A clinical observation on correlations between glycosylated hemoglobin level and traditional Chinese medicine syndrome differentiations in young and middle-aged type 2 diabetic patients with heart failure and preserved ejection fraction / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate traditional Chinese medicine (TCM) syndrome differentiations and glycosylated hemoglobin (HbA1c) levels in the young and middle-aged type 2 diabetic patients with heart failure and preserved ejection fraction (HF-PEF), and to evaluate the correlations between them.Methods 235 out- and hospitalized patients with type 2 diabetes from Department of Cardiology of Affiliated Fuzhou Second Hospital of Xiamen University were enrolled. They were divided into HF-PEF group (120 cases) and non-HF-PEF (HF-NPEF) group (115 cases) according to the diastolic function results of echocardiography. In the HF-PEF group, according to the TCM differentiation of syndromes, the patients were subdivided into four types heart Qi and Yin deficiency, Yang deficiency of heart and kidney, Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes. The HbA1c levels of different TCM syndromes in HF-PEF and HF-NPEF groups were determined by high performance liquid chromatography. The patients of HF-PEF were further divided into two groups according to serum HbA1c levels > 7.0% or ≤ 7.0%, and the relationships between different serum HbA1c levels and different severity of TCM syndrome types of patients with HF-PEF were compared.Results The level of serum HbA1c in HF-PEF group was significantly higher than that in HF-NPEF group in patients with type 2 diabetes [(7.02±0.74)% vs. (6.79±0.91)%,P 0.05], while the HbA1c levels of Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes were significantly higher than those of heart Qi and Yin deficiency and Yang deficiency of heart and kidney types [(7.15±0.70)%, (7.55±0.62)% vs. (6.70±0.66)%, (6.70±0.68)%], and the HbA1c levels of edema syndrome due to Yang Deficiency was obviously higher than that of Qi deficiency and blood stasis (P 7.0%, the incidence rate of Qi deficiency and blood stasis and edema syndrome due to Yang Deficiency types was higher than that of the group of HbA1c ≤ 7.0% [61.97% (44/71) vs. 38.78% (19/49),P 7.0% (r = 0.683,P < 0.05).Conclusion Clinically using serum HbA1c level to assess the prognosis of HF-PEF has obtained consistent results, and the level is positively correlated to the development of TCM syndrome types in young and middle-aged HF-PEF patients with type 2 diabetes.