| Purpose:This article is based on type 2 diabetes mellitus as the research object.To analyze and compare the distribution rule of traditional Chinese medical symptoms,tongue coating,pulse condition and metabolic indicators in T2 DM patients with different body mass index,and to preliminarily explore the correlation between BMI and metabolic indicators in patients with T2 DM.Data and method:Patients with T2 DM who met the inclusion criteria from May 2018 to November 2019 in the outpatient clinic of the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected as the study subjects.Firstly,the general conditions of the patients including age,sex,past history,family history,height and weight were collected,and the BMI was calculated and divided into three groups:normal weight group,overweight group and obese group according to the BMI level.40 cases were selected from each group by random number table method,and a total of120 cases were included in the study.Secondly,clinical information was collected by combining the outpatient TCM inquiry form of T2 DM,including TCM symptoms,tongue coating,pulse condition and metabolic indicators(fasting blood glucose,glycated hemoglobin,fasting C-peptide,blood lipid,liver function,serum uric acid level),and triglyceride glucose index was calculated,then data were entered.Finally,SPSS26.0 statistical software was used for statistical analysis.Count datawere compared among groups by chi-square test,which was expressed by the number of cases or constituent ratio.One-way ANOVA was used to compare the measurement data with normal distribution and homogeneity of variance between groups,which was expressed as mean±standard deviation,while non-parametric test was used for those who were not satisfied,which could be expressed as median±interquartile distance.Spearman correlation was used to analyze the correlation between indicators and BMI.The difference was statistically significant at P<0.05.Results:1.Comparison of general conditions among different BMI groups:There were no significant differences in age,gender distribution and duration of T2 DM among the three groups(P>0.05).There were no significant differences in family history of diabetes mellitus and history of hypertension among the three groups(P>0.05).The average age of onset of T2 DM in obese group(44.48±11.85 years old)was smaller than that in normal weight group(50.23±10.57 years old)and overweight group(49.63±11.38 years old)(P<0.05).2.Comparison of symptom distribution of "more than three a little" among different BMI groups:Among the 120 patients,73 had no typical "more than three and less" symptoms,accounting for about 60.8%of the total.Among them,29 patients in the obese group accounted for 72.5%of the group,24 patients in the overweight group accounted for 60.0%of the group,and 20 patients in the normal weight group accounted for 50.0%of the group.There was no statistical difference in "more than three and less" symptoms among the three groups(P>0.05).3.Comparison of distribution of common TCM symptoms among different BMI groups:The top five TCM symptoms of T2 DM patients in obesity group were fatigue(20,50.0%),stool diarrhea(17,42.5%),irritability(16,40.0%),fear of heat(16,40.0%)and spontaneous sweating(15,37.5%).Compared with normal weight group(7,17.5%)and overweight group(8,20.0%),obese group(17,42.5%)had more cases of stool diarrhea(P<0.05).Compared with the normal weight group(3,7.5%),the overweight group(11,27.5%)had more cases of fear of heat(P<0.05),and the obese group(16,40.0%)had significantly more cases of fear of heat(P<0.01).There were significantly more cases(14,35.0%)of abdominal fullness and distension and bitter taste in the obese group than in the normal weight group(4,10.0%)(P<0.01).4.Comparison of tongue coating and pulse condition among different BMI groups:The normal weight group(75.0%)and the overweight group(62.5%)were dominated by thin tongue coating,while the obese group(52.5%)was dominated by greasy tongue coating.Compared with the normal weight group,the obese patients were more likely to have greasy tongue coating(P<0.01).The pulse condition of the included patients was sinking pulse(75.8%)and chord pulse(18.3%).5.Correlation between BMI and triglyceride glucose index in patients with T2DM:BMI was positively correlated with triglyceride glucose index level in T2 DM patients(correlation coefficient:0.303,P<0.01).6.Correlation between BMI and onset age and metabolic markers of T2DM:BMI was negatively correlated with age at onset and high density lipoprotein level in T2 DM patients,and positively correlated with fasting C-peptide,triglyceride,alanine aminotransferase and serum uric acid level(correlation coefficient:-0.217?-0.262?0.576?0.372?0.326?0.318,P<0.05).Conclusion:1.Overweight or obese T2 DM patients mostly do not have "more than three a little" symptoms as the typical symptoms.2.Obese T2 DM patients are prone to clinical symptoms such as stool diarrhea,irritability,spontaneous sweating,abdominal fullness and distension and bitter taste,with greasy tongue coating as the main tongue coating.However,T2 DM patients with normal weight are not prone to the above symptoms.3.BMI was positively correlated with triglyceride glucose index in patients with T2 DM.4.The age of onset in T2 DM patients with high BMI are younger,and their glycolipid metabolism,liver function and serum uric acid level are more easily disordered. |
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