Correlation Between Syndrome Elements And Diabetic Outcome In Type 2 Diabetes Mellitus And Metabonomics Study

Objective: Syndrome factor is the basic unit of syndrome type.Currently,most of the researches on syndrome factors of type 2 diabetes are confined to statistical description and lack of in-depth study.The aim of this study was to investigate the distribution of syndrome factors in type 2 diabetes and related complications,to study the correlation between major syndromes and the important outcome of type 2 diabetes mellitus,and to analyze the metabonomics characteristics of these syndromes.Methods: 1 To collect the diabetes patients who were hospitalized in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from 2016 to-2021,the distribution of their disease and syndrome factors were statistically analyzed.2.to collect the clinical data of type 2 diabetic patients who were treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from 2019 to-2021.According to whether they were combined with Qi deficiency,yin deficiency,phlegm dampness and blood stasis syndrome,they were divided into Qi deficiency group and non-Qi deficiency group,Yin deficiency group and non-Yin deficiency group,phlegm dampness group and non-phlegm dampness group,blood stasis group and non-blood stasis group.The relationship between phlegm dampness and blood stasis syndrome is related to blood sugar control,diabetes mellitus complicated with coronary heart disease and diabetic nephropathy.3.To explore the differences of metabolomics characteristics between Qi deficiency group and non-Qi deficiency group,yin deficiency group and non-Yin deficiency group,phlegm dampness group and nonphlegm dampness group,blood stasis group and non-blood stasis group through non targeted metabolomics.Result:(1)A total of 38176 patients with type 2 diabetes mellitus were screened.12234 cases were diagnosed through main diagnostic screening.The most common symptoms were Qi deficiency,yin deficiency,phlegm dampness and blood stasis.Among them,there were 8732 cases of qi deficiency syndrome elements,8147 cases of yin deficiency,1929 cases of phlegm dampness and 1617 cases of blood stasis syndrome elements.In terms of disease location,the most common are kidney,spleen and liver.(2)Compared with non-Qi deficiency patients,Qi deficiency patients have differences in the probability of coronary heart disease,smoking,body mass index(BMI),blood lipid and coagulation function.Compared with non-Yin deficiency patients,patients with Yin deficiency have shorter course of disease,lower probability of coronary heart disease,higher cholesterol level,and greater probability of abnormal increase of low-density lipoprotein level.Compared with non-phlegm dampness patients,patients with phlegm dampness syndrome have a significantly higher proportion of men,smoking,coronary heart disease,BMI and dyslipidemia.In addition,there will be abnormalities of prothrombin time,plasma thrombin time and other coagulation indexes.Compared with patients with non-blood stasis syndrome,patients with blood stasis syndrome have a significantly higher probability of coronary heart disease,a lower proportion of alcohol consumption,and a significant increase in the levels of whole blood C-reactive protein and plasma fibrinogen.(3)regression analysis showed that phlegm dampness syndrome was significantly associated with type 2 diabetic nephropathy.Blood stasis syndrome was associated with the occurrence of coronary heart disease in type 2 diabetes.No correlation between Qi deficiency and yin deficiency and glycemic control and complications was observed.No significant subgroup effect was observed in the preset subgroup analysis.(4)The metabolomic analysis of Qi deficiency elements identified 17 differential metabolites and yielded 10 potential metabolic pathways,of which the most heavily weighted metabolic pathways were phenylalanine,tyrosine and tryptophan biosynthesis.The metabolomic analysis of yin deficiency elements identified 24 different metabolites and obtained 6 potential metabolic pathways,the metabolomic analysis of phlegm-damp elements identified 28 different metabolites and obtained 8potential metabolic pathways,the metabolomic analysis of blood stasis elements identified 42 different metabolites and obtained 9 potential metabolic pathways,the most heavily weighted metabolic pathway for yin deficiency,phlegm-damp and blood stasis elements is linoleic acid metabolism.Conclusion: Qi deficiency,yin deficiency,phlegm dampness and blood stasis are the most common syndromes of type 2 diabetes.Phlegm dampness syndrome is significantly associated with type 2 diabetic nephropathy.Blood stasis syndrome is significantly associated with type 2 diabetes mellitus complicated with coronary heart disease.The metabolic pathway with the largest weight of qi deficiency syndrome elements is phenylalanine,tyrosine and tryptophan biosynthesis,and the metabolic pathway with the largest weight of yin deficiency,phlegm dampness and blood stasis is linoleic acid metabolism.