Study On The Association Of TCM Constitution Characteristics And RAGE Polymorphism In Patient With Type2Diabetes Complicating Depression

Objective:To study the association of triditional Chinese medicine(TCM) constitution characteristics and RAGE G82S polymorphism,serum esRAGE in patients with type2diabetes complicating depression.To explore the risk factors of type2diabetes complicating depression and provide information for the treatment of the type2diabetes complicating depression by combining traditional Chinese and western medicine.Objects and Methods:According to the depression scalequestionnaire(the Hamilton’s Depression Scale,HAMD),We chose79type2diabetes complicating depression patients which in accordance with the inclusive criteria as research group and68type2diabetes mellitus with normal cognitive function patients as control group.All subjects were analyzed by constitution in TCM questionnaires and clinical parameters was recorded in every case. Among them,there were114patients (72cases of the case group,42cases of the control group) get measured the RAGE G82S polymorphism and serum levels of esRAGE. Analyzed the association between RAGE polymorphism and type2diabetes complicating depression,and relationship of TCM constitution with type2diabetes complicating depression.Results:(1)Compared with the group without depression,there was significant different higher frequence of qi-depression constitution and qi-deficiency constitution and lower frequence of mildlyconstitution in the group with depression(P<0.05).There was also higher frequence of yang-deficiency constitution in the group with depression,but not significant (P>0.05).(2)Compared with the group without depression,there was significant lower esRAGE in the group with depression after adjust for age,gender,duration of type2diabetes,BMI,HbA1c(P<0.05).Significant difference between the group with depression and control group in gender,age,HbA1c,BMI,abdominal circumference,hsCRP and IMT (P<0.05) also observed.(3)The genotype distribution was in agreement with that predicted under Hardy-Weinberg equilibrium for both cases and controls.But no difference in genotypes or allele frequencies was observed between the two groups(P>0.05).(4)Compared with the group with82G/82G genotypes,there was significant different higher frequence of qi-deficiency constitution in the group with depression(P<0.05).(5)Adjust for age,gender,duration of type2diabetes,BMI,HbA1c,there were significant higher HAMD scores and lower esRAGE in82S/82G+82S/82S genotypes compared with the group with82G/82G genotypes in the group with depression (P<0.05).In addition,there were also significant higher BMI,abdominal circumference,IMT and hsCRP in82S/82G+82S/82S genotypes.(6)Multiple stepwise linear regression analysis was used to select the predictors of HAMD score in type2diabetic patients complication depression. The significant predictors found included esRAGE,gene polymorphism and TCM Constitution. Variables included in the model:sex, age, BMI, the RAGE G82S polymorphism,TCM Constitution, and esRAGE.Conclusion:(1) Qi-deficiency constitution and qi-dcpression were risk factors for type2diabetes complicating depression.Mildlyconstitution was the protective factor for type2diabetes complicating depression.Yang-deficiency constitution may be the risk factor for type2diabetes complicating depression.(2)Type2diabetes complicating depression has some special clinical characteristics.ESRAGE is the protective factor for type2diabetes complicating depression.(3)This study confirms the association between the RAGE-ligands system with type2diabetes mellitus complicating depression on a genetic level.The82S allele had lower esRAGE and severe depressive symptoms.The82S allele was the risk factor for qi-deficiency constitution and may be the risk factor for partial constitution in T2DM,especially qi-depression constitution and yang-deficiency constitution.