A Study of Traditional Chinese Medicine Body Constitution Associated with Overweight, Obesity, and Underweight

Investigating the Gut Microbiota Profile in Prehypertensive Individuals Exhibiting Phlegm-Dampness Constitution

Background

Prehypertension is the preclinical stage of hypertension, which is more likely to develop into hypertension than normal blood pressure. Although the body may experience pathological changes at this stage, there are often no symptoms. Chinese medicine constitution theory is widely used to assess an individual's health and disease status, which provides a new method for disease prevention. The phlegm-dampness constitution (PDC) is the main constitution in prehypertension. Dysbiosis of the intestinal flora is considered to be related to the development of hypertension. However, the characteristics of the intestinal flora in prehypertensive populations with PDCs are still unknown.

Methods

16S rRNA gene sequencing of fecal samples was performed in this study, which included 30 prehypertensive subjects with PDCs, 30 nonphlegm-dampness constitution (NPDC) prehypertensive individuals with balanced constitution, and 30 ideal blood pressure subjects with balanced constitution (BC). On the basis of the composition of the intestinal flora, a random forest classifier was constructed to screen the specific bacteria of the prehypertensive PDC population, and the diagnostic efficiency was determined by the area under the curve (AUC).

Results

At the phylum level, the abundance of Bacteroidetes decreased in the PDC group compared with the NPDC group. Bacteroides was the most important genus at the genus level. Compared with those in the NPDC or BC group, the relative abundances of o_RF39, f_Porphyromonadaceae, f_Christensenellaceae, g_parabacteroides, and g_nitrobacteria in the PDC group were significantly greater. The random forest analysis results revealed that Alistipes, Butyricimonas, Odoribacter, Parabacteroides, and Corynebacterium are bacterial genera that significantly differ between the PDC and NPDC groups and greatly contribute to group differentiation. Receiver operating characteristic (ROC) analysis revealed that the AUC range of differential bacteria and its combined diagnostic model ranged from 0.653 (95% CI: 0.511-0.794) to 0.706 (95% CI: 0.573-0.838), suggesting that it is a potential risk marker for phlegm-dampness constitution with prehypertension.

Conclusions

Our study indicates that PDC individuals with prehypertension can be distinguished from NPDC individuals according to their gut microbiome characteristics. Prevention and treatment measures based on these biomarkers may be beneficial in opening new ideas and directions for identifying more aggressive and effective interventions for prehypertensive populations.

Objective Analysis of Traditional Chinese Medicine Syndrome Differentiation of Patients With Diabetes and Prediabetes: Protocol for a Nonrandomized, Exploratory, Observational Case-Control Study Using Digitalized Traditional Chinese Medicine Diagnostic Tools

BACKGROUND

Diabetes and prediabetes are diagnosed differentially by Western and Chinese medicine. While Western medicine uses objective laboratory analysis of biochemical parameters to define the severity of diabetes and prediabetes, Chinese medicine uses a comprehensive approach that integrates observation, inquiry, pulse palpation, and tongue diagnosis. The medical information collected is then categorized into different syndromes. However, traditional methods of pulse and tongue diagnoses used to determine syndrome differentiation are highly subjective and skill dependent.

OBJECTIVE

This study aims to identify the gap in conventional traditional Chinese medicine (TCM) diagnostic techniques for syndrome differentiation analysis using contemporary diagnostic devices. We devised a protocol for a nonrandomized, exploratory, observational case-control study with equal allocations in 5 arms to investigate the syndrome differentiation of diabetes and prediabetes. We hypothesize that the TCM syndrome differentiation of diabetes and prediabetes in the tropical climate may differ from that defined based on the Chinese demographic. We also speculate that the high-frequency spectral energy may reflect a difference in pulse wave intensity and density between the healthy and diabetes groups.

METHODS

A total of 250 eligible participants will be equally assigned to 1 of 5 arms (healthy or subhealthy, prediabetes, diabetes, prediabetes with hypertension and dyslipidemia, and diabetes with hypertension and dyslipidemia). Participants aged 21-75 years, of any sex or race, and have been diagnosed with diabetes (fasting plasma glucose [FPG] of 7 mmol/L, or 2-hour plasma glucose [2hPG] of 11.1 mmol/L) or prediabetes (impaired FPG of 6.1-6.9 mmol/L, or impaired glucose tolerance with an 2hPG of 7.8-11 mmol/L) will be included. The Health Evaluation Questionnaire, Physical Activity Questionnaire, sugar intake assessment, Constitution in Chinese Medicine Questionnaire, radial pulse diagnosis, and tongue diagnosis will be performed in a single visit. ANOVA for continuous data and chi-square tests of independence will be used for categorical data assessments, with a level of P<.05 considered significant.

