| ObjectiveAtherosclerosis is a common cardiovascular disease all over the world. Currently metabolic syndrome is a recognized risk factor for atherosclerosis. Nevertheless, it is obvious that not all individuals with metabolic syndrome would develop atherosclerosis, suggesting that a subpopulation prone to atherosclerosis may exist. Different TCM constitution of patients with metabolic syndrome may be one of the possible reasons. Therefore, the aim of the present study was to estimate whether the TCM constitution associated with atherosclerosis. Furthermore, we analyzed the correlation between the distribution of TCM constitution and the risk factors for atherosclerosis, such as blood lipid (triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein), body glucose, the blood pressure, BMI, uric acid and so on.MethodsBetween January 2015 and December 2015, a total of 84 eligible patients with metabolic syndrome were newly histologically diagnosed from the Traditional Chinese Medicine Hospital of Guangdong Province. All subjects were asked to complete face-to-face interviews by trained interviewers using a structured questionnaire. The information of TCM constitution was obtained from the interview. The clinical characteristics of the patients were collected from medical records, such as history of disease, body mass index,blood pressure, blood glucose,the blood lipid. All the data were estimated whether there is a relationship between the TCM constitutions.Results1. In 84 cases of metabolic syndrome, the basic characteristics of the population are mainly middle-aged and elderly, more male than female. Among them, BMI abnormalities accounted for 79.7%, the preference of greasy food accounted for 47.6%, and the carotid artery color Doppler ultrasound examination showed that the severity of atherosclerotic plaque 2-4 grade 66.7% and vascular stenosis accounted for 72.6%. In 9 kinds of single TCM constitution, Phlegm-dampness constitution and Qi-deficiency constitution are major types, followed by Static-blood constitution and yang-insufficiency constitution.2. We conducted a multivariate model to explore the association between constitution and atherosclerosis. Overall, patients with Qi-insufficiency constitution were discovered to have a significant increased risk for atherosclerosis stage 4, [OR (95% CI):4.76 (1.03-22.13)]. Compared with patients without phlegm dampness, the group who have phlegm dampness constitution associated with an increased risk for more than 1 plaque [OR (95% CI):4.35 (1.16～16.27)]. Furthermore, our present study found that patients with phlegm dampness constitution had an statistical significant increased risk for hemadostenosis, and the OR was as high as 5.20 (95% CI:1.29～20.84).3. In Wilcoxon rank test, there were no correlations of BMI between participants with different TCM constitutions (P>0.05). But the BMI of phlegm dampness population is the largest in this study.4. A significant difference for systolic pressure was found in both Qi-deficiency constitution and Static-blood constitution (P<0.05). Patients who have either Qi-deficiency constitution or Static-blood constitution have a higher level in blood pressure.5. Overall, no significant difference of blood glucose was observed in patients the common TCM constitutions (P<0.05). But the fasting blood glucose of Qi-insufficiency and phlegm dampness populations is larger than the others.6. Using t-test, patients with either Qi-insufficiency constitution or Static-blood constitution were found to have a high level in high-density lipoprotein (P<0.05). Moreover, patients with yang-insufficiency constitution has significant higher levels triglyceride (P<0.05).7. Using t-test, we found that there was statistical significance for levels of uric acid in Static-blood constitution (P<0.05).ConclusionThe trend of atherosclerosis in patients with different constitution of metabolic syndrome is also different. Overall, Phlegm dampness constitution of metabolic syndrome can promote the occurrence of atherosclerosis by influencing atherosclerotic plaque formation and restenosis, and indirectly lead to atherosclerosis with influencing the uric acid metabolism. Meanwhile, Qi-insufficiency constitution in incidence of atherosclerotic plaque is more serious, which is more likely to cause artery infarction and other life-threatening lesions. In the numerous factors of atherosclerosis, Qi deficiency and blood stasis constitution can affect systolic blood pressure levels and high density lipoprotein metabolism, while blood stasis constitution can affect the metabolism of uric acid level, and yang-deficiency constitution prefer to effect of triglyceride metabolism. They increased the risk of atherosclerosis in varying degrees, and indirectly promote atherosclerosis occurrence and development. |
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