Clinical Study On The Relationship Between Glucolipid Metabolic Disorders And Blood Pressure,Variability And Constitution Of Traditional Chinese Medicine

Background:Glucolipid Metabolic Disease(GLMD)is a disease characterized by abnormal glucose metabolism and abnormal lipid metabolism.It is a general term for diseases with diabetes mellitus,dyslipidemia,and non-alcoholic fatty liver diseases.It incidence rate has increased year by year and has become a worldwide problem.Clinical practice and epidemiological research results show that glucose and lipid metabolic diseases and hypertension often appear in the form of combined disease and(or)combined disease,and the cardiovascular risk of patients with combined disease increases exponentially.The increase of blood pressure and blood pressure variability and glucose and lipid metabolic diseases are important risk factors of cardiovascular disease.There are also interactions among blood glucose,blood lipid and blood pressure.In the past,the diagnosis and treatment of glucose and lipid metabolism diseases mainly focused on glucose and lipid metabolism indexes,but the attention to blood pressure indexes was insufficient.Therefore,understanding the relationship between glucose and lipid metabolism diseases and blood pressure and blood pressure variability is important for a deeper understanding of glucose and lipid metabolism diseases,more accurate early intervention,comprehensive prevention and treatment of glucose and lipid metabolism diseases,and effectively reducing the risk of target organ damage and cardiovascular disease It is of great significance.Objective:This article intends to study the characteristics of blood pressure variability(BPV)in patients with GLMD and its correlation with the TCM constitution from the perspective of integrated Chinese and Western medicine,and explore the characteristics of BP and BPV in patients with GLMD and their relationship with related metabolic indicators.To explore the distribution of BP and BPV in patients with different TCM constitution in patients with GLMD,and to provide a reference for the clinical comprehensive management of GLMD.Method:1.111 samples(58 males and 53 females)are included,which come from the Department of First Affiliated Hospital of Guangdong Pharmaceutical University and Guangdong Metabolic Disease Research Center during 2018 to2021,ages 18-85.Collect the patient’s general information,anthropometric indicators,laboratory indicators,24-hour ambulatory blood pressure monitoring data and traditional Chinese medicine data in a unified way.2.The patients are grouped according to their different glucose metabolism,lipid metabolism,clinical diagnosis,and traditional Chinese medical constitution.The relevant diagnostic criteria for abnormal glucose metabolism,lipid metabolism,and glucose and lipid metabolism diseases refer to the latest prevention and treatment guidelines for each disease,and the standard for identification of TCM constitution adopts the "Traditional Chinese Medicine Body Mass Table" compiled by Professor Wang Qi’s team.3.Use SPSS24.0 for statistical analysis.Counting data are represented by the number of cases and percentage(n(%)),((?)±s)stands for normal distribution of measurement data,ANOVA analyze statistics and Pearson correlation analysis are used to normally distributed data,non-parametric rank test and Spearman rank correlation are used to non-normally distributed data.Use logistic regression analysis to explore protective factors and risk factors.When P<0.05,it means that exists statistical significance.Results:1.GLDM is closely related to BP and BPV.Both nm SBP and n SBPSD are independent risk factors for T2 DM,24hm SBP,dm SBP,24 hm DBP,and dm DBP are all independent risk factors for dyslipidemia,24 hm DBP,dm DBP,and nm DBP are all independent risk factors for NAFLD,and d DBPCV is an independent protective factor for NAFLD.2.The levels of glucose metabolism and lipid metabolism are related to BP and BPV.Among the glucose metabolism indexes,FBS,2h PG,Hb Alc,HOMA-IR are positively correlated with nm SBP,n SBPSD,HOMA-IS is negatively correlated with nm SBP;lipid metabolism indexes TG is positively correlated with 24 hm SBP,24 hm DBP,dm SBP,HDL-C is positively correlated with 24 hm SBP,24 hm DBP,Dm SBP,dm DBP are negatively correlated;CAP is positively correlated with 24 hm DBP,nm DBP(P<0.05).3.TCM physique is closely related to BP and BPV.The constitution of yin deficiency and phlegm-damp constitution has the highest level of nm SBP,special constitution has the lowest nm SBP.Yang-deficiency constitution has a higher degree of d SBPSD、d SBPCV,damp-heat constitution has a lower degree of d SBPSD、d SBPCV.Yin deficiency constitution is positively correlated with anti-dipper blood pressure,and negatively correlated with non-dipper blood pressure(P<0.05).Conclusion:There is a significant correlation between GLMD,glucose metabolism,lipid metabolism,TCM constitution and BPV.The FBS,2h PG 、Hb Alc 、HOMA-IR,TG are positively correlated with BPV in GLMD patients.HOMAIS,HDL-C and BPV are negatively correlated.yin deficiency,phlegm-damp,Yang-deficiency and damp-heat constitution are all significantly related to BPV.The circadian rhythm of BP is also affected by TCM.