RESULTS

The recruitment is in progress. We anticipate that the study will conclude in June 2025. As of July 15, 2024, we have enrolled 140 individuals.

CONCLUSIONS

To the best of our knowledge, this is the first study to use contemporary TCM diagnostic instruments to map expert and empirical knowledge of TCM to its scientific equivalents for the purpose of evaluating the syndrome differentiation of diabetes. We designed this protocol with the exploratory goal to examine objectively the syndrome differentiation of patients with diabetes and those with prediabetes using TCM diagnostic technologies. The data collected and evaluated under standardized conditions using these contemporary diagnostic devices will exhibit a higher degree of stability, hence yielding dependable and unbiased results for syndrome differentiation. Thus, our findings may potentially increase the accuracy of identification, diagnosis, treatment, and prevention of diabetes and prediabetes through a system of targeted treatment.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05563090; https://clinicaltrials.gov/ct2/show/NCT05563090.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56024.

Associations between traditional Chinese medicine body constitution and obesity risk among US adults

Background

Traditional Chinese medicine (TCM) body constitution (BC), primarily determined by physiological and clinical characteristics, is an important process for clinical diagnosis and treatment and play a critical role in precision medicine in TCM. The purpose of the study was to explore whether the distributions of BC types differed by obesity status.

Methods

We conducted a study to evaluate BC type in US population during 2012-2016. A total of 191 White participants from Personalized Prevention of Colorectal Cancer Trial (PPCCT) completed a self-administered Traditional Chinese Medicine Questionnaire (TCMQ, English version). In this study, we further compared the distribution of major types of TCM BC in the PPCCT to those Chinese populations stratified by obesity status.

Results

We found the Blood-stasis frequency was higher in US White adults, 22.6% for individuals with BMI <30 and 11.2% for obese individuals, compared to 1.4% and 1.8%, respectively, in Chinese populations. We also found the percentages Inherited-special and Qi-stagnation were higher in US White adults than those in Chinese populations regardless of obesity status. However, the proportions of Yang-deficiency were higher in Chinese populations than those in our study conducted in US White adults regardless of obesity status.

Conclusions

These new findings indicate the difference in distribution of BC types we observed between US and Chinese populations cannot be explained by the differences in prevalence of obesity. Further studies are needed to confirm our findings and understand the potential mechanism including genetic background and/or environmental factors.

DIA-PRM Proteomic Analysis of Phlegm-Dampness Constitution with Glucolipid Metabolic Disorders by the Intervention of Hua Tan Qu Shi Recipe

Background

Phlegm-dampness constitution as one of nine constitutions in traditional Chinese medicine (TCM) has been a high risk factor for glucolipid metabolic disorders (GLMD). Based on our previous findings, Hua Tan Qu Shi recipe (HTQSR) could effectively improve metabolic indicators of GLMD by targeting on phlegm-dampness constitution. However, the proteomic mechanisms of GLMD with the treatment of HTQSR targeting on phlegm-dampness constitution remain unknown.

Methods

Clinical participants from phlegm-dampness constitution with the prediabetic state (T), phlegm-dampness constitution with marginally elevated blood lipids (Z), and phlegm-dampness constitution before sickness (W) were included in this study, who orally took HTQSR for 12 weeks and, respectively, marked AT, AZ, and AW. Data-independent acquisition (DIA) and parallel reaction monitoring (PRM) were performed to identify the differential proteins; then, Venn analysis was used to investigate coexpressed and coregulated proteins. In addition, ingenuity pathway analysis (IPA) software was utilized to explore the related pathways and diseases and biofunctions.

Results

LXR/RXR activation, acute phase response signaling, and production of nitric oxide and reactive oxygen species in macrophages were obviously activated between the T and AT groups, as well as the Z and AZ groups. In contrast, these three pathways were inhibited between the W and AW groups. Importantly, one coexpressed and coregulated differential protein, B2MG, was validated by PRM among all groups.

