| Purpose: To investigate the distribution of tongue image parameters in patients with type 2 diabetes mellitus(T2DM)under different ankle-brachial index(ABI)levels,and to analyze the correlation between tongue image parameters and physical and chemical parameters.Materials and Methods: A total of 130 patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from August 2021 to January 2023 were selected.According to the ankle brachial index,patients with type 2 diabetes mellitus were divided into three groups: normal ABI group(1<ABI≤1.3),normal ABI group(1<ABI≤1.3),and normal ABI group(1<ABI≤1.3).The borderline ABI group(0.9<ABI≤1)and abnormal ABI group(ABI≤0.9)were 32,42 and 56 cases,respectively.The carotid intima-media thickness(IMT),serum cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin(Hb A1c),lipid ratio and tongue image parameters were observed in the three groups.SPSS 26.0 software was used to analyze the data by one-way analysis of variance,non-parametric test and chi-square test.P< 0.05 indicated statistical significance.Results:By analyzing the tongue characteristics of 130 T2 DM patients with different ABI levels,it was found that:(1)There was no significant difference in gender,age,and course of disease among the normal ABI group,the borderline ABI group,and the abnormal ABI group(P>0.05),and the different groups were comparable.(2)In the normal ABI group,the frequency of tongue color from high to low was red purple tongue(53.1%)> cyanotic tongue(18.8%)= pale white tongue(18.8%)> light red tongue(9.4%);In the ABI critical group,the frequency of tongue color from high to low was red purple tongue(57.1%)> cyanotic tongue(21.4%)> light red tongue(16.7%)> light white tongue(4.8%).In the abnormal ABI group,the frequency of tongue color from high to low was red purple tongue(50%),cyanotic tongue(23.2%),light red tongue(17.9%),and light white tongue(8.9%).Compared with the normal ABI group,the abnormal ABI group had a lower proportion of red tongue and a higher proportion of purple tongue,suggesting a higher risk of blood stasis.(3)The L value was statistically different among the normal ABI group,the critical ABI group,and the abnormal ABI group(52.91 ± 2.56,48.81 ± 1.42,43.00 ± 2.58,P<0.01).The lower the ABI value,the lower the L value,indicating the dark tongue color.The a value of the normal ABI group,the borderline ABI group,and the abnormal ABI group were statistically different(20.25 ± 2.29,20.52 ± 1.58,22.98 ± 2.23,P<0.05).The lower the ABI value,the higher the a value,indicating the change of tongue color from red to cyan.There was no significant difference in b value among the normal ABI group,the borderline ABI group and the abnormal ABI group: 9.00 ± 1.64,9.40 ± 1.68,10.18 ± 1.57,P>0.05.(4)The tongue color parameter L value was positively correlated with ABI,and negatively correlated with Hb A1 c,LDL,IMT and LDL/HDL;a value was negatively correlated with ABI,positively correlated with LDL,IMT and LDL/HDL,but not correlated with Hb A1 c.b value was negatively correlated with ABI,Hba1 c,LDL and LDL/HDL,but not with IMT.Conclusion:1.Through the analysis of tongue image of T2 DM patients,it was found that there were significant differences in digital tongue image characteristics of T2 DM patients under different ankle-brachial index stratification.Patients with low ABI were more likely to have purple tongue and red tongue,and had a higher probability of blood stasis syndrome.2.Lab was correlated with ABI,IMT,blood lipid and Hba1 c.3.Tongue image can reflect the vascular condition of T2 DM patients to some extent,and can be used as an auxiliary tool to predict diabetic peripheral vascular disease in the future. |
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