Study On The Characteristics Of TCM Syndrome Elements And Physicochemical Indicators Of Metabolic Syndrome With Phlegm Syndrome And Their Relations With PPAR-gamma And CDKN2A

ObjectiveTo study the characteristics of disease locations and pattern elements of the patients with phlegmpattern and non-phlegm patternin metabolic syndrome(MS),analyze thecorrelation betweenphysicochemical parameters and phlegm pattern and non-phlegm pattern in metabolic syndrome(MS),explore the correlation between phlegmpatternin MS and the expression of PPAR-gamma and CDKN2 A,reveal the TCM pathological characteristics of thephlegm patternand non-phlegm in MS,and explore the possible genetic factors for the formation of the phlegm patternin MS,to provide a theoretical basis for the Syndrome differentiation and treatment,and to enrich the etiology and pathogenesis of of the phlegm patternin MS.Methods1.MS patients were divided into MS phlegm syndrome group,MS non-phlegm sy ndrome group and non-MS group as control group according to the MS diagnostic cri teria of 2017 edition.Those who did not meet MS diagnosis were classified as contro l group.Those who met MS diagnostic criteria and whose phlegm-syndrome score wa s The subjects with phlegm syndrome element integral less than 100 were classified a s MS non-phlegm syndrome group.To compare the characteristics of TCM syndromes in the three groups.2.Measure the sex,age,height,weight,abdominal circumference and blood pressure of all subjects and calculate their body mass index(BMI).Eight hours on an empty stomach,collects their Peripheral venous blood to check blood lipid,liver function and kidney function.3.Real-time Quantitative PCR was used to detect the gene expression of PPAR-gamma and CDKN2 A.Enzyme-Linked ImmunoSorbent Assay(ELISA)was used to detect the protein expression of PPAR-gamma and CDKN2 A in serum.Results1.General information of each groupThere was no significant difference in sex between groups(P> 0.05).Generally speaking,female(111 cases)were more than male(40 cases),and female in each group were more than male.In age composition,there were significant differences between group B and group A(P< 0.01),and between group C and group A(P < 0.05).In the medicalhistory of diabetes,hypertension and gout,there was no significant difference between group B and group C(P> 0.05).2.Distribution of TCM Syndrome Factor in each group(1)Among the three groups of integral of syndrome elements in phlegm: group B > group A > group C,there were significant differences between group B and group A(P < 0.01)(2)In each group,among the common disease locations,the occurrence of frequencies in spleen,liver,kidney and lung were higher than those of heart.In group B,the occurrence of frequencies in common diseases locations were lung > liver > kidney = spleen > heart.In group C,the occurrence of frequencies in common diseases locations were liver > kidney > spleen = lung > heart.The occurrence of frequency in spleen and lung in group B was higher than that in group C.The occurrence offrequency in liver and kidney in group C was higher than that in group B.In the occurrence of frequency ofdiseaseslocationsin spleen: group B > group C,there were significant differences between group B and group C(P< 0.01);in the frequency ofdiseaseslocations inlung: group B > group C,there were significant differences between group B and group C(P < 0.01);in the frequency ofdiseaseslocations inliver: group C > group B,there was no significant difference between the two groups(P> 0.05).In the occurrence of frequency ofdiseases locations in kidney: group C > group B,there was no significant difference between the two groups(P> 0.05).In the occurrence of frequency of diseases locations inheart:group C > group B,there was no significant difference between the two groups(P > 0.05).(3)The common disease nature of syndrome elements in each group were Qi stagnation,dampness and heat.The occurrence of frequency of real common clinical manifestations in group B was heat > dampness > Qi stagnation.In group C,The occurrence of frequency of real common clinical manifestations was dampness > heat > Qi stagnation.The occurrence of frequency of heat,dampness and qi stagnation in group B was higher than that in group C.In the occurrence of frequency of heat : group B > group C,there were significant differences between group B and group C(P < 0.01);In the occurrence of frequency ofQi stagnation: group B > group C,there were significant differences between group B and group C(P< 0.01);In the occurrence of frequency ofdampness: group B > group C,there was no significant difference among groups(P > 0.05).(4)The common deficiency diseases in each group were Yin deficiency,Yang deficiency,Qi deficiency and blood deficiency.In group B,theoccurrence of frequency of each common deficiency diseases: Yin deficiency > Yang deficiency > Qi deficiency > blood deficiency.In group C,the occurrence of frequency of each common deficiency diseases: Yin deficiency > blood deficiency > Qi deficiency > Yang deficiency.The occurrence of frequency ofYin deficiency: group C > group B,there is no significant difference between the two groups(P> 0.05);The occurrence of frequency ofYang deficiency: group B > group C,there is no significant difference between the two groups(P> 0.05);The occurrence of frequency ofQi deficiency: group B > group C,there is no significant difference between the two groups(P > 0.05);The occurrence of frequency ofblood deficiency: group C > group B,there is no significant difference between the two groups(P > 0.05);3The information of physical and chemical indexes of each groupIn group A,the levels ofHDL-C and LDL-C were higher than the other two groups,and there was a significant difference between group C and group A and B(P < 0.05).In group B,the levels ofBMI,WC,SBP,DBP,ALT,AST,TG,TC,GLU and BUN were higher than those of the other two groups,and there was significant difference between group C and group A and B(P< 0.05).In group C,the levels of gamma-GT,CR and UA were higher than those of the other two groups,and there was a significant difference between group C,group B and A(P< 0.05).The level ofHDL-C in group B was lower than group C,andthe level ofLDL-C was higher than group C,and there was a significant difference between group B and group C(P< 0.05).4The gene and protein expression of PPAR-gamma in Different Groups(1)Among the three groups,the gene expression of PPAR-gamma: group B>group C>group A,and there was significant difference between group C and group A and B(P < 0.05).(2)Among the three groups,the protein expressionof PPAR-gamma:group B > group C > group A,and there were significant differences between group C and group A and B(P< 0.05).5The gene and protein expression of CDKN2 A in Different Groups(1)Among the three groups,the gene expression of CDKN2A: group B > group C > group A,and there was significant difference between group C and group A and B(P< 0.05).(2)Among the three groups,the protein expression of CDKN2A: group B > group C > group A,and there were significant differences between group C and group A and B(P< 0.05).Conclusion1.The distribution of MS phlegm syndrome is mainly related to liver,spleen,lung and kidney.The distribution of MS phlegm syndrome is characterized by deficiency and excess,mainly dampness,heat,Qi stagnation,Yin deficiency,Qi deficiency,Yang deficiency and blood deficiency.2.Increased BMI,WC,SBP,DBP,ALT,AST,TG,TC,GLU,BUN and LDL-C may increase the risk of MS phlegm syndrome formation,while increased HDL-C,gamma-GT,CR and UA may reduce the risk of MS phlegm syndrome formation.3.The high expression of PPAR-gamma and CDKN2 A may affect the formation of MS phlegm syndrome,which may be used as an index for the diagnosis of metabolic syndrome phlegm syndrome.