Conclusions

This work firstly reported the underlying proteomic mechanisms of GLMD with the treatment of HTQSR targeting on phlegm-dampness constitution, indicating that intervention of phlegm-dampness constitution might be a novel strategy for the preventive treatment of GLMD.

Different traditional Chinese medicine constitution is associated with dietary and lifestyle behaviors among adults in Taiwan

The World Health Organization states prevention of chronic diseases should be based on good lifestyle behaviors and healthy diets as they can reduce the risk of chronic diseases by 80%. The theory of traditional Chinese medicine constitution (TCMC) emphasizes the congenital differences of TCMC stem from the genes of parents, while acquired differences in TCMC are caused by factors as living environments, lifestyle behaviors, and dietary habits. From the perspective of preventive medicine, this study explores the correlation between dietary habits and lifestyle behaviors as potential risk factors for different types of TCMC-balanced constitution, Yang deficiency, Yin deficiency, and Phlegm stasis. Research data were collected from 2760 subjects aged 30 to 70 years participating in a survey conducted by Taiwan Biobank in 2012 to 2017. The survey included basic demographic characteristics, lifestyle behaviors, and dietary habits along with a Body Constitution Questionnaire. Compared to men, women were 3 to 4 times more likely to develop Yang-deficiency, Yin-deficiency, and Phlegm stasis. Variables that affected TCMC were smoking, midnight snack consumption, consumption of gravy-soaked or lard-soaked rice/noodles, deep-fried soybean products, bread spread, pickled vegetables as side dishes for the main course of a meal, and the dietary habit of vegetables or fruits instead of high-fat desserts. Poor dietary habits and lifestyle behaviors are the cause of unbalanced TCMCs. Understanding the specific TCMC of individual can provide useful information and predictions to maintain physical health and achieve early disease prevention to meet the goal of preventive medicine.

Effects of Chinese medicine for COVID-19 rehabilitation: a multicenter observational study

Objectives

This study aimed to evaluate the effects of Chinese Medicine (CM) on the health condition of the post-COVID-19 patients, particularly with the CM Syndrome diagnosis and Body Constitutions (BC), as well as related clinical characteristics.

Methods

150 participants who had COVID-19 and discharged from Hong Kong public hospitals were recruited. They were provided with three to six months of CM treatments, during which assessments were made per month and at follow-up on their CM syndromes, BC, lung functions, and other medical conditions. This study was divided into two parts: (1) Retrospective survey: medical history of participants during COVID-19 hospitalization was collected during the baseline visit; (2) Prospective observation and assessments: clinical symptoms, lung functions, and BC status were evaluated in participants receiving CM treatment based on syndrome differentiation and clinical symptoms.

Results

The median hospitalization period was 16 days. Symptoms were presented in 145 (96.6%) patients at the day they were diagnosed with COVID-19. Fever, fatigue, and dry cough were the most common symptoms, exhibiting in 59.3% (89 of 150), 55.3% (83 of 150), and 46% (70 of 150) participants, respectively. Among the 150 post-COVID patients, majority (71.3%) were of the two particular post-COVID CM Syndromes (Qi Deficiency of Lung and Spleen, and Qi and Yin Deficiency). Upon CM treatment, there was an observable increase in participants reaching a balanced BC (i.e. healthy body conditions). The increase was observed to be more prominent in those without the particular CM Syndromes compared to those with the CM Syndromes. Main clinical symptoms in participants with the CM Syndromes decreased upon CM treatment. Occurrence of fatigue also dropped after CM treatment though not all accompanied clinical symptoms were resolved fully. Further to the improvement in terms of CM assessments, lung functions of the participants were found to show improvement after treatment. Both the performance in 6MWT and scores in the LFQ improved upon CM treatments (P < 0.05).

Conclusion

This study provided evidence for individualized CM treatment on COVID-19 rehabilitation concerning the clinical symptoms improvements, lung functions improvement, and achieving a balanced BC. It is believed that CM may be a key to further promote rehabilitation and resolution of residual symptoms. Long-term large scale follow-up studies on sub-categorising post-COVID patients according to different CM syndromes would be required to further elucidate treatment of persistent symptoms that may be associated with long-COVID.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13020-022-00654-z.

Comparison between Traditional Chinese Medicine Constitution and Blood Biochemical Markers Associated with Left and Right Mammary Hyperplasia in Rural Areas of Southwest China

Background

Hyperplasia of mammary glands (HMG) is the breast disease with the highest clinical incidence. Many traditional Chinese medicine (TCM) doctors suggest that the treatment of HMG should be based on the left and right breast pain difference. However, these views are based on case reports, and an objective basis has not been established for treatment according to left-side and right-side differences.

