The Study Of The Relationship Between Prediabetes Traditional Chinese Medicine Syndrome Types And Insulin Resistance

ObjectiveIn this study,a cross-sectional study was conducted in patients with prediabetes diagnosis and exclusion criteria.Through the collection of four diagnostic data of patients diagnosed as prediabetes,we classify the patients into different syndrome types,and discuss the relativity between TCM syndromes and insulin resistance,islet β cell function,fasting insulin,2h plasma insulin,blood lipid,uric acid,blood pressure,body mass index,etc.Observe the distribution of insulin resistance in the prediabetes states of TCM syndrome,and guide its TCM treatment.MethodsWe collected the four diagnostic information of TCM from 104 cases of prediabetes patients diagnosed by department of Endocrinology inpatient and department of physical examination in our hospital from January 2015 to February 2017.The patients were classified into liver qi stagnation,spleen deficiency and phlegm dampness,spleen dampness heat,phlegm and blood stasis syndrome,yin deficiency syndrome,according to the collected information by more than two attending physicians.The numerical value of OGTT fasting and 2h plasma blood glucose,fasting insulin,uric acid,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,body height,body weight,blood pressure were collected.Then we calculated the body mass index(BMI),insulin resistance index(HOMA-IR),and islet beta cell function(HOMA-β)etc.The above data were processed by SPSS22.0 software to analyze the relationship between TCM syndrome types and HOMA-IR,HOMA-β,FINS,FPG,2hPG,uric acid,blood lipid,blood pressure and BMI.ResultsThe fasting insulin of various TCM syndromes were different.The difference of FINS between spleen deficiency phlegm dampness group、phlegm and blood stasis group and liver qi stagnation group、spleen dampness heat group were statistically significant.The average level of FINS in different TCM syndromes was:spleen deficiency phlegm dampness group>phlegm and blood stasis group>yin deficiency group>spleen dampness heat group>liver qi stagnation group;The HOMA-IR of various TCM syndromes were different.The difference of HOMA-IR between liver qi stagnation group and phlegm and blood stasis group,spleen deficiency phlegm dampness group and liver qi stagnation group、spleen dampness heat group、yin deficiency group.The average level of HOMA-IR in different TCM syndromes was:spleen deficiency phlegm dampness group>phlegm and blood stasis group>yin deficiency group>spleen dampness heat group>liver qi stagnation group;The UA of TCM syndromes existed difference between spleen dampness heat group and liver qi stagnation group、spleen deficiency phlegm dampness group in statistics.The value of UA in TCM syndrome type were variant,which manifested as spleen dampness heat group>yin deficiency group>phlegm and blood stasis group>liver qi stagnation group>spleen deficiency phlegm dampness group;There were no significant difference in HOMA-β,FPG,2hPG,BP,TC,TG,HDL-C,LDL-C and BMI of TCM types.Conclusion1.This research used a cross-sectional epidemiological study to investigate the law of TCM syndrome types in prediabetes.The results showed that the spleen with phlegm syndrome in prediabetes is the most common,followed by liver qi stagnation,spleen dampness heat,phlegm and blood stasis syndrome,yin deficiency syndrome.2.The FINS and HOMA-IR of phlegm and blood stasis syndrome、spleen deficiency phlegm dampness syndrome in prediabetes patients were higher than the other syndromes.So,we consider the phlegm and blood stasis and spleen deficiency phlegm dampness are the key link of insulin resistance,and we should strengthen the power of promoting blood circulation and resolving phlegm to improve insulin resistance and enhance insulin sensitivity.3.There were 65 cases in all the prediabetic patients with BMI>24kg/m2,which accounting for 62.5%.4.The average uric acid level of spleen dampness heat group was higher than the other types.Uric acid might be considered as an objective index for spleen dampness heat syndrome.5.There were no significantly difference between different syndromes in HOMA-β、FPG、2hPG、BMI、BP、TC、TG、HDL、LDL.