| From 2011 to 2021,the number of patients with diabetes in China increased from90 million to 140 million,an increase of 56%.With the aging of the population,the situation of prevention and treatment of diabetes will be more serious.Type 2 diabetes mellitus(T2DM)belongs to the category of "Xiao KeM in traditional Chinese medicine(TCM).A large number of clinical studies have shown that deficiency of both qi and yin is one of the most common and important TCM syndrome type of T2 DM.At the same time,phlegm turbidity and blood stasis play an important role in the occurrence and development of T2 DM.T2DM is a complex polygenic genetic disease,and its specific pathogenesis has not been clarified.ABO blood group is a genetic character of human body,which has the characteristics of genetic polymorphism.At present,the correlation between ABO blood group and T2 DM is limited,and the conclusions are controversial.TCM syndrome types have individual characteristics,different people may form different TCM syndrome types under the same environment and risk factors,which may be related to genetic factors.Up to now,far too little attention has been paid to the association between ABO blood group and TCM syndromes.Therefore,this present study aims to explore the relationship between T2 DM,TCM syndromes and ABO blood group on the macro level,so as to provide evidence-based medical evidence for revealing the susceptibility of different TCM syndrome of T2 DM and exploring the pathogenesis of T2 DM from a genetic perspective Clinical research1.1 Meta-analysis of ABO blood type and the risk of diabetesObjective: To evaluate the relationship between ABO blood types and the risk of diabetes using systematic review and meta-analysis.Methods : CNKI,Wan Fang data,PubMed,Web of Science,the Cochrane Library and Embase were used to identify relevant studies published from the date of their inception to February 20,2022.Cochrane systematic review tool were performed to incorporate the literature that met the inclusion criteria.Meta-analysis was conducted by Review Manager 5.3.Odds ratio(OR)and 95% confidence interval(Cl)were used to assess the risk of diabetes for ABO blood group.Results: A total of 9 case-control studies were included for analysis,with a total of 13705 participants,including 4414 in the observation group and 9291 in the control group.The results of pooled data showed that the proportion of A blood group(OR,1.13[95% Cl,(1.03-1.24)],P=0.007)and B blood group(OR? 1.14[95% Cl,(1.04-1.26)],P=0.008)in diabetic patients was higher than that in the healthy control group,while O blood group was more common in the control group(OR,0.81 [95%,(0.74-0.89)],P<0.00001).Subgroup analysis showed that the distribution of A(OR,1.19[95%CI,(1.05-1.36)],P=0.008)and O(OR,0.85[95%CI,(0.74-0.97)],P=0.02)blood groups was statistically significant in T2 DM,while the B blood group was not(OR,1.05[95%CI,(0.92-1.20)],P=0.48).However,all the results showed that there was no substantially correlation between AB blood and the risk of diabetes.Conclusion: ABO blood group may be related to the risk of diabetes.A blood type may be a risk factor for T2 DM,while O blood type is a protective factor.However,there is no substantially relationship between AB blood type and diabetes.1.2 Association between ABO blood group and type 2 diabetesObjectives To evaluate the relationship between ABO blood group and the risk of T2 DM based on electronic medical record data.Methods: The information of inpatients with completed ABO blood group records in Xiyuan Hospital of China Academy of Chinese Medical Sciences between January2015 and October 2020 was consecutive collected.Multivariate logistic regression was conducted to explore the association between ABO blood group and type 2 diabetes.The multiple imputation method based on SAS chain equation was used to deal with the missing data,and the subgroup analysis was performed to verify whether the core results were stable in different populations.Results: A total of 25181 eligible patients were enrolled,with 6813 cases of A blood type,8143 cases of B blood type,7650 cases of O blood type and 2575 cases of AB blood type.The prevalence of T2 DM was 6.47%(95%CI,6.16%-6.77%).Multivariate logistic regression results showed that compared with non-A blood group,A blood group was associated with a substantially increased risk of T2DM(OR,1.91[95% Cl,(1.44-2.52)],P<0.0001).In contrast,the risk of T2 DM in O blood group was43% lower than that non-0 blood group(OR,0.57[95% Cl,(0.46-0.71)],P<0.0001).There was no significant correlation between B blood group,AB blood group and the occurrence of T2 DM.The data after multiple imputation and subgroup analysis proved the stability of the core results.Conclusion: ABO blood group may be associated with the risk of T2 DM.A blood type is an independent risk factor for T2 DM.On the contrary,O blood group is a protective factor,while AB blood group and B blood group are not.1.3 Relationship between ABO blood group and traditional Chinese medicine syndromes of type 2 diabetesObjectives To investigate the correlation between ABO blood group and TCM syndromes of T2 DM including deficiency of both qi and yin.phlegm blended with blood stasis,and phlegm blocking.Methods: The inpatients with T2 DM as the first diagnosis and ABO blood group recorded in Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences between January 2015 and October 2020 were consecutive collected,while the baseline characteristics of per patients were also extracted.Univariate and multivariate logistic regression were performed to evaluate the relationship between ABO blood group and TCM syndromes of T2 DM.Results: A total of 407 patients were included for analysis,with 170 cases of deficiency of both qi and yin,174 cases of phlegm blended with blood stasis,and 63 cases of phlegm blocking.The distribution of A blood group and O blood group in deficiency of both qi and yin and phlegm blocking had statistically significant^ while the other two blood groups had not.In addition,univariate and multivariate logistic regression showed that compared with non-A blood group,A blood group was the protective factor for T2 DM with deficiency of both Qi and Yin(OR,0.46[95% Cl,(0.27-0.78)],P^O.004),and also a risk factor for phlegm blocking(OR,2.12 [95%CI,(1.06-4.26)],P=0.035).On the contrary,O blood type was a risk factor for deficiency of both qi and yin(OR,2.86 [95% Cl,(1.69-4.84)],P<0.0001)and a protective factor for phlegm blocking(OR,0.25[95%CI,(0.11-0.60)],P=0.002)in T2 DM compared with non-0 blood type.B blood type and AB blood type were not related to the three TCM syndromes of T2 DM.Conclusion: A blood group and 0 blood group are significantly correlated with the occurrence risk of deficiency of both qi and yin,and phlegm blocking in T2 DM,while B blood group and AB blood group are not.It is suggested that early identification of high-risk patients with phlegm blocking and deficiency of both qi and yin in patients with type 2 diabetes,and early intervention of invigorating the spleen and resolving phlegm or supplementing qi and nourishing yin can play a role in "preventing before illness,and preventing from changing". |
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