Methods

We enrolled 150 patients who met the clinical diagnostic criteria of HMG. The incidence bias was determined according to the score difference between bilateral breast pain and mass in patients with HMG. A left group, right group, and bilateral group were included, and TCM constitution was investigated in each group. Blood biochemical indicators were measured for 120 fasting patients. We conducted a network pharmacology study of the key herb qingpi and chenpi, which are used by TCM doctors to treat different lateral HMG.

Results

In patients with biased onset of HMG, the results showed that the frequency and constitution score of stagnant blood in the L group were higher than those of the R group, and the frequency and constitution score of phlegm-dampness in the R group were higher than those of the L group. Both the L and R groups had high proportion of stagnant Qi. The results indicated that the concentration of coagulation factor VIII (FVIII) was higher in the L group than that in the R group, and the concentration of lipoprotein a (Lp-α) was higher in the R group than that in the L group. The results showed that sinensetin and neohesperidin contained in qingpi might interfere with platelet activation, thrombogenesis, prolactin signaling pathway, and atherosclerosis process, in removing “blood stasis” and eventually treating the left-leaning group of HMG patients. Sitosterol and citromitin contained in chenpi could regulate lipid metabolism by interfering with regulation of lipolysis in adipocytes, salivary secretion, estrogen signaling pathway, and thyroid hormone signaling pathway. Chenpi could eliminate “phlegm turbidity” and treat HMG patients in the right-leaning group.

Conclusions

We preliminarily confirmed that the clinical pathogenesis of HMG is not a left-right equilibrium and TCM constitution, coagulation function, and lipid metabolism may be used as the objective basis for the difference between the left and right in HMG pathogenesis. For left-sided HMG patients, the doctor can consider qingpi, herb of activating blood and removing stasis, to treat HMG. However, for right-sided HMG, we think doctors should apply herb of activating Qi and eliminating phlegm, such as chenpi.

Traditional Chinese Medicine Constitution Identification Based on Objective Facial and Tongue Features: A Delphi Study and a Diagnostic Nomogram for Blood Stasis Constitution

Objective

The aim of this study was to systematically summarize and form an expert consensus on the theoretical experience of tongue and facial features for the identification of nine types of traditional Chinese medicine (TCM) constitution. Additionally, we sought to explore the feasibility of TCM constitution identification through objective tongue and facial features.

Methods

We used Delphi method to investigate the opinions of experts on facial and tongue feature items for identifying TCM constitution. We developed and validated a diagnostic nomogram for blood stasis constitution (BSC) based on objective facial and tongue features to demonstrate the reliability of expert consultation.

Results

Eleven experts participated in two rounds of expert consultation. The recovery rates of the two rounds of expert consultation were 100.0% and 90.9%. After the first round, 39 items were screened out from 147 initial items, and 2 items were supplemented by experts. In the second round, 7 items were eliminated, leaving 34 items for 8 types of TCM constitution. The coefficient of variation in the first round was 0.11–0.49 for the 147 items and 0.11–0.29 for the included items. The coefficient of variation in the second round was 0.10–0.27 for the 41 items and 0.10–0.20 for the included items. The W value was 0.548 (P < 0.001) in the first round and 0.240 (P < 0.001) in the second round. Based on expert consultation, we selected BSC as an example and developed and validated a diagnostic nomogram consisting of six indicators: sex, hair volume, lip color-dark purple, susceptibility-facial pigmentation/chloasma/ecchymosis, zygomatic texture-red blood streaks, and sublingual vein-varicose and dark purple. The nomogram showed good discrimination (AUC: 0.917 [95% confidence interval [CI], 0.877–0.956] for the primary dataset, 0.902 [95% CI, 0.828–0.976] for the validation dataset) and good calibration. Decision curve analysis demonstrated that the nomogram was clinically useful.

Conclusion

This is the first study to systematically summarize the existing knowledge and clinical experience to form an expert consensus on the tongue and facial features of nine types of TCM constitution. Our results will provide important prior knowledge and expert experience for future constitution identification research. Based on expert consultation, this study presents a nomogram for BSC that incorporates objective facial and tongue features, which can be conveniently used to facilitate the individualized identification of BSC.

