基于色谱质谱联用技术的中医痰湿体质的代谢组学研究

Chromatography Mass Spectrometry-Based Metabolomics Approach to Study Phlegm-Dampness Constitution of Traditional Chinese Medicine

目的:寻找中医痰湿体质血清标志性代谢物及其引起的代谢通路变化,结合糖脂代谢、胰岛素抵抗指数等指标,探讨中医痰湿体质形成、发展等各阶段的病理特征以及中医关于"肥人多痰湿"的发病机制。方法:收集正常组平和质、超重组非痰湿质和痰湿质、肥胖组痰湿质的血清样本,分析比较4组间体脂参数(体重指数BMI、腰围WC、腰臀比WHR)、血脂(TG、CHOL、HDLC、LDLC)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(Homa-IR),并分别与中医痰湿体质积分作相关性分析。应用高效液相色谱-四级杆-飞行时间质谱联用(HPLC-Q-TOF/MS)的代谢组学技术为基础、使用多元数据统计分析寻找痰湿体质的血清差异代谢物,进一步探讨中医痰湿体质内在的病理学特征及相关疾病的发病机制。结果:BMI、WC、WHR、TG随着组别依次呈现逐渐增大的趋势,HDL-C则逐渐减小,肥胖组痰湿质的FINS、Homa-IR指数显著高于正常组平和质(P<0.01);全组中医痰湿体质积分与BMI、WC、WHR、TG水平呈显著正相关(P<0.05);与HDL-C水平呈显著负相关(P<0.01);超重组非痰湿质显著性差异表达血清代谢物有8种,超重组痰湿质有9种,肥胖组痰湿质有9种(P<0.05)。结论:痰湿质肥胖症存在着显著的体脂分布异常、脂代谢紊乱、胰岛素水平过高、高胰岛素抵抗等病理特征,提示中医痰湿体质是肥胖症的易患体质;中医痰湿体质存在显著性差异表达血清代谢物。

Objective： In order to find out the symbolic serum metabolites and changes in metabolic pathways of Phlegm-dampness constitution,combing glucose and lipid metabolism,homeostasis model assessment insulin resistance to explore formation,development and pathological characteristics of phlegm-dampness constitution and pathogenesis of＂obesity was prone to phlegm-dampness constitution＂. Methods： Collect normal control group peace constitution,overweight group non-phlegm-dampness and phlegm-dampness constitution,obesity group phlegm-dampness constitution. Compare body fat parameter[Body Mass Index（ BMI）,waist circumference（ WC）,waist-to-hipratio（ WHR） ],blood lipid（ TG,CHOL,HDL-C,LDL-C）,fasting plasma glucose（ FPG）,fasting serum insulin（ FINS） and homeostasis model assessment insulin resistance（ Homa-IR） among 4 groups and make correlation with phlegm-dampness scores. Based on HPLC-Q-TOF/MS,use multivariate statistical analysis to find out the difference serum metabolites of phlegm-dampness constitution and explore internal pathological features of phlegm-dampness constitution and pathogenesis of related-disease. Results： BMI,WC,WHR and TG increased in turn,while HDL-C decreased. FINS and Homa-IR in obesity group（ phlegm-dampness constitution） was higher than that of normal control group（ peace constitution）（ P〈0. 01）.Phlegm-dampness integral had a positive correlation to BMI,WC,WHR and TG（ P〈0. 05）,genetic correlation to HDL-C（ P〈0. 01）. Eight differentially expressed metabolites in overweight group（ non-phlegm-dampness constitution）can be identified. The overweight and obesity group（ phlegm-dampness constitution） had 9 in each（ P〈0. 05）. Conclusion： Phlegm-dampness constitution of obesity has obvious pathological characteristics in abnormal body fat distribution,lipid metabolism disorders,high-FINS level and insulin resistance. Phlegm-dampness is the susceptible constitution of obesity and it has different serum metabolites.