Study On The Risk Factors Of Type 2 Diabetes Complicated With Carotid Plaque Formation And The Correlation Of TCM Syndromes

Purpose:By comparing the data of type 2 diabetes mellitus(T2DM)patients with carotid plaque(CP)and T2DM patients without CP,this paper analyzes the risk factors of T2DM patients with CP,so as to achieve the purpose of early prevention and treatment of diabetic macroangiopathy and reduction of cardiovascular events.At the same time,to explore the relationship between the main risk factors and the distribution of TCM syndrome types,in order to provide a reference for TCM syndrome differentiation and treatment as well as disease prevention.Material and method:469 patients with type 2 diabetes were selected from the Department of Endocrinology,Affiliated Hospital of Liaoning University of traditional Chinese medicine from December 2018 to November 2019.According to the diagnostic criteria of type 2 diabetes and the results of neck color Doppler ultrasound,the patients were divided into two groups: the group with plaque(249 cases)and the group without plaque(220 cases).Data included: age,gender,course of diabetes,smoking history,waist circumference(WC),visceral fat area(VFA),body mass index(BMI),glycosylated hemoglobin(Hb A1c),fasting C peptide and C peptide 2 hours after meal,C-reactive protein(CRP),blood lipid indexes: triglyceride(TG),total cholesterol(CHOL),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C).To analyze the related risk factors of carotid plaque in type 2 diabetic patients,and then analyze the distribution of the main risk factors in each TCM syndrome type,using SPSS23.0 statistical software to analyze.The measurement data is represented by mean±standard deviation.The homogeneity test of normality and variance is carried out first,and the one-way ANOVA is used to meet the normality and the homogeneity of variance,and the nonparametric test is used if it does not meet the requirements;the composition ratio and percentage are used to represent the count data,and the ?2 test is used.The main factors of T2DM with carotid plaque were analyzed by logistic regression.ROC curve analysis VFA predicted risk tangent value.Results: 1.Comparison of general data and laboratory examination results between the two groups:A total of 469 patients with T2DM were included in this study,including 220 patients with plaque(46.9%)and 249 patients without plaque(53.1%).The mean age,course of diabetes,smoking history,BMI,WC,VFA,CHOL,LDL-C,Hb A1 c and CRP of the patients with plaque were higher than those of the patients without plaque(P<0.05).There was no significant difference in fasting C-peptide,C-peptide,TG and HDL-C between the two groups(P>0.05).2.Comparison of TCM syndrome types between the two groups: In the plaque group,the proportion of spleen dampness and heat stagnation and blood stasis(108 cases,49.1%)was the highest,which was significantly different from that of Qi Yin deficiency(11 cases,5%),Qi Yin deficiency and blood stasis(60 cases,27.3%),yin yang deficiency and blood stasis(41 cases,18.6%),with statistical significance(P<0.05).In the two groups with or without plaque,the proportion of spleen dampness and Heat Stagnation with blood stasis in the group with plaque was higher than that in the group without plaque(79 cases,31.7%),the difference was statistically significant(P<0.05).3.Analysis results of risk factors of T2DM combined with CP: With age,course,smoking history,BMI,WC,VFA,Hb A1 c,CRP,CHOL and LDL-C as covariates,multivariate logistic regression analysis was conducted.The results showed that course,smoking history and VFA entered the equation(P<0.05).Course of diabetes,smoking history and VFA were the main risk factors of carotid plaque formation.ROC curve was used to analyze the cut-off point value of VFA in predicting T2DM with carotid plaque formation,which was 109.5cm2 for male and 109cm2 for female.4.Relationship between TCM syndrome types and main risk factors in T2DM combined with CP group: The course of diabetes in the patients with deficiency of both yin and Yang and blood stasis was higher than that in the patients with deficiency of both qi and Yin,deficiency of both qi and Yin and blood stasis,and the difference was statistically significant(P < 0.05).The VFA of patients with dampness heat stagnation and blood stasis syndrome was higher than that of patients with Qi Yin deficiency,Qi Yin deficiency and blood stasis syndrome,and the difference was statistically significant(P<0.05).There was no significant difference in smoking history among the four syndrome types(P>0.05).Conclusion: 1.Age,course of disease,smoking history,BMI,WC,VFA,Hb A1 c,CRP,CHOL and LDL-C are the related factors that affect the formation of carotid plaque in T2DM,among which course of disease,smoking history and VFA are the main risk factors.2.VFA can be used as an index to predict the formation of carotid plaque in T2DM patients.When VFA in male is more than 109.5cm2 and VFA in female is more than 109cm2,the risk of carotid plaque in T2DM patients increases.3.In T2DM patients with carotid plaque formation,the syndrome of spleen dampness and heat stagnation and blood stasis was the most,followed by the syndrome of Qi and yin deficiency and blood stasis,yin and yang deficiency and blood stasis,and Qi and yin deficiency.4.The high index of VFA in T2DM patients with carotid plaque can be used as an objective index to diagnose the syndrome of spleen dampness and Heat Stagnation with blood stasis.