Effect of Hedan Tablets on Body Weight and Insulin Resistance in Patients with Metabolic Syndrome

INTRODUCTION

Apart from their recognized lipid-lowering effect, Hedan tablets, a mixture of Chinese herbal medicines, have demonstrated a certain weight-loss effect in clinical practice. The aim of this randomized, double-blind, placebo-controlled study was to verify the effect of Hedan tablets on body weight (BW) and insulin resistance (IR) in patients with metabolic syndrome (MetS).

METHODS

A total of 62 eligible patients with MetS were divided into two groups: the treatment group (Hedan tablets at 4.38 g/day tid) and the control group (placebo treatment). Both groups attended follow-ups at 8, 16, and 24 weeks during the process. The parameters of the assessment include lipid level, BW, triglyceride (TG) to high-density lipoprotein cholesterol (HDLc) ratio (TG/HDLc), homeostasis model assessment for IR (HOMA-IR) index, and adiponectin.

RESULTS

Patients in the treatment group showed a significant decrease in BW compared to those in the control group (-4.47 vs. 0.06 kg) after 8 weeks of treatment. A significant decrease in body mass index (BMI) was also observed in the treatment group after 16 weeks of treatment (-1.79 vs. -0.03 kg/m2). In the treatment group, 20 out of 31 (64.5%) patients lost 5-10% BW and 4 out of 31 (12.9%) patients lost over 10% BW after 24 weeks of treatment. Although there were no significant changes in the patients' HOMA-IR, the treatment group showed a significant reduction in TG/HDLc (-0.98 vs. -0.19) after 8 weeks of treatment and a significant increase in adiponectin (6.87 vs. -0.43) after 16 weeks of treatment.

DISCUSSION/CONCLUSION

The Hedan tablets significantly improve BW, BMI, TG/HDLc, and adiponectin in patients with MetS. Thus, Hedan tablets may be used as an adjunct to existing MetS management methods.

Epigenetic Studies of Chinese Herbal Medicine: Pleiotropic Role of DNA Methylation

Accumulating knowledge has been achieved on DNA methylation participating in numerous cellular processes and multiple human diseases; however, few studies have addressed the pleiotropic role of DNA methylation in Chinese herbal medicine (CHM). CHM has been used worldwide for the prevention and treatment of multiple diseases. Newly developed epigenetic techniques have brought great opportunities for the development of CHM. In this review, we summarize the DNA methylation studies and portray the pleiotropic role of DNA methylation in CHM. DNA methylation serves as a mediator participating in plant responses to environmental factors, and thus affecting CHM medicinal plants growth and bioactive compound biosynthesis which are vital for therapeutic effects. Furthermore, DNA methylation helps to uncover the pharmaceutical mechanisms of CHM formulae, herbs, and herbal-derived compounds. It also provides scientific validation for constitution theory and other essential issues of CHM. This newly developed field of DNA methylation is up-and-coming to address many complicated scientific questions of CHM; it thus not only promotes disease treatment but also facilitates health maintenance.

A Meta-Analysis of the Association between Diabetes Mellitus and Traditional Chinese Medicine Constitution

Objective

To explore the distribution of constitution types of diabetes mellitus (DM) in traditional Chinese medicine (TCM) and to provide evidence-based medicine basis for the prevention and treatment of diabetes.

Methods

PubMed, Embase, Web of Science, and three Chinese databases were searched to include research literature on the relationship between diabetes and TCM constitution. The single rate study of cross-sectional literature was conducted with RStudio software, and the control meta-analysis of the diabetic and nondiabetic population was performed with Review Manager 5.3 software. Two independent reviewers assessed the methodological quality of the studies' data. The main outcomes included the distribution of constitutional types in the diabetic population and the odds ratio (OR) between the two. Effect sizes are expressed as proportions or ORs with 95% confidence intervals (CI).

Results

A total of 28,781 diabetic cases were included in 87 articles. Yin-deficiency, phlegm-dampness, and qi-deficiency accounted for 18% (95% CI (15%, 20%), P < 0.01), 17% (95% CI (15%, 19%), P < 0.01), and 13% (95% CI (11%, 15%), P < 0.01) of the total diabetic cases. The risk of diabetes in people with yin-deficiency and phlegm-dampness was 3.06 (95% CI (1.38-6.78), P=0.006) and 1.89 (95%CI (1.05-3.42), P=0.03) times higher than that in those with other constitutions, respectively. The distribution of TCM constitution of DM patients varied significantly in different regions and ages.

