Sasang constitution affects the prevalence of functional dyspepsia

Systematic review with meta-analysis: global prevalence of uninvestigated dyspepsia according to the Rome criteria

BACKGROUND

Prevalence of uninvestigated dyspepsia varies across cross-sectional surveys. This may be due to differences in definitions used or study methodology, rather than global variability.

AIM

To determine the global prevalence of uninvestigated dyspepsia according to Rome criteria.

METHODS

MEDLINE and EMBASE were searched to identify population-based studies reporting prevalence of uninvestigated dyspepsia in adults (≥18 years old) according to Rome I, II, III or IV criteria. Prevalence of uninvestigated dyspepsia was extracted, according to criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, odds ratios (OR), and 95% confidence intervals (CIs) were calculated.

RESULTS

Of 2133 citations evaluated, 67 studies fulfilled eligibility criteria, representing 98 separate populations, comprising 338 383 subjects. Pooled prevalence ranged from 17.6% (95% CI 9.8%-27.1%) in studies defining uninvestigated dyspepsia according to Rome I criteria, to 6.9% (95% CI 5.7%-8.2%) in those using Rome IV criteria. Postprandial distress syndrome was the commonest subtype, occurring in 46.2% of participants using Rome III criteria, and 62.8% with Rome IV. Prevalence of uninvestigated dyspepsia was up to 1.5-fold higher in women, irrespective of the definition used. There was significant heterogeneity between studies in all our analyses, which persisted even when the same criteria were applied and similar methodology was used.

CONCLUSIONS

Even when uniform symptom-based criteria are used to define the presence of uninvestigated dyspepsia, prevalence varies between countries. This suggests that there are environmental, cultural, ethnic, dietary or genetic influences determining symptoms.

Effect of Lifestyle Factors on Hypertension by Constitution Type: A Large Community-Based Study

Background. The risk of hypertension differs according to lifestyle factors and individual constitution types. The aim of this study was to investigate the effect of lifestyle factors on hypertension and to assess whether those effects differ according to the constitution types. Methods. A total of 5,793 men and women were recruited between 2012 and 2014. Odds ratios for hypertension associated with constitution types and lifestyle factors were estimated. Lifestyle factors included smoking status, body mass index, alcohol consumption, physical activity, and sleep quality. Constitution types were estimated based on the Sasang constitutional medicine as the TE type, SE type, and SY type. Results. The risk of hypertension was significantly higher for SY (odds ratio 1.25 (95% confidence interval 1.03 to 1.52) and TE types (1.38 (1.10 to 1.74)) than the SE type even with adjustment of health behaviors. Compared with individuals who had an unhealthy lifestyle, those with healthy lifestyle scores showed significantly lower risk of hypertension in only SY (odds ratio 0.62 (95% confidence interval 0.48 to 0.81)) and TE types (0.69 (0.58 to 0.81)). The difference in risk for hypertension among constitution types was decreased with a healthy lifestyle (1.34 in SY and 2.35 in TE types, as compared with the SE type) versus an unhealthy lifestyle (2.21 in SY and 3.64 in TE types, as compared with the SE type). Conclusion. The risk of hypertension was different by Sasang constitution types. The impact of lifestyle factors differed according to Sasang constitution types, and the difference in risk of hypertension among constitution types was decreased with a healthy lifestyle.

Heart rate variability in middle-aged adults: Use of Sasang typology to distinguish individuals susceptible to stress

While stress is known to cause many diseases, there is no established method to determine individuals vulnerable to stress. Sasang typology categorizes humans into four Sasang types (So-Eum, Tae-Eum, So-Yang, and Tae-Yang), which have unique pathophysiologies because of their differential susceptibilities to specific stimuli, including stress. The purpose of this study was to determine if Sasang typology can be used identify individuals who are vulnerable to stress by evaluation of heart rate variability (HRV).This was a cross-sectional study. A total of 399 healthy men and women aged 30 to 49 years were recruited. Physical examinations for stress included HRV measurement and blood tests. The subjects also completed questionnaires about psychological stress, self-awareness, and lifestyle. HRV was analyzed using frequency-domain analysis. Subjects were divided into So-Eum (SE) and non-So-Eum (non-SE) groups according to their diagnosis.The weight and body mass index in the SE group were significantly lower than those in the non-SE group (both, P = .000). There were no significant between-group differences in any other demographic variables. In HRV analysis, the normalized high frequency (nHF) was higher (P = .008) while the normalized low frequency (nLF; P = .008) and LF:HF ratio (LF/HF; P = .002) were lower in the SE group than in the non-SE group.Although there was no difference in variables affecting HRV, HRV values were significantly different between groups. The LF/HF value for the SE group was at the lower limit of the normal range, although there were no associated clinical problems. These findings suggest that individuals with the SE type are more susceptible to stress than those with the other types. Thus, middle-aged individuals who are vulnerable to stress can be identified using Sasang typology.

