The Relationship Between Metabolic Syndrome And Ischemic Stroke And The Elements Of Traditional Chinese Medicine Syndromes

ObjectiveThis research is to compare the changes of metabolic syndrome(MetS)compositions of the elderly in Wangzuo town,Beijing Fengtai district in three years;and to analyze the risk factors of CIS patients of Dongfang hospital during the year 2014 to 2016,to explore the association between MetS and cerebral ischemic stroke(CIS)events;and to explore association between CIS and CIS with MetS;to initially identify the effect of Mets risk factors in the development of CIS,providing the evidence to early intervention and early prevention of cardio-cerebral vascular disease and MetS.And preliminary explore the distribution and changes of the TCM syndrome element of MetS,to providing the basis for the establishment of TCM specification.Method1.The Dongfang hospital developed the questionaire,researchers were trained in the same standard to collect information.Cases of high stroke risk selected from Wangzuo town in Beijing Fengtai district in year of both 2012 and 2015,573 cases were finally included in the study,Using the NCEP-ATP?-R diagnostic criteria,and selected 385 complete information cases which were suited for the diagnose.and had complete information.And collected all of the patients medical history data,physical examination,physical and chemical indexes and TCM four diagnostic information;The cases of retrospective study were all patients from the Dongfang hospital during 2014-2016.2.A database was established by EpiData3.1.Statistics were processed by SPSS21.0.Data Analysis with statistic methods as t test,chi-square analysis,chi-square trends analysis,correlation analysis and logistic regression model.Factor analysis was used to find out the common syndrome factors.The reasonable number of common syndrome factors and was identified according to the results of factor analysis and opinions from experts.Then,the function equations of common factors were formed,and the common factor scores were calculated.Analyze the correlation between syndrome factors and physical and chemical index.Finally,the cluster analysis was used to explore the reasonable combination of syndrome factors.Result1.Cohort Study 1.1 Analysis the different components of the Mets group and combination types of constituent ratio,Found "Obesity+hypertension+dyslipidemia" is the largest proportion,from the high to low proportion,"Obesity+high blood pressure+dyslipidemia">"obesity+dyslipidemia+ hyperglycemia">"high blood pressure+dyslipidemia+hyperglycemia">obesity+high blood pressure+hyperglycemia">"obesity+high blood pressure+dyslipidemia+hyperglycemia".1.2 Analysis the factors of the related components of Mets,three main factors are obtained,since Factor 1 has the highest variance contribution rate(19.36%),namely factor 1 is the one of the most important factor.Factor 1("high blood pressure " factor)includes two main variables:SBP and DBP;Factor 2("Obesity,fasting blood glucose,blood lipid" factor)mainly including 4 main variables:BMI,WC,FPG and HD-C;Factor 3(" fasting blood glucose,blood lipids " factor)mainly including 4 main variables:FPG,TG,HDL,LDL-C;Among them,factor 2 and factor 3 are interconnected by FPG and HDL-C.1.3 Analysis the different components of MetS with CIS group and non-CIS group,found SBP and LDL-C in the cerebral ischemic stroke(CIS)group are higher than in the non-CIS group,WC and HDL-C are lower than non-CIS group,the differences are statistically significant(P<0.01),analysis the component change of CIS group from the years of 2012 to 2015,found HDL-C is siginificant reduction(P<0.01)from the MetS combine CIS patients.1.4 The single factor logistic regression analysis of Mets and CIS's influence factors shows that the rise of blood pressure,smoking and intima thickening are the risk factors of MetS with CIS,further two classification logistic stepwise regress analysis shows that the rise of SBP and smoking are correlation with MetS in CIS.1.5 Analysis the factors of MetS group in 2012 and 2015,According to the mathematical model of calculating factor score function,calculate the common factor score of each individual and factor score of each