Correlation analysis of glycolipid metabolism and Chinese medicine syndrome elements before and after metabolic surgery in obese patients

Jiang Qinyu; Meng Fanqiang; Wu Lili; Jin Xian; Xie Lingding; Li Zhaoqing; Chen Xiaoping

doi:10.3760/j.issn.1673-4777.2024.09.025

Abstract：Objective To explore the correlation between glucose and lipid metabolism and traditional Chinese medicine(TCM)syndrome elements in obese patients before and after metabolic surgery.Methods The obese patients who underwent metabolic surgery in China-Japan Friendship Hospital from February 2023 to March 2024 and followed-up in outpatient clinic 1 and 3 months after operation were selected.The blood biochemical indexes and TCM syndrome factors were collected before operation,1 and 3 months after operation,and the correlation between them was analyzed.Results A total of 95 obese patients were included,85 patients were reexamined 1 month after operation,and 60 patients were reexamined 3 months after operation.The body mass,body mass index and waist circumference of male and female at 1 and 3 months after operation were lower than those before operation(all P＜0.05).At 1 and 3 months after operation,the percentage of overall body mass reduction was higher in the severely obese group than in the mildly and moderately obese group(all P＜0.001).The levels of fasting blood glucose,glycosylated hemoglobin,fasting insulin and homeostasis model assessment of insulin resistance index(HOMA-IR)in obese patients at 1 and 3 months after operation were lower than those before operation.The levels of fasting insulin and HOMA-IR in the heat syndrome group were higher than those in the non-heat syndrome group in obese patients with diabetes mellitus[37.4(17.0,55.4)mIU/L vs 19.8(14.4,32.6)mIU/L,12.3(11.0,21.8)vs 6.6(5.6,11.2)](all P＜0.05).Heat syndrome factor was positively correlated with fasting insulin and HOMA-IR levels,respectively(Hazard ratio=0.371,P=0.030)and(Hazard ratio=0.415,P=0.026).Conclusions Metabolic surgery can quickly and effectively reduce the body mass of obese patients and improve glucose and lipid metabolism in obese patients.The more obvious the heat syndrome factor before operation,the higher the fasting insulin and HOMA-IR levels in patients with obesity combined with diabetes mellitus.