A Comparative Study Of Serum Metabolic Group Between Phlegm Syndrome And Non-phlegm Syndrome In Patients With Metabolic Syndrome

Objective:Obtaining differential metabolites of patients with metabolic syndrome(MS)on phlegm and non-phlegm syndromes and exploring possible biomarkers and key metabolic pathways of phlegm syndromes in MS,which is not only the early detection of phlegm syndromes in MS,diagnosis and design of conditioning programs to provide a micro-mechanism and basis,but also enrich the scientific connotation of the formation of phlegm syndromes in MS,and provide reference to the essence of TCM syndromes.Methods:Using the method of syndrome differentiation to carry out western medicine diagnosis and syndrome factor extraction of subjects from TCM health management center in the Third People's Hospital of Fujian University of TCM and the department of endocrinology in Jinjiang Hospital of TCM Affiliated to Fujian University of TCM.When people was diagnosed with MS and his or her phlemg syndrome score>100,he or she would be classified as MS phlegm syndrome group.When people was diagnosed with MS and his or her phlemg syndrome score<100,he or she would be classified as MS non-phlegm syndrome group and healthy individuals collected over the same period were classified as healthy group.Each group with 30 individuals.Serum samples of three groups were collected and their metabolites were detected by 1H NMR and compared with each other.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)would be used to find potential biomarkers and different metabolites in phlegm syndrome of MS and different metabolites in non-phlegm syndrome of MS.Logging into the Kyoto Gene and Genome Encyclopedia(KEGG)Pathway database find metabolic pathways that involve the formation of phlegm syndrome in MS.Results:1.Compared with the healthy group,the differential metabolites in serum of MS phlegm syndrome group were:VLDL(CH3-(CH2)n-),a-glucose,(3-glucose,Ethanol,1-Methylhistidine,3-Hydroxybuyarate,Acetate,Acetoacetate,Alanine,Choline,Citrate,Creatine,Dimethylamine,Ethanolamine,Glutamate,Glutamate&Glutamine,Glutamine,Glycerol,Glycine,Isobutyrate,Isoleucine,LDL(CH3-(CH2)n-),Leucine,Lipid(-CH2-CH=CH-,= CH-CH2-CH-),Lysine,Malonate,Methanol,Methoinine,myo-Inositol,N,N-Dimethylglycine,N-Acetylglycoprotein,Phenylalanine,Phosphocholine,Sarcosine,Threonine,Trimethylamine N-oxide,Tyrosine,Valine.2.MS non-phlegm syndrome group compared with the healthy group,the differential metabolites in the serum are:Acetate,Acetone,Ethanol,Glycerol,Glycine,?-glucose,3-Hydroxybuyarate,Acetoacetate,Citrate,Creatine,Dimethylamine,Ethanolamine,Glutamate,Glutamine,Isobutyrate,Isoleucine,LDL(CH3-(CH2)n-),Leucine,Lipid(-CH2-CH=CH-),Lysine,Malonate,Methanol,Methoinine,myo-Inositol,N,N-Dimethylglycine,N-Acetylglycoprotein,Phenylalanine,Phosphocholine,Threonine,Trimethylamine N-oxide,Tyrosine,Valine,VLDL(CH3-(CH2)n-).3.Compared with non-sputum syndrome group and healthy group,the potential biomarkers of MS phlegm syndrome group were:Alanine,lipid(=CH-CH2-CH-),Sarcosine.4.KEGG database was accessed to search for differential metabolites of MS phlegm syndrome.Ten metabolic pathways were obtained,including digestion and absorption of protein,ATP-binding cassette transporter,carbon metabolism,glycine,serine,threonine metabolism,glycolysis/gluconeogenesis,lipid Metabolism,arginine and proline metabolism,thiamine metabolism,glucose metabolism,tricarboxylic acid cycle.These metabolic pathways are mainly involved in energy metabolism,glucose metabolism,lipid metabolism,amino acid metabolism,enrich the biological connotation of the formation of MS sputum syndrome.5.KEGG database was accessed to search for differential metabolites of MS non-phlegm syndrome.Eight metabolic pathways were obtained,including digestion and absorption of protein,ATP-binding cassette transporter,carbon metabolism,glycolysis/gluconeogenesis,lipid Metabolism,thiamine metabolism,glucose metabolism,tricarboxylic acid cycle.Due to the overlapping of the metabolic pathways of the MS phlegm syndrome,it was not able to highlight the differences very well.Therefore,after re-comparison and removing the overlapping part,five pathways were obtained,including lipid metabolism,glycolysis/gluconeogenesis,thiamine metabolism,glucose metabolism,tricarboxylic acid cycle.These metabolic pathways mainly involve energy metabolism,glucose metabolism,and lipid metabolism.Conclusions:Compared with healthy individuals,,MS phlegm syndrome patients have differences in energy metabolism,glucose metabolism,lipid metabolism and amino acid metabolism.Compared with healthy individuals and MS phlegm symdrome patients,MS non-phlegm syndrome has metabolic characteristics in energy metabolism,glucose metabolism,and lipid metabolism,and can infer its possible TCM pathological factors.Patients with phlegm syndrome of metabolic syndrome are more severe in energy metabolism and glucose metabolism than those without phlegm.