Analysis on the differences in blood glucose homeostasis and amino acid metabolism between new-onset type 2 diabetes mellitus with qi and yin deficiency syndrome and spleen deficiency and phlegm-dampness syndrome
10.3760/cma.j.cn115398-20231123-00280
- VernacularTitle:新发2型糖尿病气阴两虚证和脾虚痰湿证血糖稳态及氨基酸代谢差异分析
- Author:
Yali LI
1
;
Xiaoxia GUO
;
Yan LI
Author Information
1. 山西中医药大学第一临床学院2021级硕士研究生，太原 030024
- Keywords:
Diabetes mellitus, type 2;
Qi Yin deficiency;
Phlegm dampness due to spleen deficiency;
Amino acid metabolism;
Differential metabolites
- From:
International Journal of Traditional Chinese Medicine
2024;46(10):1286-1294
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the differences in glucose homeostasis and amino acid metabolism between patients with new-onset T2DM with qi-yin deficiency syndrome and those with spleen deficiency and phlegm-dampness syndrome.Methods:This study was a cross-sectional and cohort study. From January 2021 to December 2022, 136 T2DM inpatients were selected from the Department of Metabolic Diseases of Shanxi Traditional Chinese Medicine Hospital, and 18 patients were screened to meet the inclusion criteria of new-onset T2DM, and were identified as qi-yin deficiency syndrome and sspleen deficiency and phlegm-dampness syndrome, and were included in corresponding qi-yin and deficiency group and spleen deficiency and phlegm-dampness group, with 9 cases in each group. All patients wore a dynamic blood glucose monitoring system to calculate the 24-h mean standard deviation of blood glucose (SDBG), the coefficient of variation of blood glucose (GLU cv), the maximum value of blood glucose (GLU max), the minimum value of blood glucose (GLU min), the maximum amplitude of glucose fluctuation (LAGE), the average amplitude of glucose fluctuation (MAGE), and the proportion of time within the target range of blood glucose (TIR). Blood specimens were retained for amino acid metabolism testing to screen for differential metabolites and metabolic pathways in the 2 groups of syndromes. Results:Patients in the spleen deficiency and phlegm-dampness group had mAlb [27.61 (13.60,40.45) mg/L vs. 5.10 (1.95, 9.70) mg/L, Z=-2.34], GLU-0 h [(14.83±4.79) mmol/L vs. (9.72±2.35) mmol/L, t=2.87], GLU-1 h [(24.40±5.23) mmol/L vs. (17.71±2.68) mmol/L, t=3.42], GLU-2 h [(25.17±4.43) mmol/L vs. (19.69±3.11) mmol/L, t=3.03], HOMA2-IR [1.83 (1.46, 3.19) vs. 1.14 (0.90, 1.35), Z=-2.14] were higher than those in the qi-yin deficiency syndrome ( P<0.05), GLU cv [16.86 (13.58, 26.20)% vs. 28.30 (23.17, 40.87)%, Z=-2.08] was lower than that of the qi-yin deficiency syndrome ( P<0.05) and had severe blood glucose fluctuations. Screening of 2 groups of differential metabolites identified threonine, alanine, and glutamine as potential metabolic markers for T2DM with qi-yin deficiency versus spleen deficiency and phlegm-dampness. Analysis of the 2 groups of differential metabolite pathways for different TCM syndromes revealed that Aminoacyl-tRNA biosynthesis was the most significantly enriched pathway. Conclusion:Patients with T2DM spleen deficiency and phlegm dampness syndrome had worse insulin function and glucose homeostasis than those with qi-yin deficiency syndrome; differences in amino acid metabolism were important influences on the development of the 2 types of the syndromes, namely, spleen deficiency and phlegm dampness syndrome versus qi-yin deficiency syndrome; and Aminoacyl-tRNA biosynthesis participates in the development of early diabetes mellitus, which plays a key role in the pathogenesis of T2DM.
