| Background:The incidence of chronic metabolic diseases is increasing year by year.Characterized by insidious onset and slow course,these diseases are often easily ignored by people.However,they have serious long-term health consequences and are risk factors for a variety of serious chronic diseases,but also bring great economic burden.Modern research believes that early detection and timely intervention control are important coping strategies for chronic metabolic diseases.infrared thermography(IRT),as a sensitive medical imaging technology,is very sensitive to changes in metabolic function of the body.Previous studies also suggest that IRT is operable in the identification of patients with various chronic metabolic diseases.In addition,the sensitive detection of body surface temperature by IRT is in line with the theoretical characteristics of TCM,which means that the infrared heat map can be interpreted from another Angle by combining the theory of TCM.Metabolic Syndrome(MS)is a cluster of chronic metabolic diseases,including hyperglycemia,hypertension,dyslipidemia,and abdominal obesity.MS is a symptom of metabolic abnormalities that have developed to a certain stage.It is a type that should be focused on in the early screening of chronic metabolic diseases.Therefore,this study strictly screened the subject population,took MS as the main observation focus,paid attention to multiple single type metabolic abnormalities under MS diagnostic criteria,and looked for different characteristics on the infrared heat map between populations.The risk of type 2 diabetes mellitus(T2DM)is that chronic hyperglycaemia can cause vascular and neurological damage and lead to a variety of chronic complications.Complex chronic complications also make screening difficult.Diabetic peripheral neuropathy(DPN),in particular,still lacks a uniform,convenient and accurate non-invasive screening assessment.In previous studies,IRT has identified some specific changes on IR thermograms in T2DM,DPN and even diabetic foot populations.In this study,dynamic IR thermography was introduced in an attempt to provide some basis for the application of IRT in the screening of diabetic complications.Objective:To explore the pattern of changes in the infrared thermograms of people with metabolic abnormalities and the characteristic changes in the thermograms of different types of metabolic abnormalities,and to explore the differences between the recovery of hand temperature in T2DM patients and healthy people after cold stimulation,so as to provide a basis for the application of infrared thermography in the early auxiliary diagnosis of chronic metabolic diseases,condition assessment and early screening of chronic complications of diabetes.Methods:Study 1:This is a retrospective study.A total of 584 study subjects,including healthy and abnormal metabolic populations,were included.Among them,four subgroups were extracted from the metabolic abnormality population with reference to the MS diagnostic criteria,including:the MS group(which fully met the MS diagnostic criteria),the hypertension group,the abdominal obesity group and the dyslipidaemia group(which only met the relevant metabolic abnormality criteria in the MS diagnostic criteria).Infrared thermographic data,anthropometric data and laboratory indices were collected from each group separately.The head and face,forehead,midface,nose,palms of both hands,dorsum of both hands,dorsum of both feet,frontal torso,and dorsal torso were used as one group of Regions of Interest(ROI),and the upper-jiao,middle-jiao,lower-jiao regions and some acupoints included the bilateral Qimen(LA 14),bilateral Riyue(GB24),bilateral Zhangmen(LR13),Zhongwan(CV12),and Shengqu(RN8)were used as another group of ROIs.Further correlation analysis of between the ROI mean temperature and the measurement index or laboratory data was performed.Study 2:25 controls and 26 patients with T2DM were included,and general information such as their medical history records,information on their usual hand use,height and weight were collected,and the subjects were subjected to local cold stimulation(10℃ for 90 seconds)on their hands.Thermal images of the subject’s hand were taken continuously with a thermal imaging camera before and for 7 minutes after the cold stimulation and the maximum temperature of each fingertip was calculated.Based on the temperature values at different time points,temperature recovery curves were plotted and the baseline temperature(T-baseline),the initial temperature after cooling(T0),the magnitude of the temperature decrease(T-amplitude)and the area under the recovery curve(S)with T0 as the baseline were calculated.Results:Study 1:(ⅰ)There were statistically significant differences between healthy males and females in the temperature of the chest and both lower limbs,with the temperature of the calves and knees being significantly higher in males than in females(P<0.01),while the temperature of the chest was significantly higher in females than in males(P<0.05).The temperature of the head,forehead,midface,nose,front of neck and frontal torso decreased with age in healthy females(P<0.05),while the temperature of the lower legs increased with age(P<0.05).