Zhongguo linchuang yanjiu (Dec 2023)
Relationship between blood glucose fluctuation and skeletal muscle in type 2 diabetes mellitus patients with different Chinese medicine syndrome types
Abstract
Objective To explore the associations of blood glucose fluctuation indexes with skeletal muscle content in different Chinese medicine syndromes of type 2 diabetes mellitus (T2DM). Methods A retrospective study was performed on 330 T2DM patients hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from September 2020 to September 2021. According to different Chinese medicine syndrome, the patients were divided into Qi and Yin deficiency syndrome (n=169), dryness-heat due to Yin deficiency syndrome (n=88) and damp-heat tapping spleen syndrome (n=73). For cenalying the relationship between blood glucose fluctuation and skeletal muscle content, the following indicators were observed and compared among the patients with different syndrome types, including time in range (TIR), standard deviation of blood glucose (SDBG), mean amplitude of glycemic excursion (MAGE), mean of daily difference (MODD), coefficient of variation (CV), glycosylated hemoglobin (HbA1c), relative appendicular skeletal muscle (RASM), appendicular skeletal muscle mass (ASM) and total lean mass (TLM). Compliance was based on TIR ≥ 70%. Results The TIR compliance rate of Qi and Yin deficiency syndrome group was 46.7%, dryness-heat due to Yin deficiency syndrome group was 30.7%, and damp-heat tapping spleen syndrome group was 47.9%. There was a significant difference in the TIR compliance rate among the three groups（χ2=7.145, P=0.028）, and the TIR compliance rate of Qi and Yin deficiency syndrome group and damp-heat tapping spleen syndrome group was significantly higher than that of dryness-heat due to Yin deficiency syndrome group (P<0.05). SDBG, MAGE, MODD and CV in dryness-heat due to Yin deficiency syudrome group were significantly lower than those in Qi and Yin deficiency syndrome group and dryness-heat due to Yin deficiency syndrome group（P＜0.05）. In Qi and Yin deficiency syndrome group, ASM was significantly lower than that in other two groups (P＜0.05). In dryness-heat due to Yin deficiency syndrome group, RASM was respectively negatively correlated with SDBG (r=-0.234, P=0.029), MODD (r=-0.248, P=0.029) and CV (r=-0.355, P=0.001). Conclusion There are differences in blood glucose fluctuation and skeletal muscle content in T2MD patients with different Chinese medicine syndromes types. There is a correlation between blood glucose fluctuations and skeletal muscle content in patients with dryness-heat due to Yin dificiency syndrome.
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