individual,obtained the factor distribution,the result shows MetS's main disease syndrome factors are Liver,Spleen and Kidney,the main symptom factor of disease nature can be divided into two categories:empirical symptom and deficiency syndrome.The empirical symptom including the qi stagnation,blood stasis,phlegm dampness and heat excess,the deficiency symptom including the Yin,Yang and Qi deficiency;With the highest percentage of qi deficiency.MetS has the characteristic of intermingled empirical and deficiency syndrome.MetS group in 2012 with the highest percentage of qi deficiency(36.6%),then phlegm dampness(23.7%),heat excess(21.1%),Yin deficiency(8.4%),blood stasis(7.6%),qi stagnation(2.6%);MetS group in 2015 with the highest percentage of qi deficiency(36.3%),then heat excess(19.5%),yin deficiency(16.8%),blood stasis(9.5%),phlegm dampness(8.9%),qi stagnation(8.9%).There are Statistically significant differences(P<0.01)between the distribution of phlegm dampness,yin deficiency and qi stagnation in 2012 and 2015.Age and blood stasis are positive correlated,HDL-C reduction and qi deficiency,qi stagnation,blood stasis are positivce correlated.2.Retrospective study results2.1 The MetS group and non-MetS group were all had higher rate in prevalence of CIS during the age of 51-60,The MetS group were all had higher rate in prevalence than MetS during age of 51-70,The non-MetS group were all had higher rate in prevalence than non-MetS after 71 years old.The peak of incidence of CIS advanced in MetS group than in non-MetS group,the prevalence of CIS in MetS group is showed gradually younger trend.2.2 The family medical history of hypertension,diabetes in MetS group had larger number than non-MetS group,the difference with statistical significance,MetS group had a family aggregation tendentiousness.2.3 The pacients with 3 or more than 3 anomalous components are more susceptible to getting CIS than the pacient with less than 3 anomalous components.2.4 The result of single factor logistic regression analysis showed that,The family medical history of diabetes(OR=6.281,P=0.002)were the risk factors of CIS with MetS.TG(OR=4.295),FPG(OR=1.662)were risk factors of CIS with MetS,HDL-C(OR=0.277)is the protective factor.Conclusion1.The conclusion of the cohort study1.1 "Obesity+hypertension+dyslipidemia" group have the largest proportion in MetS group.1.2 The core factor in MetS group component is "blood pressure";with FPG and HDL-C,"obesity,FPG and blood lipid" factors and "FPG,blood lipid" factors are interrelated,each factor can not individual explain all metabolic disorder in MetS,it shows MetS have a complicated pathophysiologic mechanism,may results from combined interaction of obesity,IR and nflammatory response.1.3 In MetS with CIS group,lower HDL-C were the most risk factors;Smoking,BP and intimal thickening were risk factors of MetS with CIS;vegetables eating were protective factors of MetS with CIS.Smoking and SBP were associated with CIS.1.4 The characteristics of TCM syndrome of MetS was deficient root and excessive superficial,intermingled deficiency and excess,and was mainly manifested as phlegm and blood stasis,which was rooted in Qi deficiency and Yin deficiency.As the disease progresses,the proportion of Yin deficiency,phlegm and excessive heat gradually decreased.the proportion of yin deficiency,blood stasis gradually increased.It had no difference in gender factor distribution.1.5 Low level of HDL-C was positively correlated with Qi deficiency,Qi depression and blood stasis,the higher the degree is,the greater the changes will be in HDL-C.2.The conclusions of retrospective study2.1 The peak of incidence of CIS advanced in MetS group than in non-MetS group,the prevalence of CIS in MetS group is showed gradually younger trend.2.2 The proportion of hypertension and diabetes of family medical history owned the largest number in MetS group than non-MetS group,the MetS has a tendency of familial aggregation.2.3 The pacients with 3 or more than 3 anomalous components are more susceptible to getting CIS than the pacient with less than 3 anomalous components.2.4 The Increased in TG,FPG were risk factors of CIS with MetS,the increased in HDL-C is the protective factor.