Correlation Between Traditional Chinese Medicine Syndrome Type And SLCO1B1&ApoE Genotyping Of Carotid Artery Unstable Plaque

ObjectiveFirst,to explore the distribution of TCM syndrome types in patients with carotid artery unstable plaque,explore the key of its pathogenesis,and provide evidence for clinical syndrome differentiation and treatment.Second,to explore the distribution characteristics of SLCO1B1&Apo E gene polymorphism and study its correlation with patients with carotid artery unstable plaque,so as to provide reference for the prediction of high-risk groups of carotid artery unstable plaque.Third,to explore the relationship between SLCO1B1&Apo E gene polymorphism and TCM syndrome types of patients with carotid artery unstable plaque,to understand the essence of TCM syndrome types of carotid artery unstable plaque from the perspective of heredity,and then through SLCO1B1&Apo E gene detection,targeted TCM prevention and treatment,which is conducive to preventing the disease in advance and preventing the disease from changing.Methods100 patients with carotid artery unstable plaque hospitalized in the Department of Encephalopathy,the Eighth Clinical College of Guangzhou University of Chinese Medicine(Foshan Hospital of Traditional Chinese Medicine)from January 2022 to December 2022 were selected.Clinical data and data such as basic information(medical record number,name,age,gender,height and weight),personal history(whether smoking or drinking),previous history(hypertension,diabetes,etc.),TCM four diagnosis data and SLCO1B1&APOE genotyping of all included subjects were collected,and the collected data were input into SPSS26.0 for statistical analysis.Results1.100 patients with carotid artery unstable plaque were aged from 37 to 97 years old,with an average age of(62.58±13.76).The male-female ratio was about 1.2:1,with an average age of(66.00±12.40)for males and(65.71±13.76)for females.75 cases were complicated with hypertension,33 cases were complicated with diabetes,27 cases were complicated with hyperlipidemia,23 cases were complicated with coronary heart disease,64 cases were complicated with cerebral infarction.55 cases had a history of smoking and37 cases had a history of drinking.2.Among the 100 patients with carotid artery unstable plaque,TCM syndrome types were mainly liver-kidney Yin deficiency type and phlegm-stasis interassociation type,accounting for 46% and 24% respectively,followed by phlegm-dampness blocking collages type and qi deficiency and blood stasis type,accounting for 14% and 16%respectively.There was no statistical significance among the different TCM syndrome types in gender,age,smoking and drinking history,and whether there was a combination of hypertension,diabetes,hyperlipidemia,coronary heart disease or cerebral infarction(P>0.05).The baseline of the four groups was the same and comparable.Compared with liver-kidney Yin deficiency group and qi deficiency and blood stasis group,BMI level of phlegm-dampness blocking collateral-collateral system group was significantly increased(P<0.05);Compared with phlegm-stasis interjunction group,there was no significant difference in BMI level in phlegm-dampness blocking collateralization group(P>0.05).Compared with liver-kidney Yin deficiency group and qi deficiency and blood stasis group,TC level in phlegm-dampness-blocking collaged-collateral group was significantly increased(P<0.05);Compared with phlegm-stasis interjunction group,there was no significant difference in TC level in phlegm-dampness-blocking collateral-collateral group(P>0.05).Compared with liver-kidney Yin deficiency group and qi deficiency and blood stasis group,the level of LDL-C in phlegm-dampness-blocking collaged-collateral group was significantly increased(P<0.01);Compared with phlegm-stasis interjunction group,there was no significant difference in the level of LDL-C in phlegm-dampness-blocking group(P>0.05).There were no significant differences in the levels of TCM syndrome type HCY and HDL-C among four groups(P>0.05).3.In the comparison of single alleles,the frequency of E3 alleles in liver-kidney Yin deficiency group was significantly higher than that in phlegm-dampness blocking collages group(P<0.05).The E4 allele frequency of liver-kidney Yin deficiency group was significantly lower than that of phlegm-dampness blocking collages group(P<0.05).The GG allele frequency of group II was significantly