2型糖尿病患者体重指数与糖化白蛋白及中医辨证分型关系探讨

目的:探讨2型糖尿病患者体重指数(BMI)与糖化白蛋白及中医辨证分型的关系。方法:选取2型糖尿病住院患者80例,按照体重指数分为3组:BMI<24 kg/m2为非肥胖组,24²8 kg/m2者为超重组,BMI>28 kg/m2者为肥胖组。测量身高、体重、腰围、臀围,计算体重指数[(BMI=体重(kg)/身高2(m2)]。入院后第2天测定空腹血糖、餐后30 min血糖、餐后120 min血糖、血脂、糖化血红蛋白、糖化血清白蛋白、谷丙转氨酶及血清视黄醇结合蛋白、CRP等。对GA与BMI及糖化血红蛋白分别进行相关性分析,并对其他因素进行逐步多元回归分析,对不同体重指数患者进行中医辨证分析,评价体重指数与GA及中医辨证分型的关系。结果:GA与BMI呈显著负相关(r=-0.559,P<0.01),与糖化血红蛋白呈显著正相关(r=0.334,P<0.05),且年龄、空腹血糖、餐后血糖、腰围、臀围及体重为影响GA的因素。不同BMIDE的2型糖尿病患者中医证型所占比例不同,肥胖2型糖尿病患者以湿浊内蕴及气滞血瘀两种证型多见。结论:临床应用GA评价患者血糖水平时应考虑BMI的影响,痰与瘀在2型糖尿病的发病过程中有重要作用。应重视痰与瘀在糖尿病及并发症发生中的作用。

Discussion in Relationship Between BMI and GA and Different Syndromes in TCM

Objective ： To investigate the relationship between body mass index （ BMI ）, glycated albumin （ GA ） and syndrome pattern in traditional Chinese medicine. Methods ： 80 patients with type 2 diabetic mellitus were enrolled in this study. According to BMI, they were divided into three groups ： the first group （ BMI 〈 24 kg/m2 ） was non - obesity group , the second group （ BMI be- tween 24 kg/m2 and 28 kg/m2 ） was overweight group ; the third group （ BMI 〉 28 kg/m2 ） was obesity group. Height, weight, waist circumference and hip circumference were measured and body mass index was calculated by weight （kg） dividing height square （ m2 ） . Fasting blood glucose, postprandial blood glucose, blood lipid, glycolated hemoglobin, Glycated albumin, glutamic - pyruvic transamiuase, retinol - binding protein and C - reactive protein were measured on the second day in hospital. Correlation analysis was made between GA and glycosylated hemoglobin, GA and BMI respectively. And stepwise multiple regression analysis was made to search for other factors influencing GA. Different syndrome patterns in TCM were investigated in patients with different BMI values to assess relationships between BMI and GA, BMI and syndrome pattern. Results ： There was a significant negative cor- relation between GA and BMI （r-- -0. 559 ,P 〈 0. 01 ）, otherwise HbAlc positively correlated with GA （r-~ 0. 334 ,P 〈 0. 05 ）. GA was Mso influenced by age, blood glucose, waist circumference, hip circumference and weight. Major syndrome pattern was not the same in three groups. Phlegm - damp and blood stasis were the common syndrome in obesity group. Conclusion ： BMI should be considered when GA was used to assess patients＇ blood glucose. Phlegm and stasis take important part in the pathogenesis of type 2 diabetes. Therefore, attentions should be paid in the role of phlegm and stasis in the formation of T2DM and complications.