Stroke Risk Assessment In People With Metabolic Syndrome And The Characteristics Of Chinese Medical Evidence

Objective: To evaluate the 10-year risk of stroke onset and TCM symptoms in 970 patients with metabolic syndrome,to summarize the characteristics of changes in TCM symptoms among different stroke risk classes,and to analyze the key features in the disease development process.Methods: Physical examination data and TCM four-diagnosis information scale were collected from January 2021 to August 2022 from patients with metabolic syndrome who underwent health checkups at the Affiliated Hospital of Changchun University of Traditional Chinese Medicine.The China-PAR model was used to assess the 10-year risk of stroke onset in patients,and Jamovi 2.3 software was applied to describe the TCM Four Diagnostic Information and Physical and Chemical Indexes in 970 patients with cardiovascular and cerebrovascular disease risk population.Lantern 5.0 was applied to build a data model to categorize the TCM symptoms of patients with different cardiovascular and cerebrovascular disease classes,and summarize the TCM symptoms of different stroke risk groups after synthesizing the machine learning results and expert opinions.Results: The number and proportion of 970 patients aged 40-60 years with metabolic syndrome at 10-year low,intermediate and high risk of stroke were 333(34.33%),353(36.39%)and 284(29.28%)cases,respectively.The mean age of low-risk patients was(48.88±5.56)years.There were 147(44.14%)males and 186(55.86%)females.Total cholesterol averaged 5.39±0.68 mmol/L,which was at borderline elevated level;HDL cholesterol averaged 1.18±0.10 mmol/L;systolic blood pressure averaged 141.24±5.65 mm Hg and diastolic blood pressure averaged 90.87±6.37 mm Hg;fasting glucose 5.83±0.32mmol/L;patients taking antihypertensive drugs were 214(64.26%);145(43.54%)patients with a history of diabetes mellitus;a total of 106(31.83%)patients with a history of smoking;and 75(23.12%)patients with a family history of ASCVD.The mean age of the intermediate risk patients was(51.70±5.40)years.There were 239(67.71%)males and 114(32.29%)females.Total cholesterol averaged 5.38±0.72 mmol/L;HDL cholesterol averaged 0.98±0.11mmol/L;systolic blood pressure averaged 142.82±5.43 mm Hg and diastolic blood pressure averaged 87.18±6.35 mm Hg;fasting blood glucose 6.07±0.84 mmol/L;patients taking antihypertensive drugs were 236(66.86%)people;171(48.44%)patients with a history of diabetes mellitus;238(67.42%)cases with a history of smoking;124(35.13%)cases with a family history of ASCVD.The mean age of the high-risk patients was(50.14±6.90)years.There were 257(90.49%)males and 27(9.51%)females.Total cholesterol averaged5.66±0.66 mmol/L;HDL cholesterol averaged 0.84±0.06 mmol/L;systolic blood pressure averaged 154.35±9.09 mm Hg and diastolic blood pressure averaged 102.81±9.41 mm Hg;fasting glucose 7.11±1.05 mmol/L;patients taking antihypertensive drugs were 206(72.54%);152(53.52%)patients with a history of diabetes mellitus;a total of 192(67.61%)cases with a history of smoking;and 112(39.44%)cases with a family history of ASCVD.A total of 33 TCM symptoms were included,and 12,12 and 13 cryptic categories were obtained by stratifying the cryptic structure model.Low-risk patients with metabolic syndrome mainly presented with liver and kidney yin deficiency evidence and spleen qi deficiency evidence;intermediate-risk patients were more commonly seen with spleen deficiency and phlegm obstruction evidence and yin deficiency and fire evidence;high-risk patients were mainly with spleen and kidney deficiency evidence and liver yang hyperactivity evidence.The identification rules were established to calculate the distribution of 970 patients with metabolic syndrome among the various symptoms,and the final number of patients belonging to each symptom within each risk class was obtained.There were 137(41.14%)patients with liver and kidney yin deficiency syndrome and 121(36.34%)patients with spleen and kidney spleen deficiency syndrome;176(49.86%)patients with spleen and phlegm deficiency syndrome and 165(46.74%)patients with yin and fire deficiency syndrome;102(35.92%)patients with liver and yang hyperactivity syndrome and 101(35.56%)patients with spleen and kidney deficiency syndrome in the high-risk patients.Conclusion: The risk of stroke in patients with metabolic syndrome is at a high level.As a stroke risk group,metabolic syndrome involves mainly the liver,spleen and kidney,with Yin deficiency,Qi deficiency,phlegm(dampness),and fire(heat)as the most common pathologies.Combined with modern theoretical research views,it is concluded that deficiency is the basis for increasing the degree of stroke risk in metabolic syndrome population and contributing to its continuous development to cerebrovascular disease,with Yin deficiency and Yang hyperactivity being important manifestations of being at high risk.