Study On The Correlation Of Type 2 Diabetes With Non-alcoholic Fatty Liver TCM Syndrome Element,CAP^TM And Main Risk Factors

Objectives To explore the correlation between the controlled attenuation parameters(CAP^TM),the main risk factors and the TCM patterns of type 2 diabetes mellitus with nonalcoholic fatty liver,so as to improve the clinical diagnosis and treatment.Methods The cases were selected from January to December 2018 in Cangzhou Hospital Of Integrated TCM-WM·HEBEI,and 137 patients with type 2 diabetes mellitus（Group A）and 180 patients with type 2 diabetes combined with nonalcoholic fatty liver（Group B）were analyzed retrospectively.The general information（gender,age,course of disease,body mass index,waist circumference）,four diagnostic information,ALT,AST,UA,TC,TG,HDL-C,LDL-C,FC-P,FBG,Hb A1 c,Glycosylated serum protein,HOMA-IR,hypersensitive C-reactive protein,homocysteine,liver ultrasound results and liver controlled attenuation parameter were collected to complete the information of the medical record collection table.The database was established after the data being input into SPSS 22.0 statistical software,and the data were analyzed by chi square test,independent sample t-test,one-way ANOVA,multivariate binary logistic regression analysis（stepwise regression）,and other statistical methods.Results 1.There was no significant difference in sex,age and course of disease between Group A and Group B（P>0.05）;2.BMI,WC,ALT,AST,UA,TC,TG,FC-P,HOMA-IR,hs CRP and HCY in Group B were higher than in Group A,HDL-C in Group B was lower than in Group A,and the difference was statistically significant（P<0.05 or 0.01）;The differences of LDL-C,Hb A1 c and FBG were not statistically significant（P>0.05）;3.The dependent variable of multivariate logistic regression analysis was whether fatty liver existed or not,the results carried out: BMI（OR=1.236,P<0.01）,TG（OR=2.556,P<0.01）,HOMA-IR（OR=0.219,P<0.05）,HCY（OR=0.396,P<0.01）,UA（OR=0.015,P<0.05）;4.The main syndrom element of the two groups were Qi deficiency syndrome and yin deficiency（all>60%）,among them,phlegm dampness syndrome and damp heat syndrome were more common in Group B than in Group A（P<0.01）;5.BMI,TG,HOMA-IR,CAP^TM are closely related to phlegm and dampness syndrome（B=0.182/0.122/0.159/0.020,OR=1.199/1.130/0.853/1.009,P<0.05）,and patients with phlegm and dampness syndrome BMI,TG,HOMA-IR and CAP^TM were higher than those with non-phlegm and dampness syndrome,and the difference was statistically significant（P<0.05 or 0.01）;HOMA-IR and CAP^TM were closely related to the heat syndrome（B=/0.142/0.029,OR=0.868/1.009,P<0.05）,and the HOMA-IR,CAP^TM of patients with heat syndrome were higher than those without heat syndrome,the difference was statistically significant（P<0.05 or 0.01）;HCY is closely related to blood stasis syndrome Correlation（B=0.024,OR=0.992,P<0.05）,and patients with blood stasis syndrome had higher HCY than patients without blood stasis syndrome,the difference was statistically significant（P<0.05）.Conclusions 1.Obesity,high TG,insulin resistance,hyperuricemia,and the increase of inflammatory level in the body are the risk factors of NAFLD in T2 DM.BMI,TG,HOMA-IR,HCY,UA levels are positively correlated with NAFLD in T2 DM.The liver damage of T2 DM patients with NAFLD is more serious than that of T2 DM patients.2.Qi deficiency syndrome and yin deficiency syndrome are most common in T2 DM or T2 DM patients combined with NAFLD,phlegm dampness syndrome and excess heat syndrome are also more common in T2 DM patients combined with NAFLD.3.The CAP^TM level of patients with T2 DM combined with NAFLD in phlegm-dampness syndrome and excess heat syndrome is higher than other syndromes,which can provide a reference for the diagnosis of TCM syndromes;TG are closely related to phlegm dampness,IR are closely related to damp heat and phlegm dampness,obesity is closely related to phlegm dampness,HCY is closely related to blood stasis,which can deepen TCM’s understanding of T2 DM with NAFLD.Figure 0;Table 15;Reference 114...