Conclusion

Yin-deficiency and phlegm-dampness are the common constitution types of diabetic people, and they may also be the risk factors of diabetes. Balanced constitution may be a protective factor of diabetes. More high-quality cohort and case-control studies need to be designed to provide more valuable evidence-based basis for assessing the correlation between DM and TCM constitution.

Association of Traditional Chinese Medicine Body Constitution and Health-Related Quality of Life in Female Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study

Background

Traditional Chinese medicine (TCM) body constitution has been studied in many diseases, but few have focused on systemic lupus erythematosus (SLE) and particularly their association with disease-specific quality of life (QoL). Therefore, the aim of this study was to investigate the association of TCM body constitution and QoL in female patients with SLE.

Methods

A cross-sectional study was conducted on adult female patients with a clinician-confirmed diagnosis of SLE in a regional hospital in Taiwan. TCM body constitution types were determined using the Constitution in Chinese Medicine Questionnaire (CCMQ). Disease-specific QoL of the participants was assessed using the LupusQoL. Multiple linear regression analyses were conducted to assess the associations between TCM body constitution types with the score of each of the eight domains of LupusQoL and between the numbers of multiple unbalanced body constitution types and score of each of the eight domains of LupusQoL.

Results

Of the 317 female patients with SLE, 22 (6.9%) were classified to have a gentleness balanced body constitution type. Among the remaining 295 patients with unbalanced body constitution types, Qi-deficiency was the most common (64.4%), followed by Yin-deficiency (57.6%). Multiple linear regression analyses showed that Qi-deficiency was significantly associated with the emotional, pain, and fatigue domains of the LupusQoL, whereas Yin-deficiency was significantly associated with the emotional and fatigue domains of the LupusQoL. In addition, all domains of the LupusQoL showed a general pattern of poorer QoL with increasing numbers of unbalanced body constitution types.

Conclusions

Different TCM body constitution types were significantly associated with various domains of the LupusQoL. A high prevalence of multiple body constitution types in patients with SLE was observed. A consistent pattern of poorer LupusQoL with increasing numbers of unbalanced body constitution types was evident.

The Relationships between Leptin, Genotype, and Chinese Medicine Body Constitution for Obesity

Methods

The adults with body mass index (BMI) more than 27 kg/m² were enrolled in the study. General personal information, physical condition, TCMBC, biochemical, and SNPs were collected for eligible subjects. The body constitution questionnaire (BCQ) was used to evaluate the relationships between TCMBC tendency, biochemical values, and obesity-related SNPs.

Results

Obesity patients tended to have a yin deficiency constitution (YinDC) (n = 33, 66.0%); however, TCMBC in combination is not uncommon (30 subjects with more than two TCMBC in combination). For biochemical profiles, leptin was higher among patients with yang deficiency constitution (YangDC) (YangDC versus non-YangDC: 29.7 ± 24.8 versus 15.9 ± 9.9, P=0.020) and YinDC (YinDC versus non-YinDC: 28.8 ± 23.5 versus 14.4 ± 9.6, P=0.020). The leptin level was highest among YangDC subjects. Higher leptin was found among subjects with three-combined TCMBC than balanced TCMBC subjects who were not inclined to any of three TCMBC. For obesity-related SNPs, the adrenergic receptor beta-3 (ADRB3) gene tended to be high expression among YangDC (YangDC versus non-YangDC: 89.7% versus 71.4%, P=0.091) and uncoupling protein 1 (UCP1) tended to be high expression among phlegm-stasis constitution (PSC) (PSC versus non-PSC: 37.9% versus 9.5%, P=0.052).

Conclusions

The relationships between TCMBC, leptin, and SNPs present alternative viewpoints about TCMBC and could be used as a guide to treat obese patients.

Application of Artificial Intelligence in the Establishment of an Association Model between Metabolic Syndrome, TCM Constitution, and the Guidance of Medicated Diet Care

Background

This study conducted exploratory research using artificial intelligence methods. The main purpose of this study is to establish an association model between metabolic syndrome and the TCM (traditional Chinese medicine) constitution using the characteristics of individual physical examination data and to provide guidance for medicated diet care.

