Metabolomics Analysis Of Urine Samples In Young And Middle–Aged Patients With Hypertension Ofphlegm Dampness Retention Syndrome

ObjectivesThe first aim of this study is to analysis the urine samples of young and middle-aged patients with liver-fire hyperactivity syndrome, Yin deficiency and yang hyperactivity and healthy patients compared with hypertension of phlegm dampness retention syndrome by means of metabonomics and establish differential diagnosis model of hypertension of phlegm dampness retention syndrome in metabonomics and confirm its biomarker. Another purpose is to further analysis the correlation between body mass index, blood lipids, blood uric, acid fasting insulin and metabolite biomarkers and syndrome type of TCM for early intervention and precaution.Content1. Urine samples of young and middle-aged hyperpietic patients with three common syndromes and healthy volunteers were tested to analysis in full spectrum by 1H NMR(Nuclear Magnetic Resonance) combined with PCA(principal component analysis) and PLS-DA(partial least squares-discriminate analysis).2. Differential diagnosis model of hypertension of phlegm dampness retention syndrome in metabonomics was established to confirm its biomarker and investigate the material basis of hypertension of phlegm dampness retention syndrome in metabonomics level through analysis urine metabolic profiles of.hypertension of phlegm dampness retention syndrome and liver-fire hyperactivity syndrome, Yin deficiency and yang hyperactivity syndrome group patients, healthy volunteers.3. Understanding age, weight, body mass index, body fat content, serum total cholesterol, triglyceride, low density lipoprotein cholesterol, uric acid, fasting insulin and fasting C peptide level in the young and middle-aged hypertensive of phlegm dampness retention syndrome and investigating the relativity between obesity, high blood lipids, high uric acid, fasting insulin levels and other risk factors and metabonomics and TCM syndrome type.Method34 cases of 18-59 years old EH patients were selected from First Affiliated Hospital of Fujian Medical University, the hypertension patients were not taking any antihypertensive drugs or taking antihypertensive drugs after a 2 week washout period, conform to I level and II level with hypertension. According to the Ministry of health of the people’s Republic of China the 2002 edition of《Chinese medicine clinical guidelines》in the《traditional Chinese drug treatment of hypertension clinical research guiding principle》, these patients of phlegm dampness retention syndrome, liver-fire hyperactivity syndrome, Yin deficiency and yang hyperactivity syndrome were 14 cases, 14 cases, 6 cases, then select 15 cases healthy volunteers in our hospital, as four groups. Morning urine sample pretreatment and sent to test center of Fuzhou University for nuclear magnetic resonance spectrum detection, use PCA and PLS-DA and other methods, analyse the differences between every groups, and then screened and identified the metabolite differences in urine that can distinguish between young and middle-aged patients with hypertension of phlegm dampness retention syndrome, liver-fire hyperactivity syndrome, Yin deficiency and yang hyperactivity syndrome and healthy subjects, and get the "biomarker group" of young and middle-aged patients with hypertension of phlegm dampness retention syndrome.Result1. The weight, body mass index, triglyceride, uric acid, fasting insulin, fasting C peptide in young and middle-aged patients with hypertension of phlegm dampness retention group were significantly higher than that in control group; the weight, triglyceride, uric acid, fasting insulin levels in phlegm dampness retention group were significantly higher in liver-fire hyperactivity group; the weight, uric acid in phlegm dampness retention group were significantly higher than Yin deficiency and yang hyperactivity group. The control group was compared to Yin deficiency and yang hyperactivity group, age, serum total cholesterol was significantly increased.(p<0.05)2. The compounds have significant differences between young and middle-aged patients with hypertension of phlegm dampness retention group and control group: urea, citrate, ethanolamine, π- methylhistidine, glutamine, creatine, threonine. Significant differences of the compounds between hypertension of phlegm dampness retention group and liver-fire hyperactivity group: urea, creatinine, sarcosine, hippurate, phenylalanine, ethanolamine. Compounds have significant differences between young and middle-aged patients with hypertension of phlegm dampness retention group and Yin deficiency and yang hyperactivity group: urea, creatinine, trimethylamine N-oxide, glutamate, ethanolamine, creatine.Conclusion1. Metabonomics might provide a clear physical basis for distinguishing young and middle-aged patients with hypertension of phlegm dampness retention syndrome and liver-fire hyperactivity syndrome, Yin deficiency and yang hyperactivity syndrome, healthy people.2. Urea, citrate, ethanolamine, π- methylhistidine, glutamine, creatine and threonine might be metabolomic biomarkers of young and middle-aged patients with hypertension of phlegm dampness retention,that is major and closely related to three metabolism and purine metabolism,may be associated with high fat diet and high purine diet.3. Blood uric acid, fasting insulin levels might make roles in differential diagnosis of young and middle-aged patients with hypertension of phlegm dampness retention syndrome based on the comparison between phlegm dampness retention group with other groups in general and physicochemical indexes.