The Relationship Between The Level Of Bile Acid And Syndrome Of Phlegm-dampness In Patients With Type 2 Diabetes Mellitus

Objective:This paper is intended to study the level of serum bile acid in Type2 diabetes patients with phlegm-dampness syndrome.By exploring the relationship between serum bile acid levels and phlegm-dampness syndrome, the author tries to provide more theoretical basis for objectifying the study of TCM syndrome diabetes. At the same time, this also discusses the crrelation between BA other glycolipid metabolism indexes (FPG, HbAlc, TC, TG, LDL-C, HDL-C), the correlation with body mass index (BMI) and so on, providing a new method to cure Type2 diabetes.Methods:This study collected totally 278 cases of patients with Type2 diabetes, including 159 cases of male patients and 119 cases of female patients aging from 22 to 88 with duration of disease from 0 to 30 years. According to TCM syndrome differentiation typing, all these cases are classified into two groups, namely phlegm-dampness group (including 110 cases) and non-phlegm-dampness group (including 168 cases). For this study, the author recorded the serum bile acid level of each patients, and analyzed its correlation with patients’gender, age, waist circumference, BMI, blood pressure (SBP and DBP), glycolipid metabolism indexes (FPG, HbAlc, TC, TG, LDL-C, HDL-C), fasting insulin(FINS), fasting C peptide(FC-P), according to the HOMA model to insulin resistance index(HOMA-IR). Compared the level difference between the bile acid in the phlegm dampness syndrome and the non-phlegm dampness syndrome group, and analyzed the correlation between the level of bile acid and BMI, glucose and lipid metabolism by Spearman statistics.Results:1. Type2 diabetes patients with phlegm dampness syndrome accounted for 39.57%, non phlegm dampness syndrome accounted for 60.43%, suggesting that more than 1/3 of patients with type2 diabetes realized signs of phlegm dampness; 2.The bile acid level of phlegm dampness syndrome group was 5.05+5.13umol/L, and the phlegm dampness syndrome group was 3.60+3.50umol/L, and the phlegm dampness group was significantly higher than that in the non-phlegm dampness syndrome group, the difference was statistically significant.(.P=0.000<0.01); 3. Compared with non-phlegm-dampness group, phlegm-dampness group has higher BMI level(P=0.000<0.01), larger waist circumference(P=0.000<0.01), higher TG level (P=0.01), increasing FINS level (P=0.001<0.01) and FC-P level (P=0.000<0.01) whereas lower HDL-C level (P=0.015<0.05) and decreased HbA1c level (P=0.009<0.01).In the meantime, between the two groups, the gender, age, DBP SBP, TC, LDL-C, HOMA-IR and other indexes show no statistically significant difference.4. Spearman correlation analysis:bile acid level was positively correlated with age, waist circumference, BMI, LDL-C and FC-P (r=0.618, P=0.05≤0.05; r=0.225,P=0.000<0.01; r=0.207,P=0.001<0.01; r=0.836, P=0.000<0.01; r=0.237, P=0.000<0.01) and was negatively correlated with HbAlc level (r=-0.166, P=0.006<0.01); while has no relationship with duration of disease, DBP, SBP, TC, LDL-C, FPG, FINS, HOMA-IR(P>0.05).However, partial correlation analysis showed that there was no significant correlation between serum BA and the other indexs above.Conclusions:1. Comparing phlegm-dampness group with non-phlegm-dampness group, the former group has higher level of bile acid, the bile acid level may be suggested as one of the pathological essences of phlegm-dampness syndrome and used as one of the objective indexes for diagnosing the phlegm-dampness syndrome.2. The facts of higher level of BMI, waist circumference, TG,FINS and FC-P as well as lower level of HDL-C, HbAlc imply that phlegm-dampness Phlegm dampness plays an important role in the disorder of glucose and lipid metabolism; Phlegm is one of the main pathogenesis of Type 2 diabetes; therefore reducing phlegm and removing dampness can be used as one of the TCM fundamental treatment of Type 2 diabetes.3.The level of bile acid in Type2 diabetes patients has correlation with BMI and glycolipid metabolism indexes, which prompting that the treatment to get bile acid involved in glucose metabolism, lipid metabolism and energy metabolism, to establish and use bile acid signaling pathway may become new methods for preventing and treating Type 2 diabetes.