for measurement data not obeying normal distribution,2 test was used for counting data,and logistic regression analysis was used for multivariate analysis.Statistical analysis was used to analyze the correlation of dyslipidemia in patients with type 2diabetes mellitus complicated with NAFLD,and to explore its relationship with clinical syndromes of traditional Chinese medicine.Results:1.The results showed that body mass index(BMI),triglyceride(TG),cholesterol(TC),low-density lipoprotein(LDL-C)and uric acid(UA)were significantly elevated in the NAFLD group compared with the NAFLD-free group.(P<0.05),suggesting that patients with NAFLD are more obese than obesity,and are more prone to dyslipidemia and hyperuricemia.Both FPG and 2h FPG in T2 DM patients with NAFLD group were significantly increased(P<0.05),suggesting that glucose metabolism abnormalities are more likely to occur after NAFLD.Logistic regression analysis showed that BMI,TG,CHE and 2h PG were independent risk factors for T2 DM patients with nonalcoholic fatty liver disease(P<0.05).2.The results of TCM syndrome differentiation showed that compared with the non-NAFLD group,the TCM syndrome distribution of T2 DM in the combined NAFLD group was: Qi and Yin deficiency and phlegm syndrome> Qi and Yin deficiency syndrome > Liver and kidney yin deficiency syndrome>Spleen and stomach dampness syndrome>Qi deficiency and blood stasis syndrome > Lung heat and zinc injury syndrome.The TCM syndrome type of T2 DM patients with NAFLD was mainly due to Qi and Yin deficiency syndrome and Qi and Yin deficiency syndrome(P<0.05).Conclusions: The occurrence of T2 DM disease combined with NAFLD is related to obesity,insulin resistance,glycolipid metabolism disorder and TCM syndrome differentiation.Body mass index and triglycerides are important risk factors,indicating a chronic association between chronic hyperglycemia and dyslipidemia.Through the analysis of TCM syndrome types,T2 DM patients with NAFLD are mainly composed of Qi and Yin deficiency syndrome and Qi and Yin deficiency syndrome.Analysis of the relationship between type 2 diabetes with nonalcoholic fatty liver and dyslipidemia and TCM syndrome differentiation can help to further prevent diabetes and its complications.