Characteristics Of TCM Syndrome Elements Of Metabolic Syndrome With Different Syndromes Of Phlegm Syndrome And Their Relationship With FTO And SH2B3 Genes

ObjectiveTo study the characteristics of TCM syndromes and their relationship with clinical physicochemical indexes in patients with metabolic syndrome(metabolic syndrome,MS)with different types of phlegm syndrome(deficiency of yin,heat and dampness).From the point of view of traditional Chinese medicine,it provides some reference for the differentiation and treatment of MS phlegm with different syndromes;To preliminarily explore the correlation between different types of phlegm syndrome with MS and FTO and SH2B3 genes,so as to provide microscopic indexes and basis for the diagnosis of different types of phlegm syndrome with MS,and provide certain reference for the prevention and treatment of different types of phlegm syndrome with MS from the perspective of genetics.Methods1.According to the 2017 version of MS diagnostic criteria and syndrome differentiation principle,patients with MS sputum syndrome were divided into three groups,namely sputum syndrome and yin deficiency group(group B,in line with MS diagnostic criteria and sputum,yin deficiency syndrome score ? 100,heat,wet syndrome score <100),phlegm syndrome and heat group(group C,in line with MS diagnostic criteria and sputum,heat syndrome score ? 100,yin deficiency,wet syndrome score <100),phlegm syndrome and dampness group(D Group,in line with MS diagnostic criteria and sputum,wet syndrome score ? 100,yin deficiency,heat syndrome score <100),and non-MS physical examination volunteers set as a control group(group A,does not meet MS diagnostic criteria).Collect clinical data,analyze the distribution of syndromes and analyze clinical physical and chemical indicators.2.Chi-square test was used to analyze the distribution characteristics of TCM syndromes of different types of MS phlegm syndrome with multiple syndromes,and one-way anova and non-parametric test were used to analyze the correlation between different types of MS phlegm syndrome with multiple syndromes and clinical physicochemical indexes.3.The detection System of real-time Quantitative PCR(QPCR)and enzyme-linked ImmunoSorbent Assay(ELISA)were used to detect the expressions of FTO,SH2B3 mRNA and protein respectively in the whole blood and serum of human body.Results1.Basic information of each groupA total of 121 samples were included in this study,including 37 cases in group A,30 cases in group B,30 cases in group C and 24 cases in group D.There was no significant difference in age composition among the groups(P> 0.05).There were more females(89 cases)than males(32 cases)in gender composition.Frequency of common medical history: there was no statistically significant difference between groups B,C and D(P>0.05).2.Distribution of TCM syndrome elements in different types of MS phlegm syndrome(1)Integral of phlegm syndrome elements: group D> group C> group B> group A.There were significant differences between group A and other three groups(P<0.01),group D,group C and group B(P<0.01),and group D and group C(P<0.01).(2)The common disease sites were mainly distributed in spleen,liver,kidney and lung.Frequency of common disease sites in each group: Group B: lung> liver> kidney;Group C: lung> liver;Group D: spleen> lung> kidney.Frequency of each group in common disease sites: Spleen: the frequency was highest in group D,and the difference was statistically significant(P<0.01).Liver: group C> group A> group B> group D,group A,group C and D were statistically significant differences(P<0.05);Kidney: group D> group A> group B> group C;Lung: > group B> group C> group D> group A,and the differences between group B,C and A were statistically significant(P<0.01).(3)Solid disease distribution: There are mainly qi stagnation and cold,and the frequency of qi stagnation is the highest.Qi stagnation and cold: group D had the highest frequency.(4)Virtual disease distribution: Mainly for Qi deficiency and Yang deficiency.Qi deficiency and Yang deficiency: Group D had the highest frequency,which was significantly different from Group B and Group C(P<0.01).3.Comparison of Clinical Physicochemical Indicators of MS Phlegm Syndrome with Different SyndromesGroup B: SBP,ALT and GLU were all higher than the other three groups.SBP: the difference between group B and group A was statistically significant(P<0.01).ALT: the difference between group B and group A was statistically significant(P<0.05).GLU: there were statistically significant differences between group B and the other three groups(P<0.01).Group C: UA,CR and DBP were all higher than the other three groups.UA: the difference between group C and group A was statistically significant(P<0.05).CR: the difference between group C and the other three groups was statistically significant(P<0.01).DBP: the difference between group C and group A was statistically significant(P<0.01).Group D: BMI,WC,TG,TC,and LDL-C were all higher than the other three groups.BMI: the difference between group D and group B was statistically significant(P<0.05),and that between group D and group A was statistically significant(P<0.01).WC: the difference between group D and group A was statistically significant(P<0.01).4.The correlation between different types of MS phlegm syndrome with FTO ge ne and SH2B3 gene(1)Relative expression of FTO mRNA: group D> group B> group C= group A.There were statistically significant differences between group B,group D and group A(P<0.01),and between group B,group D and group C(P<0.01).(2)FTO protein expression: group D> group B> group C> group A.There were statistically significant differences between group B,group D and group A(P<0.01),and between group B,group D and group C(P<0.01).(3)Relative expression of SH2B3 mRNA: group B> group D> group C> group A.There were statistically significant differences between group A and group B(P<0.01),and between group A and group C,group D(P<0.05).(4)SH2B3 protein expression: group B> group D> group C> group A.the differences between group A and the other three groups were statistically significant(P<0.01).Conclusion1.The location distribution of MS phlegm syndrome with different types of combined syndrome mainly involves liver,spleen,lung and kidney,and the disease distribution is characterized by the mixture of deficiency and excess;2.The physical and chemical indexes of MS phlegm syndrome with different clamps(clamping Yin deficiency,clamping heat and clamping dampness)are different.SBP,ALT,GLU affect the formation of MS phlegm syndrome and Yin deficiency,UA,CR,DBP affect the formation of MS phlegm syndrome and heat,BMI,WC,TC,TG,LDL-C affect the formation of MS phlegm syndrome and dampness;3.FTO gene is related to the formation of MS phlegm syndrome with Yin deficiency and MS phlegm syndrome with dampness.SH2B3 gene is related to the formation of MS phlegm syndrome and Yin deficiency.