Analysis Of Syndrome Distribution And Risk Factors In Type 2 Diabetes Mellitus Combined With Hyperhomocysteinemi

BackgroundThe number of diabetes patients worldwide is rapidly increasing due to aging of the population and changes in lifestyle.Type 2 diabetes mellitus(T2DM)not only causes metabolic abnormalities such as blood sugar and cholesterol levels,but also increases the risk of arteriosclerosis,leading to various serious complications of diabetes,which could seriously affect the quality of life and safety of patient..High homocysteine levels(HHcy)are one of the causes that lead to related complications in diabetic patients.As traditional Chinese medicine plays an increasingly important role in the clinical treatment of diabetes,it is of great clinical significance to explore the distribution characteristics and risk factors of different syndromes in T2DM patients with HHcy for targeted treatment in the future.ObjectiveTo explore the risk factors of type 2 diabetes mellitus(T2DM)complicated with hyperhomocysteinemia(HHcy)and the distribution characteristics of TCM syndromes,so as to provide some reference for the diagnosis and treatment of T2DM complicated with HHcy.MethodsTotal 200 patients diagnosed as T2DM in Department of Endocrinology,Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine from January 2019 to June 2021 were selected as the research subjects.According to whether there were HHcy,the patients were divided into T2DM combined with HHcy group(T2DM-HHcy group for short)and T2DM group,with 100 cases in each group.The general information[age,sex,diabetes course,body mass index(BMI)],basic medical history[diabetic retinopathy(DR),diabetic peripheral neuropathy(DPN),diabetic nephropathy(DN),abnormal lipid metabolism,cardiovascular disease,cerebrovascular disease,non-alcoholic fatty liver disease(NAFLD)],and laboratory indexes[fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(HbA1c),uric acid(UA)]of patients in the two groups were collected,and the difference of TCM syndrome types between the two groups was compared.SPSS 26.0 was used for statistical analysis of all data.Independent sample t-test was used for measurement data conforming to normal distribution,and non-parametric test was used for measurement data conforming to abnormal distribution.χ2 test was used for enumeration data.The influencing factors of T2DM with HHcy were analyzed by logistic regression.Results1.General data:There were statistically significant differences between the two groups in gender,age and course of disease(P<0.05).The results of logistic regression analysis showed that compared with women,the risk of HHcy in male patients with diabetes was significantly increased(OR=3.659,95%CI:1.705-7.850,P=0.001);As age increases,the risk of HHcy also gradually increases(OR=1.047,95%Cl:1.016-1.079,P=0.003);There was no statistically significant difference in BMI between the two groups of patients(P>0.05).2.Complications and complications of diabetes:There was a statistically significant difference between the two groups in the complications of diabetes(DR,DPN,DN),cardiovascular disease,NAFLD(P<0.05).The results of logistic regression analysis showed that compared with patients without cardiovascular disease,patients with cardiovascular disease had a significantly increased risk of HHcy(OR=2.070,95%CI:1.002-4.276,P=0.049);There was no statistically significant difference in lipid metabolism abnormalities and cerebrovascular diseases(P>0.05).3.Laboratory indicators:There was a statistically significant difference in HbAlc and UA levels between the two groups of patients(P<0.05).The logistic multiple factor regression analysis showed that as HbA1c increased,the risk of HHcy also increased significantly(OR=1.285,95%CI:1.082-1.526,P=0.004).There was no statistically significant difference in FPG,TG,TC,LDL-C,and HDL-C(P>0.05).4.Distribution of Traditional Chinese Medicine Syndrome:There was a statistically significant difference in the distribution of traditional Chinese medicine syndromes between the two groups of patients(P<0.05).Among them,the T2DM HHcy group has the highest proportion of yin yang deficiency syndrome and blood stasis syndrome,while the T2DM group has the highest proportion of qi yin deficiency syndrome.Conclusions1.Male,elderly and high HbA1c value are independent risk factors for type 2 diabetes with hyperhomocysteinemia;hyperhomocysteinemia is a risk factor for cardiovascular disease.2.There are differences in the distribution of TCM syndromes between the T2DM-HHcy group and the T2DM group:the T2DM-HHcy group has the most Yin Yang deficiency syndrome and blood stasis syndrome,while the T2DM group has the most Qi Yin deficiency syndrome,indicating that the detection of Hcy can provide reference for clinical TCM syndrome differentiation.