Methods

Basic demographic and laboratory data were collected from a regional hospital health examination database in northern Taiwan, and artificial intelligence algorithms, such as logistic regression, Bayesian network, and decision tree, were used to analyze and construct the association model between metabolic syndrome and the TCM constitution. Findings. It was found that the phlegm-dampness constitution (90.6%) accounts for the majority of TCM constitution classifications with a high risk of metabolic syndrome, and high cholesterol, blood glucose, and waist circumference were statistically significantly correlated with the phlegm-dampness constitution. This study also found that the age of patients with metabolic syndrome has been advanced, and shift work is one of the risk indicators. Therefore, based on the association model between metabolic syndrome and TCM constitution, in the future, metabolic syndrome can be predicted through the syndrome differentiation of the TCM constitution, and relevant medicated diet care schemes can be recommended for improvement.

Conclusion

In order to increase the public's knowledge and methods for mitigating metabolic syndrome, in the future, nursing staff can provide nonprescription medicated diet-related nursing guidance information via the prediction and assessment of the TCM constitution.

Treatment with the traditional Chinese medicine BuYang HuanWu Tang induces alterations that normalize the microbiome in ASD patients

Autism spectrum disorders (ASDs) are prevalent neurobiological conditions with complicated causes worldwide. Increasing researcher awareness of ASD and accumulated evidence suggest that the development of ASD may be strongly linked to the dysbiosis of the gut microbiota. In addition, most of the current studies have compared autistic children and neurotypical children or have compared ASD patients before and after antibiotic treatment. Treatment of autism with traditional Chinese medicine (TCM) has increasingly been promoted, but the relationship between its efficacy and intestinal flora has rarely been reported. Under the premise that treatment with the TCM BuYang HuanWu Tang is effective, we conducted a comparative bioinformatics analysis to identify the overall changes in gut microbiota in relation to ASD by comparing the intestinal flora before and after treatment with TCM and contrasting the intestinal flora with that of healthy controls. At the phylum level, Proteobacteria showed a significant increase in children with ASD, which may be a signature of dysbiosis in the gut microbiota. At the genus level, Blautia, Coprococcus 1, the Lachnospiraceae family, and the Ruminococcaceae family were found at the lowest levels of relative abundance in children with ASD, whereas the abundances of Escherichia-Shigella, Klebsiella, and Flavonifractor were significantly increased compared with those in the healthy control group. In sum, this study characterized the alterations of the intestinal microbiome in children with ASD and its normalization after TCM treatment (TCMT), which may provide novel insights into the diagnosis and therapy of ASD.

Dyslipidemia associated with body constitution in Traditional Chinese Medicine

Objective: This study aimed at investigating the association between dyslipidemia and body constitution of traditional Chinese medicine (BCTCM) may be clinically meaningful for the early diagnosis and treatment of dyslipidemia.

Methods: More than 4,000 participants were invited to a screening visit between 2011 and 2014, and 3,748 participants were available for data analysis. All study subjects underwent complete clinical baseline characteristics evaluation. Differences were determined using one-way analysis and [Formula: see text] analysis. Univariate regression analyses and multiple-variable logistic regressions (MLRs) determined the association between BCTCM variables and outcomes.

Results: In the dyslipidemia group, the Qi-deficient and Yang-deficient types accounted for more participants than others, and these two types were significantly associated with the outcome ([Formula: see text]). MLRs detected significant associations between the Qi-deficient and Yang-deficient types with dyslipidemia ([Formula: see text] for the two), and their odds ratios (ORs) for dyslipidemia were 1.211 and 1.234, respectively.

Conclusion: Qi-deficient and Yang-deficient types are independently and significantly associated with dyslipidemia. Participants with Qi-deficient and Yang-deficient constitutions have a higher incidence of dyslipidemia.

Cohort profile: the Lanxi Cohort study on obesity and obesity-related non-communicable diseases in China

PURPOSE

The Lanxi Cohort was established to systematically investigate the aetiology and interplay of body fat distribution and multiple factors with obesity and obesity-related non-communicable diseases in China.

PARTICIPANTS

The baseline investigation of the Lanxi Cohort study took place between June 2015 and August 2017 in Lanxi, Zhejiang Province, China. Permanent residents from one urban community and four rural villages were involved in this study. The baseline investigation included questionnaire survey, physical examination, dual-energy X-ray absorptiometry (DXA) scan, blood samples collection and traditional Chinese medicine (TCM) inquiry.