higher than that of phlegm-stasis interjunction group(P<0.05);The frequency of AG allele in liver and kidney Yin deficiency group was significantly lower than that in phlegm-dampness blocking collages group(P<0.05).The frequency of E3 alleles in liver and kidney Yin deficiency group was significantly higher than that in phlegm-dampness blocking collages group(P<0.05).The frequency of E2+E4 allele in liver-kidney Yin deficiency group was significantly lower than that in phlegm-dampness blocking collages group(P<0.05).The frequency of GG alleles in liver-kidney Yin deficiency group was significantly higher than that in phlegm-stasis interjunction group(P<0.05).The frequency of A allele in liver-kidney Yin deficiency group was significantly lower than that in phlegm-stasis interjunction group(P <0.05).4.In 100 patients with carotid artery unstable plaque,Apo E gene was divided into three alleles: E2,E3 and E4,among which E3 accounted for 74%,followed by E2 and E4,accounting for 14% and 12%,respectively.There were six genotypes of ε2/ε2,ε2/ε3,ε3/ε3,ε2/ε4,ε3/ε4 and ε4/ε4,accounting for 0%,14%,73%,1%,12% and 0%,respectively.Therefore,Apo Eε3/ε3 genotype and E3 allele were the most common.There were no significant differences between Apo E genes in gender and age(P>0.05),indicating that APOE was comparable.The levels of BMI,TC and LDL-C in E4 group were higher than those in E2 and E3 groups(P<0.05),but there was no statistical significance in the average values of BMI,TC and LDL-C between E2 group and E3 group(P>0.05).There was no statistical significance in the median values of HCY and HDL-C among the Apo E alleles(P>0.05).5.In 100 patients with carotid artery unstable plaque,TT was the most common SLCO1B1 521 T>C locus gene,accounting for 78%,TC and CC accounted for 20% and2%,respectively.The majority of SLCO1B1 388A>G genotypes were GG(52%),AG(46%)and AA(2%).The comparison of alleles of SLCO1B1 in gender and age did not have statistical significance(P>0.05),so they were comparable.There were no significant differences in BMI,HCY,TC,HDL-C and LDL-C levels between TT group and TC+CC group(P>0.05).There was no statistical significance in the changes of BMI,HCY,TC and HDL-C levels between GG group and AA+AG group(P>0.05),but there was statistical significance in the increase of LDL-C level in AA+AG group compared with GG group(P< 0.05).Conclusion1.The levels of BMI,TC,and LDL-C in patients with unstable carotid plaques of phlegm dampness obstruction type are significantly higher than those of liver kidney yin deficiency type and qi deficiency blood stasis type,indicating that phlegm and dampness evil may be one of the key pathogenic factors for unstable carotid plaques.2.The results of this study indicate that the Apo E and SLCO1B1388A>G gene polymorphisms may be associated with the susceptibility risk of liver kidney yin deficiency syndrome,phlegm dampness obstruction syndrome,and phlegm stasis syndrome in patients with unstable carotid artery plaques.In the traditional Chinese medicine syndrome differentiation and classification of unstable carotid plaques,patients carrying the E3 and GG alleles are often characterized by liver and kidney yin deficiency syndrome,patients carrying the E4 or E2+E4 and AG alleles are often characterized by phlegm dampness obstruction syndrome,and patients carrying the A allele are often characterized by phlegm stasis accumulation syndrome.This provides a new approach for us to further understand and grasp the characteristics of traditional Chinese medicine syndrome types of patients with unstable carotid plaques through genetic analysis,Provide new basis for the modernization and scientificization of traditional Chinese medicine syndrome differentiation and classification.3.The BMI,TC,and LDL-C levels of E4 allele carriers are significantly higher than those of E2 and E3 allele carriers.Mutations in the E4 allele may be associated with abnormal lipid metabolism in patients with unstable carotid artery plaques,suggesting that E4 gene carriers may be a high-risk population for unstable carotid artery plaques.Apo E gene testing can provide a reference for disease risk assessment.4.The LDL-C levels of AA+AG allele carriers were significantly higher than those of GG allele carriers,indicating that carrying the A allele may be one of the important risk factors for the occurrence and development of unstable carotid plaques.