Research On TCM Syndrome Types, Serum Metabolic Indexes And Breath Components Of Non-alcoholic Fatty Liver Disease

BackgroundThe incidence of nonalcoholic fatty liver disease(NAFLD)has gradually increased over these years.However,there are still a lack of non-invasion examinations with reliable specificity and sensitivity based on evidence-based studies with large samples.Both pathogenesis and pathophysiological changes of NAFLD are closely related to metabolic disorders,while the exhalation of human body carries a large amount of metabolites.When the human body suffers from diseases and the functions of organs and tissues change,the metabolites will also change,and the exhalation composition may change accordingly.At present,many studies have found that the human body's exhaled breath composition might be specifically associated with a variety of diseases,and had the potential to be applied in clinical diagnosis.Currently,there are few studies on the relationship between NAFLD disease and exhaled breath composition in the medical field,so it is of great necessity and high potential value to continue the research.ObjectiveTo explore the differences and characteristics between NAFLD patients and healthy volunteers in terms of metabolic indicators and exhaled breath composition.MethodsVolunteers were randomly recruited among the people who participated in the physical examination in the health examination center of China-Japan friendship hospital from September 2018 to March 2019.Among them,54 were diagnosed as NAFLD by MRI-PDFF and met the inclusion and exclusion criteria,and 16 healthy volunteers met the inclusion and exclusion criteria(hereinafter referred to as "NAFLD group" and "healthy group").Then,general data,bodily form data,symptom data,serum biochemical index data and exhaled breath samples were collected from all samples,and TCM syndrome differentiation was carried out according to the symptom data.In the meantime,the exhaled breath samples were determined by thermal desorption+gas chromatography-mass spectrometry(TD+GCMS)for quantitative and qualitative analysis.Finally,the obtained data information was collected and analyzed by statistical methods,and the differences between NAFLD patients and healthy volunteers were compared.Results1.General informationThere were 2 males in the healthy group(12.5%)and 33 in the NAFLD group(61.1%),and there were significant differences in age and gender between the two groups.2.Somatotype dataThe NAFLD patients had an average BMI of 28.50,an average waist-to-hip ratio of 0.91,and an average waist circumference of 97.90cm.BMI,waist-to-hip ratio and waist circumference of the NAFLD group were significantly higher than normal ranges.3.Serum biochemical indicatorsThe abnormal rates of various biochemical indicators in the NAFLD group were:ALT:31.48%,AST:7.41%,Urea:12.96%,CR:1.85%,UA:29.63%,GLU:35.19%,TC:22.22%,TG:57.41%,HDL-C:46.30%,and LDL-C:27.78%.And more than half of NAFLD patients had an abnormal TG.Therefore,it could be seen that the indicators of ALT,AST,UA,GLU,TG and LDL-C in NAFLD patients were significantly higher than those in the healthy control group,and their HDL-C was significantly lower than that in the healthy control group.4.Metabolic syndromeThere were a total of 39 patients with metabolic syndrome in the NAFLD group,accounting for 72.22%,so there was a significant difference in the proportion.5.Exhalation compositionAt first,a total of 113 substances were quantitatively and qualitatively detected in 70 samples of the two groups,and 79 substances were obtained after the combination of isomers.After adopting different statistical methods:some specific substances with a large content difference have been found,and their molecular formula may be C4H9NO?C7H7NO3.Conclusions1.Most of the patients were overweight and obese,especially abdominal obesity.The proportion of NAFLD patients with metabolic syndrome was significantly higher.2.The TCM syndrome of NAFLD patients was mainly dampness-heat.3.Serum metabolic indicators of NAFLD patients were significantly abnormal from those of healthy people.4.There were differences in the exhaled breath composition between NAFLD patients and healthy people.Currently,some specific substances with a large content difference have been found,for instance some of their molecular formula may be C4H9NO?C7H7NO3.