| Purpose:To study the distribution of TCM constitution in middle-aged and elderly primary dyslipidemia patients of Han nationality living in Beijing.To investigate the correlation between primary dyslipidemia in middle-aged and elderly patients and their TCM constitutions.This clinical research would provide theoretical and clinical bases for middle-aged and elderly primary dyslipidemia patients treated by differentiation of individuals, and also supply group precaution and therapy of TCM for middle-aged and elderly primary dyslipidemia patients.Methods:1. We investigated 250 cases who accorded with the subclinical group inclusive criteria and 250 cases who met the inclusive criteria of concurrent group.Specifically, to survey individual medical history, past medical history and types of TCM constitution of them.Then, to measure blood-lipid of them including TC, TG, HDL-C and LDL-C.2. Then analyzed data collected from those two groups patients.We did the statistical analysis on the correlation between middle-aged and elderly patients and their taste preferences by Logistic multiple regression analysis. We also did the Logistic multiple regression analysis on the correlation between middle-aged and elderly patients and their TCM constitutions.On the other hand, we analyzed association between TCM constitutions of middle-aged and elderly patients and their blood-lipid, and the relativity of their TCM constitutions and their general condition like BMI and exercises, and the relevance of their TCM constitutions and their taste preferences, and the relationship of their blood-lipid and their general condition, and also their blood-lipid and their taste preferences by Canonical Correlation Analysis(CCA).Results:1.We had retrieved 442 valid questionnaires, including 226 surveys of sub-clinical group and 216 questionnaires of concurrent group. The qualified retrieval rate was 88.4%.2. There were no statistical differences at baselines of gender and age between sub-clinical group and concurrent group patients (P>0.05). There were also no discrepancies of BMI, smoking and exercise habit in these two groups(P>0.05). In the concurrent group we gathered two typical atherosclerotic diseases of middle-aged and elderly primary dyslipidemia patients including coronary atherosclerotic heart disease (CAHD) and atherothrombotic cerebral infaction (ATCI). We didn't find differences of BMI and smoking between CAHD group and ATCI group(P>0.05), while we foud discrepancy of exercise habit in these two groups(P<0.05).3. To compare taste preferences of sub-clinical group patients with that of concurrent group patients, there were no differences of milk products, meat, aquatic products, vegetable, fruit, coffee and tea in these two groups(P>0.05), but, discrepancies were fond between these groups of bean products,dessert and fried foods(P>0.05). Then the Multiple Logistic regression analysis was carried out to analyze correlation in food preferences and concurrent diseases of middle-aged and elderly primary dyslipidemia patients. As the result, fried foods(x8) was the only factor taken into the multiple regression equation as the standard level was P<0.05, and the equation was Logit (p)=ln (p/1-p)=-1.6376+1.0557 x8(fried foods).That was to say, preferring fried foods was the risk factor of the occurrence of concurrent diseases(including CAHD and ATCI) in middle-aged and elderly primary dyslipidemia patients.4. There were no statistical discrepancies of TC,'TG, HDL-C and LDL-C distribution levels between sub-clinical group patients and concurrent group patients(P>0.05). We didn't find statistical differences of TC and LDL-C distribution levels between CAHD group and ATCI group(P>0.05), while we foud distinction of TG and HDL-C distribution levels in these two groups(P<0.05).5. In the sub-clinical group,reduced HDL-C was. the only simple type of dyslipidemia(n=77,account for 34.07%),and the most common type was that combined hyper TC, high TG with high LDL-C(n=88,account for 38.94%), the next was that mixed hyper TC with high TG(n=48,account for 21.24%). In the concurrent group, simple types of dyslipidemia were low HDL-C (n=39,account for 18.05%) and high LDL-C(n=23,account for 10.65%), and the commonest type was also that combined hyper TC, high TG with high LDL-C(n=69,account for 31.94%), and the next was that mixed hyper TC with low HDL-C(n=41,account for 18.98%), then,hyper TC combined with high TG and reduced HDL-C was the next type(n=36, account for 16.67%). There were significant discrepancies of constituent of dyslipidemia types between sub-clinical group patients and concurrent group patients (P<.0001).6. In the sub-clinical group,the total cases was 226,including 67 cases of Peace-constitution,31 cases of Yang-deficiency constitution,30 cases of 2 kinds of TCM constitutions accompanied,25 cases of 3 kinds of TCM constitutions accompanied. In the concurrent group, the total cases was 216,including 23 cases of Peace constitution,31 cases of