FINDINGS TO DATA

A total of 5132 participants, aged 18 to 80 years, were recruited at baseline; among them, 38.7% were men and 64.8% were from the urban area. The mean age was 53.04±12.77 years. The completion rates of physical examination, DXA scan, blood collection and TCM inquiry were 99.9%, 98.5%, 99.9% and 96.5%, respectively. The mean body mass index (BMI) was 23.42±3.20 kg/m² with 8.1% of the study population being obese (BMI ≥28 kg/m²). The crude prevalence of hypertension, diabetes and metabolic syndrome were 34.9%, 10.0% and 30.4%, respectively.

FUTURE PLANS

All participants will be monitored annually for cause-specific mortality and morbidity and hospital admission and will be followed up by in-person survey every 4 years. The baseline population is considered to expand in the future depending on the availability of funding support.

ETHICS APPROVAL

This study was approved by the Ethical Committee of the School of Public Health, Zhejiang University.

Identification of Traditional Chinese Medicine Constitutions and Physiological Indexes Risk Factors in Metabolic Syndrome: A Data Mining Approach

Objective

In order to find the predictive indexes for metabolic syndrome (MS), a data mining method was used to identify significant physiological indexes and traditional Chinese medicine (TCM) constitutions.

Methods

The annual health check-up data including physical examination data; biochemical tests and Constitution in Chinese Medicine Questionnaire (CCMQ) measurement data from 2014 to 2016 were screened according to the inclusion and exclusion criteria. A predictive matrix was established by the longitudinal data of three consecutive years. TreeNet machine learning algorithm was applied to build prediction model to uncover the dependence relationship between physiological indexes, TCM constitutions, and MS.

Results

By model testing, the overall accuracy rate for prediction model by TreeNet was 73.23%. Top 12.31% individuals in test group (n=325) that have higher probability of having MS covered 23.68% MS patients, showing 0.92 times more risk of having MS than the general population. Importance of ranked top 15 was listed in descending order . The top 5 variables of great importance in MS prediction were TBIL difference between 2014 and 2015 (D_TBIL), TBIL in 2014 (TBIL 2014), LDL-C difference between 2014 and 2015 (D_LDL-C), CCMQ scores for balanced constitution in 2015 (balanced constitution 2015), and TCH in 2015 (TCH 2015). When D_TBIL was between 0 and 2, TBIL 2014 was between 10 and 15, D_LDL-C was above 19, balanced constitution 2015 was below 60, or TCH 2015 was above 5.7, the incidence of MS was higher. Furthermore, there were interactions between balanced constitution 2015 score and TBIL 2014 or D_LDL-C in MS prediction.

Conclusion

Balanced constitution, TBIL, LDL-C, and TCH level can act as predictors for MS. The combination of TCM constitution and physiological indexes can give early warning to MS.

Coronary arterial disease correlates with constitutions of Traditional Chinese Medicine: A cross-sectional study in a Chinese cohort

Introduction: This study aimed to explore the associations between constitutions of traditional Chinese medicine (TCM) and coronary artery disease (CAD).

Methods: A large-scale, community-based, cross-sectional study was performed to investigate the associations. A total of 3,748 participants were available for analysis in this study. The assessment of the constitution of TCM was based on recommendations by the Association for Chinese Medicine in China. In this study, a diagnosis of CAD was based on self-reported medical history. The associations were analyzed using univariate and multivariable logistic regression (MLR).

Results: Univariate analysis showed Phlegm–dampness, Qi-deficiency, Yang-deficiency and Yin-deficiency constitutions were significantly associated with CAD, respectively ([Formula: see text] for Phlegm–dampness, [Formula: see text] for Qi-deficiency, [Formula: see text] for Yang-deficiency and [Formula: see text] for Yin-deficiency). Furthermore, MLR demonstrated significant associations among the four constitutions and CAD, after controlling for potential confounding factors (Phlegm–dampness: [Formula: see text], [Formula: see text]; Qi-deficient: [Formula: see text], [Formula: see text], Yang-Deficient: [Formula: see text], [Formula: see text]; Yin-deficient: [Formula: see text], [Formula: see text]). As compared with Neutral participants, participants with the four constitutions of TCM had higher prevalence of CAD.

Conclusion: Our findings provided evidence that the four constitutions of TCM including Phlegm-dampness, Qi-deficiency, Yan-deficiency and Yin-deficiency were significantly associated with CAD, respectively. (This study was registered in clinicaltrials.gov with the ID: NCT02998944.)