Genetic and Environmental Overlaps Among Sasang Constitution Types: A Multivariate Twin Study

According to the Sasang theory, humans can be categorized into one of the four Sasang constitution (SC) types. The four SC types are Tae-Yang (TY), Tae-Eum (TE), So-Yang (SY), and So-Eum (SE), which are determined mainly on the basis of anthropometric characteristics, personality, and the balance of the physiological functions of the major organ systems. There is a growing recognition in the complementary and alternative medicine area that SC types have the potential to be a useful scientific tool for the prevention, diagnosis, and treatment of diseases (Cooper, Evidence Based Complementary and Alternative Medicine, Vol. 6 (Suppl. 1), 2009, pp. 1–3). The main purposes of the present study are to estimate genetic and environmental influences on SC types, and to explore genetic and environmental correlations that affect phenotypic associations among the SC types. In total, 1,742 (365 monozygotic male, 173 dizygotic male, 675 monozygotic female, 271 dizygotic female, and 258 opposite-sex dizygotic) twins (mean age = 19.1 ± 3.1 year) completed a Sasang questionnaire. Univariate and multivariate model-fitting analyses were performed. Total (additive and non-additive) genetic influences were 71% for males and 81% for females in TE, 70% for males and 71% for females in SE, and 47% for both sexes in SY. Non-additive genetic effects were substantial, and shared environmental influences were negligible in most SC types. Multivariate model-fitting analysis revealed that non-additive genetic and individual-specific environmental correlations between TE and SE were -0.92 (95% CI [-0.89, -0.93]) and -0.62 (95% CI [-0.57, -0.68]), respectively. The corresponding estimates were -0.55 (95% CI [-0.48, -0.61]) and -0.44 (95% CI [-0.37, -0.51]) between TE and SY and 0.19 (95% CI [0.09, 0.29]) and -0.40 (95% CI [-0.32, -0.47]) between SE and SY. These results suggest that the phenotypic associations among SC types may be mediated by pleiotropic mechanism of genes.

Can We Determine Sasang Constitutional Body Type Merely by Facial Inspection?

OBJECTIVES

This study aimed to assess the inter-observer concordance rate of anthroscopic examination on facial features among experts in Sasang constitutional medicine (SCM) in order to evaluate the presence of statistical differences in facial structural characteristics among different body types of Sasang constitution (SC), and to develop an objective method for facial analysis for diagnosing SC types to prevent SCM experts from misdiagnosis by their perceptional errors about faces.

METHODS

This was a double-blinded cross-sectional study conducted on 174 people's faces. Ten SCM experts participated in this study. Frontal and lateral photographs of subjects were standardized and displayed to 10 SCM experts for diagnosing the SC type by anthroscopic examination alone (experiment 1). The subjects' faces were analyzed by photogrammetric method to investigate the presence of any typical structural characteristics of the faces to differentiate SC type (experiment 2). Comparing subjects' SC type with anthroscopic diagnosis by 10 SCM experts, the inter-observer concordance rates were measured (experiment 1). Using photogrammetric facial analysis, a multinomial logistic model was made for analyzing the correlation of SC type and subjects' facial structural configuration (experiment 2).

RESULTS

The inter-observer concordance rate of anthroscopic examination was 2.9% in experiment 1. Using a multinomial logistic fitting model, the predicted probability for determining SC type was 52.8-57.6% in experiment 2 (p < 0.05). Prototype composite faces were also created from photographs of subjects who received the same SC type from the SCM experts.

CONCLUSIONS

As SC type cannot be precisely diagnosed using anthroscopic examination alone, SCM needs a definitive objective and scientific diagnosing method to be a scientifically verified alternative medicine and be globalized in future.

Changes in Body Water Caused by Sleep Deprivation in Taeeum and Soyang Types in Sasang Medicine: Prospective Intervention Study

Background

There is a negative relationship between sleep deprivation and health. However, no study has investigated the effect of sleep deprivation on individuals with different body composition. The aim of this study was to determine the differential effect of sleep deprivation in individuals with different body compositions (fluid) according to Soyang type (SY) and Taeeum type (TE).

Methods

Sixty-two cognitively normal, middle-aged people with normal sleep patterns were recruited from the local population. The duration of participants' sleep was restricted to 4 h/day during the intervention phase. To examine the physiological changes brought on by sleep deprivation and recovery, 10 ml of venous blood was obtained.

Results

Total Body Water (TBW) and Extracellular Water (ECW) were significantly different between the groups in the intervention phase. Physiological parameters also varied from the beginning of the resting phase to the end of the experiment. Potassium levels changed more in SY than TE individuals.

Conclusion

Participants responded differently to the same amount of sleep deprivation depending on their Sasang constitution types. This study indicated that SY individuals were more sensitive to sleep deprivation and were slower to recover from the effects of sleep deprivation than TE individuals.

A Systematic Review on Sasang Constitutional Type-Associated Susceptibility to Disorders in Korea

BACKGROUND/OBJECTIVE

Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders.

METHODS

A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex.

RESULTS

From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants.

CONCLUSIONS

This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.