Qi-deficiency constitution,23 cases of 2 kinds of TCM constitutions accompanied,36 cases of 3 kinds of TCM constitutions accompanied,28 cases of 5 kinds of TCM constitutions accompanied. There were remarkable differences of constituent of TCM constitutions between sub-clinical group patients and concurrent group patients (P<.0001).All the lopsided constitutions were mainly consisted of accompanied constitutions, and constituent ratio of simple constitutions were all less than 50 percent. In the sub-clinical group, Yang-deficiency constitution (n=88), Qi-deficiency constitution (n=68) and Qi-stagnation constitution (n=61) were common TCM constitution factors.The top three proportion of simple TCM constitution in the lopsided TCM constitution were Yin-deficiency constitution (37.14%), Yang-deficiency constitution (35.23%) and Blood-stasis constitution(21.88%), while the last three were Damp-heat constitution(6.45%), Phlegm-damp constitution(6.52%) and Qi-stagnation constitution(6.56%).In the concurrent group, Qi-deficiency constitution (n=123), Yang-deficiency constitution (n=81) and Qi-stagnation constitution (n=77) were common TCM constitution factors.The top three proportion of simple TCM constitution in the lopsided TCM constitution were Yin-deficiency constitution (31.91%), Qi-deficiency constitution (25.20%) and Yang-deficiency constitution (20.99%), while the last three were Damp-heat constitution (3.77%), Qi-stagnation constitution(3.9%)and Phlegm-damp constitution (5.88%). The difference of the simple constitution of Yang-deficiency constitution was found between sub-clinical group patients and concurrent group patients (P<0.05).7. We did the Multiple Logistic regression analysis to analyze correlation between TCM constitutions and concurrent diseases of middle-aged and elderly primary dyslipidemia patients. The result was Qi-deficiency constitution (x2) and Blood-stasis constitution (x7) were factors taken into the multiple regression eauation as the standard level was P<0.05, and the equation was Logit (p)=ln (p/1-p)=-0.9711+0.5952x2 (Qi-deficiency constitution)+0.3582x7 (Blood-stasis constitution). We could say Qi-deficiency constitution and Blood-stasis constitution were risk factors of the occurrence of concurrent diseases(including CAHD and ATCI) in middle-aged and elderly primary dyslipidemia patients.8. We analyzed association between blood-lipid of middle-aged and elderly patients and their and their general condition (including BMI and exercises) by Canonical Correlation Analysis, and we got the first group of standard Canonical Correlation variables:W1=0.5524X1+0.2324X2, Vl=-0.3036Y1+0.3122Y2-0.4691Y3-0.1327Y4. Therefrom we concluded that W1 was mainly affected by X1(BMI), top two weights of V1 were Y3 (HDL-C) and Y2 (TG). That indicated that higher level of TG and lower level of HDL-C were existed in middle-aged and elderly patients with elevated BMI level.Conclusion:1.In the sub-clinical group, Peace-constitution and Yang-deficiency constitution were familiar simple TCM constitutions, and 2 types and 3 types combined constitutions were common mixed TCM constitutions, but they were still mainly consisited by simple TCM constitutions. In the concurrent group, Qi-deficiency constitution and Peace-constitution were common simple TCM constitutions, and 3 types and 5 types combined constitutions were common mixed TCM constitutions, and the foremost TCM constitutions were consisited by mixed TCM constitutions.There were remarkable differences of constituent of TCM constitutions between sub-clinical group patients and concurrent group patients. All the lopsided constitutions were mainly consisted of combined constitutions. In the sub-clinical group, Yang-deficiency constitution, Qi-deficiency constitution and Qi-stagnation constitution were common TCM constitution factors.But Damp-heat constitution, Phlegm-damp constitution and Qi-stagnation constitution were predominantly existed in combined constitutions.In the concurrent group, Qi-deficiency constitution, Yang-deficiency constitution and Qi-stagnation constitution were common TCM constitution factors. However, Damp-heat constitution, Qi-stagnation constitution and Phlegm-damp constitution were predominantly consisted in combined constitutions.There were no differences of the simple constitution of each lopsided constitution was found between sub-clinical group patients and concurrent group patients except Yang-deficiency constitution.2. Qi-deficiency constitution and Blood-stasis constitution were risk factors of the occurrence of concurrent diseases(including CAHD and ATCI) in middle-aged and elderly primary dyslipidemia patients, and preferring fried foods was the risk factor of the occurrence of concurrent diseases(including CAHD and ATCI) in middle-aged and elderly primary dyslipidemia patients.3. Higher level of TG and lower level of HDL-C were existed in middle-aged and elderly patients with elevated BMI level.
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