| Objective: To explore the clinical characteristics and differences between IGT patients with damp-heat constitution and IGT patients with gentleness constitution,analyze the influencing factors of IGT patients with damp-heat constitution and IGT patients with gentleness constitution,and the correlation between clinical indicators and pyroptosis in IGT patients with damp-heat constitution and IGT patients with gentleness constitution,study the difference of pyroptosis between IGT patients with damp-heat constitution and IGT patients with gentleness constitution,and the correlation between clinical indicators and pyroptosis,so as to provide reference for the prevention,diagnosis and treatment of IGT patients.Methods: Subjects from the Physical Examination Center of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine and students and staff of the school were selected from December2020 to December 2022,ranging in age from 18 to 70.A total of 96 subjects who met the criteria were recruited through the “The Classification and Judgment Criteria of TCM Constitution” questionnaire and blood glucose test.The subjects were divided into damp-heat Constitution IGT group(32 cases),gentleness Constitution IGT group(32 cases)and healthy group(32 cases).By asking the medical history,the professionals completed the physical examination of the subjects and filled in the “Subject information questionnaire”.Blood samples were collected for the detection of laboratory blood glucose,blood lipid biochemical markers and pyroptosis indicators.SPSS25.0was used for statistical analysis of the data.The general information(gender,age,family history of diabetes,smoking and drinking history,diet habits,exercise and sedentary time,sleep time,BMI,waist circumference,WHR),biochemical indicators,and pyroptosis indicators of the three groups were compared.Results:1.Compared with the healthy group,the IGT group of damp-heat constitution had the proportion of family history of diabetes,Non-exercise proportion,waist circumference,BMI,WHR,FPG,2h PG,TC,TG,HDL-C,and the difference was statistically significant(P<0.05,P< 0.01).Compared with the healthy group,there were significant differences in waist circumference,WHR,FPG,2h PG,TC and HDL-C in the IGT group of gentleness constitution(P<0.05,P<0.01).Compared with IGT group of gentleness constitution,the proportion of non-exercise,BMI,waist circumference and HDL-C of IGT group with damp-heat constitution were statistically significant.There was no significant difference in gender,age,smoking history,drinking history,dietary preference,sleep time,sedentary time and LDL-C among the three groups(P>0.05).The proportion of male drinking history in IGT group of damp-heat constitution was higher than that of female,and the difference was statistically significant(P<0.05).2.The levels of NLRP3,Caspase-1,IL-1β,and IL-18 in the IGT group of damp-heat constitution and the gentleness constitution were significantly higher than those in the healthy group(P<0.01).There were significant differences in the expression levels of NLRP3,Caspase-1,IL-18 and IL1βbetween the IGT group of damp-heat constitution and the IGT group of gentleness constitution(P<0.05,P<0.01).There was no significant difference in blood glucose levels between the IGT group of damp-heat constitution and the IGT group of gentleness constitution(P>0.05).3.Binary Logistic regression analysis of the IGT group of damp-heat constitution and gentleness constitution and general information,clinical indicators,pyroptosis showed that HDL-C and eating habits significantly affected the occurrence of IGT in damp-heat constitution group(P<0.05,OR=0.000,96.610).NLRP3,Caspase-1,IL-1β and IL-18 significantly affected the occurrence of IGT with damp-heat constitution(P<0.05,P<0.01,OR=1.115,0.630,1.690,1.151).HDL-C significantly affected the occurrence of IGT with gentleness constitution.(P <0.05,OR=26.914).4.Correlation analysis between pyroptosis and clinical indicators in the IGT group of damp-heat constitution showed that Casapse-1 was positively correlated with TC,TG,2h PG,WHR and age(P<0.05,r=0.401,0.614,0.908,0.379,0.453),it was negatively correlated with HDL-C(P<0.05,r=-0.528);NLRP3 was positively correlated with TG,FPG,2h PG and age(P<0.05,r=0.735,0.638,0.922,0.491),It was negatively correlated with HDL-C(P<0.05,r=-0.442);IL-1β was positively correlated with TG and 2h PG(P<0.05,r=0.462,0.504),It was negatively correlated with HDL-C(P<0.05,r=-0.404);IL-18 was positively correlated with TG,FPG,2h PG,WHR and age(P<0.05,r=0.692,0.528,0.844,0.374,0.361);There was a negative correlation with HDL-C and family history of diabetes(P<0.05,r=-0.471,-0.385).The regression analysis of pyroptosis related indicators in the IGT group of damp-heat constitution showed that 2h PG was a significant influencing factor of Caspase-1,NLRP3,IL-1β and IL-18,and TG and family history of diabetes significantly affected IL-18.The results of correlation analysis between pyroptosis and clinical indicators in patients with IGT group of gentleness constitution showed that Caspase-1 was positively correlated with TC,FPG,2h PG,WHR,age and sleep time(P<0.05,P<0.01,r=0.446,0.357,0.700,0.563,0.611,0.359),and negatively correlated with HDL-C(P<0.05,r=-0.399);NLRP3 was positively correlated with TC,TG,2h PG,BMI,WHR,age,waist circumference,sedentary time and sleep time(P<0.05,P<0.01,r=0.383,0.609,0.911,0.417,0.649,0.708,0.460,0.372,0.455),and negatively correlated with HDL-C(P<0.05,r=-0.399);IL-1β was positively correlated with TC,TG,2h PG,WHR,age and sleep time(P<0.05,P<0.01,r=0.350,0.627,0.817,0.545,0.628,0.450);IL-18 was positively correlated with TC,TG,FPG,2h PG,BMI,WHR,age and sleep time(P<0.05,P<0.01,r=0.472,0.622,0.405,0.804,0.384,0.451,0.746,0.460),and negatively correlated with HDL-C(P<0.05,r=-0.367).The results of regression analysis of pyroptosis-related indicators in IGT group of gentleness constitution showed that 2h PG significantly affected IL-1β,and 2h PG and WHR were significant influencing factors of NLRP3.NLRP3,IL-1β and IL-18 levels in patients with sleep time less than 6hours were significantly higher than those with more than 8 hours of sleep and 6-8 hours of sleep.NLRP3 levels in patients with sedentary time less than4 hours were significantly higher than those in patients with sedentary time greater than 8 hours and 4-8 hours.Conclusions:1.The IGT patients with damp-heat constitution have the characteristics of significantly increased TC,TG,FPG,2h PG,BMI,WHR,waist circumference,family history of diabetes,infrequent exercise and significantly decreased HDL-C.IGT patients with gentleness constitution had the characteristics of significantly increased TC,FPG,2h PG,WHR and waist circumference,and significantly decreased HDL-C.Compared with IGT patients with gentleness constitution,IGT patients with damp-heat constitution have the characteristics of less exercise,high BMI,high waist circumference and low HDL-C.2.There was significant pyroptosis in IGT patients with damp-heat constitution and IGT patients with gentleness constitution.The degree of pyroptosis in IGT patients with damp-heat constitution was more serious than that in gentleness constitution,which provided a theoretical basis for the objective study of damp-heat constitution.3.NLRP3,IL-1β,IL-18 and salty or sweet or greasy or spicy diet are risk factors for IGT in damp-heat constitution.HDL-C is a protective factor of IGT in damp-heat constitution.4.The increased expression of pyroptosis markers NLRP3,Caspase-1,IL-1βand IL-18 in patients with IGT of damp-heat constitution and gentleness constitution is closely related to glucose and lipid metabolism.Therefore,taking pyroptosis indicators as the target to interfere with glucose and lipid metabolism may be a new direction for future intervention of IGT. |
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