不同中医体质肥胖2型糖尿病患者血清脂肪因子内脂素水平和内脏脂肪厚度分析

Analysis of the correlation between serum adipokines visfatin level and visceral fat thickness in obesity patients with type 2 diabetes mellitus with different TCM constitution

目的探讨不同中医体质糖尿病患者血清脂肪因子内脂素水平和内脏脂肪厚度变化情况。方法纳入231例肥胖2型糖尿病患者,根据2009年版《中医体质分类与判定》标准分为平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气瘀质、特禀质9种中医体质,收集各体质类型患者的一般资料,检测血清内脂素水平和内脏脂肪厚度,比较各体质类型患者之间的差异,分析总体中医体质、内脂素和内脏脂肪厚度明显异常的中医体质与内脂素、内脏脂肪厚度间的相关性。结果本研究23例患者中平和质29例,气虚质26例,阳虚质22例,阴虚质24例,痰湿质27例,湿热质23例,血瘀质28例,气瘀质24例,特禀质28例。痰湿质和阴虚质患者血清内脂素水平明显高于其他体质患者(P均<0.05)。痰湿质患者内脏脂肪厚度最高,其次为湿热质患者,最低为平和质患者,痰湿质和湿热质患者内脏脂肪厚度均明显高于平和质患者(P均<0.05)。相关性分析显示内脂素、内脏脂肪厚度与痰湿体质相关性最高(r=0.607,P<0.05;r=0.398,P<0.05)。结论痰湿质、湿热质和阴虚质肥胖2型糖尿病患者血清内脂素水平和内脏脂肪厚度明显异常,其中痰湿质患者血清内脂素水平和内脏脂肪厚度变化最明显。

Objective It is to investigate the changes of serum adipokines visfatin level and visceral fat thickness in obesity type 2 diabetes patients with different traditional Chinese medicine constitution. Methods 231 patients with obesity type 2 diabetes were enrolled and divided into 9 kinds of TCM constitutions which were peace constitution, Qi deficiency constitution, Yang deficiency constitution, Yin deficiency constitution, phlegm dampness constitution, damp heat constitution, blood stasis constitution, Qi stasis constitution and special gift constitution according to the criteria of the 2009 edition of TCM Constitution Classification and Judgment. The general information of the patients of every kind of constitution types were collected, the serum visfatin level and visceral fat thickness were detected. The differences in these indexes among every kind of constitution types were compared, and the correlation between TCM constitution and visfatin and visceral fat thickness were analyzed in the ones with abnormal general TCM constitution, visfatin and visceral fat thickness. Results There were 29 cases of peace constitution, 26 cases of Qi deficiency constitution, 22 cases of Yang deficiency constitution, 24 cases of Yin deficiency constitution, 27 cases of phlegm dampness constitution, 23 cases of damp heat constitution, 28 cases of blood stasis constitution, 24 cases of Qi stasis constitution and 28 cases of special gift constitution in 231 patients enrolled in this study. The level of serum visfatin in the patients with phlegm dampness constitution or Yin deficiency constitution were significantly higher than that in the patients with other constitution(P<0.05). The visceral fat thickness was the highest in patients with phlegm-dampness constitution, followed by damp-heat patients, and the lowest was in patients with peace constitution, the thickness of the patients with phlegm-dampness and damp-heat constitution were significantly higher than that of the ones with peace constitution(P<0.05). Correlation analysis showed that the correlation between visfatin and visceral fat thickness and phlegm-dampness constitution was the highest(r=0.607, P<0.05;r=0.398, P<0.05). Conclusion Serum visfatin levels and visceral fat thickness are significantly abnormal in obesity type 2 diabetes mellitus patients of phlegm dampness constitution, damp heat constitution and Yin deficiency constitution, the changes of serum visfatin level and visceral fat thickness are the most obvious in the patients with phlegm-dampness constitution.