Correlation Study On TCM Constitution And Visceral Fat Area In Patients With Type 2 Diabetes Mellitus

Purpose:This paper takes the patients with type 2 diabetes mellitus as the experimental object,by comparing the differences of TCM physique and metabolic indexes of type 2diabetic patients with different visceral fat area,to find out the similarities and differences between them,and to explore the correlation between TCM physique,insulin resistance and visceral fat area in T2DM patients,in order to provide objective basis for individual treatment and nursing care of two different types of T2DM patients.To provide reference for the screening and prevention of high-risk groups of diabetes.Material and method:A total of 218 patients with type 2 diabetes mellitus who met the inclusion criteria in the Department of Endocrinology,affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2019 to November 2020 were selected.According to the results of visceral fat area(VFA)measurement,the patients were divided into visceral fat increase group(VFA?100cm~2)and non-visceral fat increase group(VFA<100cm~2).Collect basic patient information including gender,age,diabetes course,measure height,weight,waist circumference(WC)and blood pressure;measure fasting plasma glucose(FPG),fasting C-peptide(FCP),2 hours postprandial C-peptide(2h CP),fasting insulin(FINS),glycated hemoglobin(Hb A1c),blood lipids,liver function,serum uric acid(SUA)and other biochemical indicators.Body mass index(BMI),insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-?)were calculated.The visceral fat area was measured by HDS-2000 visceral fat measuring device.SPSS23.0 statistical software was used to analyze the measurement data,the measurement data were expressed as mean±standard deviation(variance±s),normality and variance homogeneity were tested first,independent sample t-test was used to satisfy normality between the two groups,one-way ANOVA was used to satisfy normality and variance homogeneity between groups,and nonparametric test was used if they were not satisfied.Counting data were expressed by constituent ratio and percentage(n,%),and chi-square test was used.The relationship between the two variables was analyzed by Spearman correlation analysis,and Logistic regression analysis was used to detect the independent risk factors of HOMA-IR.P<0.05 was considered to be statistically significant.Results:1.Comparison of general information and laboratory examination results between the two groups.A total of 218 patients with type 2 diabetes mellitus were included in this study,including visceral fat hypertrophy group(n=113,51.8%)and non-visceral adipose hyperplasia group(n=105,48.2%).The levels of SBP,BMI,WC,FCP,2h CP,FINS,HOME-IR,HOME-?,TG and SUA in visceral steatosis group were significantly higher than those in non-visceral steatosis group.There was no significant difference in age,course of disease,sex,DBP,Hb A1c,FPG,ALT,AST,TCand LDL-C between the two groups.2.Comparison of TCM constitution distribution between two groups of patients.There was a significant statistical difference between the two groups in the distribution of traditional Chinese medicine constitution(P<0.01).The top six TCM constitutions in the visceral fat increase group were:phlegm-dampness(33 cases,29.29%),yin deficiency(20cases,17.7%),qi deficiency(16 cases,14.2%),damp-heat constitution(16 cases,14.2%),blood stasis(11 cases,9.7%),yang deficiency(9 cases,8.0%);The top six TCM constitutions in the non-visceral fat increase group were:yang deficiency(28 cases,26.7%),yin deficiency(21cases,20.0%),phlegm-dampness(17 cases,16.2%),qi deficiency(11 cases,10.5%),blood stasis(10 cases,9.5%),peaceful quality(8 cases,7.6%).3.The correlation between the area of visceral fat and the physique of traditional Chinese medicine.By analyzing and comparing the correlation between the visceral fat area of the 218patients with type 2 diabetes mellitus and the constitution of traditional Chinese medicine,the results showed:the level of VFA in patients with phlegm-dampness and damp-heat were higher than those of blood stasis,qi deficiency,yin deficiency,and yang deficiency,with significant statistical differences(P<0.05).4.Correlation between visceral fat area and parameters.Correlation analysis showed that VFA was positively correlated with BMI,WC,SBP,FCP,2h CP,FINS,HOME-IR,HOME-?,TG and SUA,but negatively correlated with the course of diabetes and HDL-C(P<0.05).5.Correlation between Insulin resistance index and parameters.Correlation analysis showed that HOME-IR was positively correlated with SBP,BMI,WC,VFA,FPG,FCP,2h CP,Hb A1c,FINS and TG,but negatively correlated with the course of diabetes(P<0.05).6.Analysis of risk factors of insulin resistance index.HOME-IR is a dependent variable for multiple regression,after adjusting for the course of diabetes,SBP,BMI,WC,FCP,2h CP,Hb A1c,TG and other influencing factors,analysis shows that VFA is still an independent influencing factor of HOME-IR.Conclusion:1.Patients with T2DM with increased visceral fat are more likely to be accompanied by hypertension,hyperuricemia and dyslipidemia.2.BMI,WC and visceral fat are the related factors of insulin resistance,but the increase of visceral fat is most closely related to insulin resistance.3.T2DM patients with increased visceral fat prefer phlegm and dampness,while T2DM patients with normal visceral fat prefer yang deficiency.4.The VFA of patients with T2DM can be used as an objective indicator to predict phlegm-dampness and damp-heat quality.