Characteristics Of TCM Constitution And Metabolomics In Community Elder Hypertensive Population

Objective:The first objective of this study is to explore the TCM constitution of elder hypertensive people in community and find the distribution characteristics of TCM constitution.The second one is to find biomarkers of common TCM constitution in old age hypertension using metabolomics profiling.Finally,we will establish a microphysical discriminant model to find the micro-constitution tendency of hypertension individuals with balanced constitution.Methods:TCM symptoms of elderly hypertensive patients were collected by questionnaires and regular physical examination was performed at the same time.The constitution type was determined according to the scoring standard.In the metabolomics experimental part,we had recruited several groups of participants including common TCM constitutions,balanced constitution and health control,each group has 50 cases.Multivariate statistics and unit statistical analysis were used to screen differential metabolites of common TCM constitutions.We established a discriminant model of hypertensive common TCM constitutions by using the differential metabolites and made a preliminary judgment on the microphysical tendency of the hypertensive ones with balanced constitution.Results:The TCM constitutions of elderly hypertension patients were phlegm-dampness constitution（26.1%）,balanced constitution（23.0%）,yang deficiency constitution（8,1%）and yin deficiency constitution（6.3%）.There were significant differences between man and female in nine TCM constitutions except heat-dampness constitution and blood stasis constitution（P<0.05）.Also,there was a higher rate of blood stasis constitution in individuals older than 75 than the ones between 65 and 74（P=0.028）.Phlegm-dampness constitution had the highest rate in stage2 or stage3 hypertension,as well as in the patients whose blood pressure hadn’t well controlled（P<0.001）.By using metabolomics technology,we had find the biomarkers for hypertensive phlegm-dampness constitution including Ratio of ornithine/L-arginine,L-cysteine,phenylpyruvic acid,palmitic acid and docosahexaenoic acid,and hippuric acid,ratio of pyruvic acid/L-lactic acid,palmitic acid,creatine and ratio of guanine/guanosine for hypertensive yin deficiency constitution.Using the TCM symptoms of hypertension as the dependent variable（Y）,the potential biomarker as the independent variable（X）,we established a discriminant model which discriminant formula is Y=0.231X₁+0.158X₂+0.207X₃+0.021X₄+0.221X₅+0.755X₆+0.027X₇-0.559X₈-0.161X₉.Conclusion:1.The TCM constitutions of elderly hypertension patients were phlegm-dampness constitution,balanced constitution,yang deficiency constitution and yin deficiency constitution.2.There are significant differences of TCM constitution between man and female.We find the rate of blood stasis constitution is related to age.The phlegm-dampness constitution is related to the blood pressure level and has a certain effect on the efficacy of hypertension.3.Hypertension patients with phlegmatic or yin deficiency have different metabolic fingerprints with health people.It is clinically possible to use metabolomics to compare the metabolic profiles of different TCM constitution and normal people,and to initially find metabolite markers in patients with phlegm-dampness constitution and yin deficiency constitution.