Study On The Risk Factors And Distribution Of TCM Constitution Types In Patients With Impaired Glucose Toleranc

Background:Impaired glucose tolerance(IGT)is the prophase of diabetes,and it is an intermediate state between normal people and diabetes,which can belong to the category of "Pi dan" in traditional Chinese medicine.With the rapid development of China’s economy and the changes of people’s diet structure and living habits,the incidence of impaired glucose tolerance has increased sharply around the world,seriously affecting people’s quality of life.Therefore,early identification and prevention of impaired glucose tolerance have a far-reaching impact on human health.In the stage of impaired glucose tolerance,most patients have no typical clinical manifestations.By finding the risk factors and identifying the constitution of traditional Chinese medicine,we can take corresponding preventive measures as soon as possible,which can not only realize individualized diagnosis and treatment,but also reduce the related treatment costs,and avoid the problems of poor compliance of simple lifestyle intervention and adverse reactions caused by long-term taking hypoglycemic drugs,so as to further prevent diabetes and its complications.Objective:The purpose of this study is to explore the risk factors of patients with impaired glucose tolerance and the distribution of TCM constitution types,so as to provide new treatment ideas and methods for the prevention and treatment of impaired glucose tolerance,prevent or delay its development to diabetes,and improve the quality of life of patients with impaired glucose tolerance.Methods:In this study,a cross-sectional study was used to collect IGT patients from 8 cooperative units in the nation from January 2021 to August 2021.After the qualified patients are included,their basic information is recorded,physical examination and laboratory examination are improved,and the data of physical fitness are collected according to the "TCM Constitution Classification and Judgment Table".Finally,the relevant information is entered into EXCEL table,and the data is analyzed by SPSS 26.0 statistical software.Results:1.A total of 463 IGT patients were included in this study.The results of univariate analysis of risk factors of fasting plasma glucose show that there are significant differences in fasting plasma glucose values in gender,occupation,hobbies,exercise habits,staying up late,drinking history and hypertension history(P<0.2).The results of multiple linear regression analysis show that gender(b=-0.179,β=-0.137,P=0.028),staff(b=-0.232,β=-0.145,P=0.013),teacher(b=-0.332,β=-0.096,P=0.041),creatinine(b=-0.007,β=-0.172,P=0.003),high density lipoprotein cholesterol(b=-0.243,β=-0.120,P=0.021)significantly negatively predict fasting plasma glucose level,drinking history(b=0.174,β=0.113,P=0.034),2-hour post-load blood glucose(b=0.157,β=0.241,P<0.001),urea nitrogen(b=0.063,β=0.122,P=0.012)significantly positively predict fasting plasma glucose level.2.The results of univariate analysis of risk factors of 2-hour post-load blood glucose show that there were significant differences in 2h plasma glucose after glucose load in terms of monthly income level,personality,history of hypertension and hyperlipidemia(P<0.2).The results of multiple linear regression analysis show that personality is general(b=0.209,β=0.108,P=0.031)and fasting plasma glucose(b=0.324,β=0.212,P<0.001)significantly positively predict 2-hour post-load blood glucose level.3.In this study,13 patients have no constitution to distinguish,so the constitution analysis finally include 450 subjects.The distribution of constitution in turn is balanced constitution(frequency 168,accounting for 37.3%),yang-deficiency constitution(frequency 70,accounting for 15.6%),phlegm-dampness constitution(frequency 65,accounting for 14.4%),dampnessheat constitution(frequency 49,accounting for 10.9%),qi-deficiency constitution(frequency 29,accounting for 6.4%),qi stagnation constitution(frequency 25,accounting for 5.6%),yindeficiency constitution(frequency 24,accounting for 5.3%),blood stasis constitution(frequency 12,accounting for 2.7%)and inherited special constitution(frequency 8,accounting for 1.8%).4.The study on the general data and constitution type distribution of IGT patients show that there are significant differences in TCM constitution distribution among different gender,BMI types,smoking history,drinking history and hypertension history(P<0.05),but there are no significant differences in different age groups,hyperlipidemia history and family history of diabetes(P>0.05).Among them,in the distribution of biased constitution,the proportion of dampness-heat constitution in men is significantly higher than that in women,and the proportion of yang-deficiency constitution and blood stasis constitution in women is significantly higher than that in men(P<0.05).The proportion of yang-deficiency constitution in normal weight patients is significantly higher than that in overweight and obese patients(P<0.05).The proportion of yang-deficiency constitution and phlegm-dampness constitution in patients without smoking history is significantly higher than that in patients with smoking history(P<0.05).The proportion of yang-deficiency constitution and dampness-heat constitution in patients without drinking history is significantly higher than that in patients with drinking history(P<0.05).The proportion of yang-deficiency constitution in patients without hypertension history is significantly higher than that in patients with hypertension history(P<0.05).5.The study on the distribution of laboratory indexes and constitution types of IGT patients show that the differences in TCM constitution distribution are statistically significant in TG,HDL-C and UA(P<0.05),but not in FPG,2hPG,HbA1c,TC,LDL-C and BUN(P>0.05).Among the biased constitutions,the TG level of patients with phlegm-dampness constitution is higher than that of patients with yang-deficiency constitution(P<0.05),the HDL-C level of patients with yang-deficiency constitution is higher than that of patients with phlegm-dampness constitution(P<0.05),and the UA level of patients with phlegm-dampness constitution,dampness-heat constitution and yin-deficiency constitution is higher than that of patients with yang-deficiency constitution,and dampness-heat constitution is the highest(P<0.05).Conclusions:1.Male,worker/waiter compared with staff and teachers,decreased creatinine,high density lipoprotein cholesterol is low,drinking history,increased 2-hour post-load blood glucose and increased urea nitrogen are independent risk factors for the increase of fasting plasma glucose level in IGT patients.2.Personality is general compared with gentleness and elevated fasting plasma glucose are independent risk factors for the increase of 2-hour post-load blood glucose in IGT patients.3.The distribution of IGT patients’ constitutions is mostly balanced constitution,and the frequency of other biased constitutions is yang-deficiency constitution>phlegm-dampness constitution>dampness-heat constitution>qi-deficiency constitution>qi stagnation constitution>yin-deficiency constitution>blood stasis constitution>inherited special constitution.4.In the biased constitution distribution of IGT patients,men are mainly dampness-heat constitution and women are mainly yang-deficiency constitution and blood stasis constitution.Compared with overweight and obese patients,patients with normal weight are mainly yangdeficiency constitution;Patients with no smoking history are mainly yang-deficiency constitution and phlegm-dampness constitution;Patients without drinking history are mainly yang-deficiency constitution and dampness-heat constitution;Patients with no history of hypertension are mainly yang-deficiency constitution.5.TG level of patients with phlegm-dampness constitution is higher than that of patients with yang-deficiency constitution,HDL-C level of patients with yang-deficiency constitution is higher than that of patients with phlegm-dampness constitution,UA level of patients with phlegm-dampness constitution,dampness-heat constitution and yin-deficiency constitution is higher than that of patients with yang-deficiency constitution,and dampness-heat constitution is the highest.