Clinical Research Of Main Risk Factors And TCM Syndrome Type Of Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease

Objective:To explore the TCM syndrome and type 2 diabetes mellitus(T2DM)with nonalcoholic fatty liver disease(NAFLD)risk factors,obesity,insulin resistance,plasma glucose,blood lipid and liver function in patients with type 2 diabetes mellitus with relationship between nonalcoholic fatty liver disease,lay the foundation of non-alcoholic fatty liver for the treatment of type 2 diabetes mellitus,to provide basis of diagnosis and treatment and experience.Method:338 patients with T2 DM secreting of Diagnosis Cangzhou Hospital of integrated traditional and Western Medicine Affiliated to Hebei Medical University from March 2016 to September 2017 in combination with traditional Chinese and Western medicine,by retrospective analysis of these patients' medical clinical data,and according to the existence of patients with nonalcoholic fatty liver to group patients were divided into two groups,the study group of 140 cases,198 cases in the control group.The study group for nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus,the control group was without fatty liver disease in patients with type 2 diabetes mellitus.The risk factors of age,body mass index(BMI),course of disease,blood pressure,waist circumference(WC)and plasma glucose were observed and recorded in two groups.According to TCM syndrome differentiation criteria,TCM Syndromes of patients were analyzed.Result:1.The sex ratio of the patients in the study group and the control group was 50% and 55% respectively,and the difference between the two groups was not statistically signigicant(P>0.05).2.The difference of age,course of disease,diastolic blood pressure and systolic blood pressure between the study group and the control group was not statistically signigicant(P>0.05).The BMI and WC of the study group were significantly larger than those of the control group(P<0.05).3.The difference of Total cholesterol(TC),High density lipoprotein cholesterol(HDL-C),Low density lipoprotein cholesterol(LDL-C),2 hours plasma glucose(2hPG)and Glycosylated hemoglobin(HbA1c)levels between the study group and the control group was not statistically signigicant(P>0.05).The levels of fasting plasma glucose(FPG),fasting C peptide(FCP),2 hours C peptide(2hCP),using C-peptide to replace insulin in homeostasis model assessment(Homa)to evaluate insulin resistance(Homa-IR(CP)),Alanine amino-transferase(ALT),Glutamate transaminase(AST),Glutamyl transpeptidase(GGT)and triacylglycerol(TG)in the study group were significantly higher than those in the control group(P<0.05).4.The variables of regression analysis were fatty liver.The independent variables were BMI,FCP and TG.The OR values of three variables were 1.251,1.983,2.019,respectively.5.The radio of Qi deficiency and Yin deficiency,Blood stasis,Damp-heat was comparable in two groups(P>0.05);Spleen deficiency,Phlegm dampness constitution ratio in the study group was significantly higher than in the control group(P<0.05).Conclusion:The BMI,FCP and TG level are related to the pathogenesis of type 2 diabetes mellitus with non-alcoholic fatty liver disease.Insulin resistance and liver damage were more severe in patients of type 2 diabetes mellitus with nonalcoholic fatty liver disease.The TCM Syndromes of type 2 diabetes mellitus with nonalcoholic fatty liver disease are mainly Qi deficiency and Yin deficiency.The two syndromes of phlegm dampness syndrome and spleen deficiency syndrome are important syndromes of this disease.