(ⅱ)In both sexes,mean temperature in the frontal trunk and dorsal trunk regions was negatively correlated with body weight,BMI,waist circumference,hip circumference,FBG,UA,and TG(P<0.05)and positively correlated with HDL-C(P<0.05),and mean temperature in the anterior cervical and forehead regions was negatively correlated with age,body weight,BMI,waist circumference,and hip circumference,and nose,left palm,right palm,and The mean temperature of the nose,left palm,right palm,left dorsum of the foot and right dorsum of the foot were all positively correlated with weight and BMI(P<0.05).In women,the correlation between the mean temperature of each ROI and each measurement and laboratory index was more pronounced than in men,and in all regions of women except the left knee and right knee,there was a statistically significant correlation between age and regional mean temperature.Weight,BMI,waist circumference,hip circumference,SBP,DBP,FBG,UA,and TG all had a consistent trend on regional mean temperature in both sexes,while HDL-C had an opposite trend on regional mean temperature than the aforementioned measures and laboratory indicators.(ⅲ)In both sexes,the frontal torso and back torso temperatures were significantly lower(P<0.05),the mid-face,nose,and left and right palm temperatures were higher(P<0.05),and the forehead,head face,and front of neck temperatures were significantly lower(P<0.01)in women with metabolic abnormalities compared to healthy women.(ⅳ)The frontal trunk and dorsal trunk temperatures were significantly lower(P<0.05)and the palms of both hands were significantly higher(P<0.05)in MS patients compared to healthy individuals,regardless of gender,while the forehead temperature was significantly lower(P<0.01)and the dorsum of both feet was higher(P<0.05)in MS women compared to healthy individuals,and the mid-face and nose temperatures were higher(P<0.05)in MS men compared to healthy individuals.(ⅴ)Regardless of gender,abdominal obesity patients had lower trunk temperatures than healthy individuals(P<0.05),and their temperature distribution in all regions was extremely similar to that of the MS population(P<0.05).(ⅵ)Regardless of gender,the temperatures of the upper-jiao,middle-jiao,lower-jiao areas and some acupoints such as Riyue,Zhangmen,Zhongwan and Shengqu were significantly lower in the metabolic abnormalities group,MS patients and abdominal obesity group compared to the healthy group(P<0.05).(ⅶ)Looking at the temperature distribution of the various regions of the body surface in all subjects,the temperatures of hypertensive patients,dyslipidemic patients and abdominally obese patients were between those of MS patients and healthy people.This is in line with the progression from healthy to a single type of metabolic abnormality to MS in the population,and infrared thermography can be used as an early aid in the diagnosis and assessment of chronic metabolic diseases.Study 2:The differences between T2DM patients and controls were not statistically significant between T-baseline,T0 and T-amplitude.When the rewarming curve was drawn from the fingertip temperature of the patients after cold stimulation and the area under the rewarming curve S was calculated using T0 as the baseline,S was significantly lower in the T2DM group than in the control group(P<0.05),and when analysed for age-matched subgroups,S remained significantly lower in the T2DM subgroup than in the control subgroup(P<0.05).Conclusions:Study 1:(ⅰ)In the subject population,the temperature of the trunk portion decreased with increasing body weight,waist circumference,FBG and TG,increased with increasing HDL-C,and there was a statistically significant correlation between the mean temperature of most areas of the female body surface and age.(ⅱ)The frontal torso and back torso temperatures were significantly lower in people with metabolic abnormalities compared to healthy people,and the torso temperature of MS patients was significantly lower than that of healthy people while the palm temperature of both hands was significantly higher than that of healthy people,and there were differences in the characteristics of infrared thermographic changes in people with metabolic abnormalities or MS between genders.(ⅲ)The temperature distribution of abdominal obesity patients is very similar to that of the MS patients,and abdominal obesity may be the core cause of the body temperature distribution pattern in MS.The temperature changes in men with abdominal obesity were concentrated in the trunk,while those in men with dyslipidemia were concentrated in the palms of the hands and nose,both of which contributed to the changes in the body surface thermogram in men with MS;(ⅳ)The temperatures of the sanjiao areas of the trunk and the Riyue,Zhangmen,Zhongwan and Shengqu points in people with metabolic abnormalities,MS patients and those with abdominal obesity were all significantly lower than those in healthy people,indicating that the occurrence of MS and abdominal obesity is related to the dysfunction of the three jiao and the spleen,stomach,liver and gallbladder organs of the body.(ⅴ)Infrared thermography can be applied to the early diagnosis and assessment of chronic metabolic diseases.Study 2:The study showed that the area under the rewarming curve S after cold stimulation was significantly lower in T2DM patients than in the control group,and the cold stimulation test and the area under the rewarming curve after cold stimulation can be applied to the assessment of diabetes and screening for complications. |
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