The NMR Metabonomics Study In Serum Samples Of Young And Middle-age Hypertension Patients Of Phlegm Dampness Retention Syndrome

Objectives: This research analyzes the metabolites spectrum in serum of the young and middle-age adults, who are the hypertensive patients of phlegm dampness retention syndrome, liver-fire hyperactivity syndrome and yin deficiency and yang hyperactivity syndrome, and set up the metabonomics diagnosis and discriminate model of the hypertensive patients of phlegm dampness retention syndrome, selecting the biomarker or biomarkers of phlegm dampness retention syndrome that distinguished from other syndromes. Then investigate the relativity of the biochemical indexes and metabonomics in young and middle-age hypertensive patients of phlegm dampness retention syndrome.Methods: Patients between 18~59 years old untreated before or having stopped taking blood pressure medicine for more than 2 weeks were selected from the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2015. According to the "Guideline of clinical investigations on new drugs of traditional Chinese medicine in the treatment of hypertension", divided the patients into phlegm dampness retention syndrome group, liver-fire hyperactivity syndrome group and yin deficiency and yang hyperactivity syndrome group. Selected the healthy volunteers as control group, who went to our hospital for physical examination in the same period. 49 research subjects were brought into the research totally, 14 cases in phlegm dampness retention syndrome group, 14 cases in liver-fire hyperactivity syndrome group, 6 cases in yin deficiency and yang hyperactivity syndrome group, and 15 cases of healthy volunteers. In the morning, collected the subjects’ fasting venous blood of 12 h in yellow head coagulation promoting tubes, standing for 1h and centrifuged, then put the supernatant to-80℃ refrigerator. The serum was thawing under normal temperature, joined the heavy water and buffer solution, then getting the supernatant after centrifuged, at last sent to the Testing Center of Fuzhou University for the NMR spectrum detection. Get the matrix of each segment and the corresponding integral area value after the detection of the hydrogen spectrum. Importing the data file to the SMICA-P software for the principal component analysis(PCA) and partial least squares-discriminate analysis(PLS-DA) and then screening and identification the difference metabolites combined with t test.Result: 1.Compared the hypertension of phlegm dampness retention syndrome group, liver-fire hyperactivity syndrome group and yin deficiency and yang hyperactivity syndrome group, body fat content and LDL-C have no significant difference. The levels of age and TC in yin deficiency and yang hyperactivity syndrome group were significantly higher than those of the control group(p﹤0.05). The levels of body weight, BMI, TG, FCP in the phlegm dampness retention syndrome group were significantly higher than those in the control group(p﹤0.05), The levels of UA, FINS in the phlegm dampness retention syndrome group were significantly higher than the other three groups(p﹤0.05). 2. The main components of serum metabolites in hypertension of phlegm dampness retention syndrome group were different from the other three groups, which can be distinguished. The levels of acetone, VLDL, LDL were significantly higher and the levels of lactate, serine, glucose, methionine, alanine were significantly lower in phlegm dampness retention syndrome group than those in the control group, the levels of citrate, alanine, VLDL, LDL was significantly higher and the levels of glucose, lysine, glutamate, proline lactate were significantly lower than those in liver-fire hyperactivity syndrome group, the level of creatinine was significantly higher than that in yin deficiency and yang hyperactivity syndrome group.Conclusion: 1.There is differences in general conditions and biochemical indicators among the various syndromes of young and middle-age essential hypertension patients and the control group. 2. The metabonomics study based on the 1H-NMR method can distinguish the young and middle-age hypertension of phlegm dampness retention syndrome group from the other three groups(normal control group, liver-fire hyperactivity syndrome group and yin deficiency and yang hyperactivity syndrome group). 3. There are lipoprotein metabolism, amino acid metabolism and glucose metabolism disorder in the young and middle-age hypertensive patients of phlegm dampness retention syndrome, which might be related to high fat diet.