Association between metabolic syndrome and body constitution of traditional Chinese medicine:A systematic review and meta-analysis

Background:The constitution theory of traditional Chinese medicine(TCM)states that body constitution and disease are associated;therefore,the identification of body constitution can provide reference for disease prevention and treatment.A series of clinical studies evaluating the association between TCM constitution and metabolic syndrome(MetS)have been conducted in recent years.The aim of this systematic review is to summarize and evaluate the clinical evidence of the relationship between constitution and MetS.Methods:The PubMed,Embase,China National Knowledge Infrastructure(CNKI),Chongqing VIP,and Wanfang Data electronic databases were searched from April 2009 to July 2020.The search terms included“metabolic syndrome,”“constitution,”and“Chinese medicine.”Observational studies evaluating the relationship between body constitution of TCM and MetS were included.The primary outcome included the distribution of constitutional types in the MetS population,and odds ratio(OR)or relative risk(RR)between constitution and MetS.Effect size was expressed as proportion or OR with 95%confidence interval(CI).Methodological quality of included studies was evaluated by the NewcastleeOttawa Scale(NOS)or the American Agency for Healthcare Research and Quality(AHRQ)criteria.Results:Three caseecontrol and 26 cross-sectional studies involving 30435 cases were included.Phlegm-dampness,qi-deficiency,and damp-heat were the main constitution types in patients with MetS,accounting for 29%(22%e39%),18%(13%e24%),and 12%(9%e17%)of the population,respectively;the risk of MetS in people with phlegm-dampness and qi-deficiency constitution was 1.74[1.27,2.38]and 1.29[1.01,1.65]times higher than that in those with other constitutions.There were sex-and age-related differences in the distribution of TCM constitution in patients with MetS.Conclusion:Phlegm-dampness and qi-deficiency were associated with the occurrence of MetS.Welldesigned cohort and caseecontrol studies are needed to provide evidence for the use of TCM to prevent and treat MetS.

Need of integrated dietary therapy for persons with diabetes mellitus and “unhealthy” body constitution presentations

From a perspective of Chinese medicine （CM）, persons with unregulated ＂unhealthy＂ body constitution （BC） will further develop chronic diseases, such as diabetes mellitus （DM）. Conventional dietary therapy with nutrition component has its limitations in the regulation of ＂unhealthy＂ BC. However, empirical evidence supports that ＂unhealthy＂ BC can be regulated with food natures and flavors from a perspective of CM. Presentations of ＂unhealthy＂ BC types, such as Yin-deficiency, Yang-deficiency and Yin-Yangdeficiency were found in persons with DM. It would be necessary to regulate the ＂unhealthy＂ BC presentations with integration of conventional dietary therapy and Chinese food therapy. The ultimate goal is to either stabilize glycaemic control or prevent the development of other chronic diseases leading to reduction of disease burden, such as disease-related poor quality of life, stress of healthcare professionals and the rising of healthcare cost.

Prevalence of neutralizing antibodies against liver-tropic adeno-associated virus serotype vectors in 100 healthy Chinese and its potential relation to body constitutions

Recombinant adeno-associated virus （rAAV） serotype 2, 3 and 8 vectors are the most promising liver- tropic AAV serotype vectors. Liver diseases are significant problems in China. However, to date, few studies on AAV neutralizing antibodies （Nabs） were working with the Chinese population or with the rAAV3 vectors. The present study aimed to determine the prevalence of Nabs in Chinese population against wild-type AAV2, AAV3 and AAV8 capsids as well as additional two AAV3 variants. In addition, we performed a preliminary analysis to investigate the potential influence of traditional Chinese medicine body constitutions on AAV Nabs. Our work demonstrated that the majority of healthy Chinese subjects were positive for AAV Nabs, with the order of AAV2 〉 AAV3 = AAVLK03 〉 AAV8. There was no difference between： 1）AAV3 and its variants; 2） male and female subjects; and 3） different age cohorts （〈 35, 36- 50, and 〉 51 years old）. People in the Qi-deficiency constitution had significantly increased AAV8 Nabs than people in the Gentleness constitution. Our studies may have impact on the future clinical design of AAV-based gene therapy in the Chinese population.

Reliability and validity of the Tibetan medicine constitution scale: a cross-sectional study of the general population in Beijing, China

Background:The constitutional theory is an important aspect of Tibetan medicine,however a quantitative measurement tool for constitution identification still does not exist.The objective of this study is to evaluate the reliability and validity of a Tibetan medicine constitution scale(TMCS)that consists of three sub-scales and 31 items.Methods:From June to July 2019,622 people from the general population in Beijing,China,aged 18 to 60 were investigated.We employed Cronbach’s alpha(α),split-half reliability,and test-retest reliability to determine the reliability of the scale.The content validity and contract validity of the TMCS were evaluated using factor analysis and correlation analysis based on Tibetan medicine theory.The items were screened according to the reliability test results.Results:After the items were screened,22 items remained in the scale.The Cronbach’s alpha value for the internal consistency reliability of the TMCS was 0.754(95%confidence interval(CI):0.700–0.761).The correlation coefficient for the two-week test-retest of the total score was 0.726(95%CI:0.571–0.834).The split-half coefficient was 0.689(95%CI:0.640–0.734).The scale can be explained by eight potential factors,including morphological structure,physiological function,personality,adaptability,etc.The body mass index was negatively correlated with the score of the sub-rlung scale(r=−0.376),slightly positively correlated with the sub-mkhris pa scale(r=0.099),and positively correlated with the sub-bad kan scale(r=0.362).Conclusion:The TMCS is a reliable and valid instrument that can be used to assess the body constitution of the general population in Beijing,China.Future studies are needed to explore the differences in biological characteristics among the constitutional types and the association between constitution and disease.

Traditional Chinese Medicine constitution among patients with allergic rhinitis and its correlation with anxiety and depression

OBJECTIVE:To preliminary investigate the distribution of Traditional Chinese Medicine(TCM)constitution among patients with allergic rhinitis(AR)and reveal the related factors with anxiety and depression.METHODS:Between July 2020 and June 2021,specialist doctor recruited AR patients in Beijing and Shanghai.A total of 630 patients admitted to participate in the survey,and 516(81.9%)(male 54.3%,female 45.7%)participants completed the questionnaires.Three scales including Constitution in Chinese Medicine Questionnaire(CCMQ),Generalized Anxiety Disorder Questionnaire(GAD-7)and The Patient Health Queationaire-9(PHQ-9)were applied.Theχ^(2)and the Fisher’s exact test were used to evaluate the classification data,multivariate logistic regression was used to explore the related factors of anxiety and depression.RESULTS:According to 516 AR patients,the most commonly first-constitution was Yang-deficiency(22.1%)and frequent of all constitutions was inherited-special(21.6%).One third of AR patients(33.5%)suffered from anxiety,nearly half of AR patients(46.5%)were found to be depressive.Inherited-special(27.7%)was the most common constitution in patients with anxiety whereas Yang-deficiency(26.7%)was most common constitution in patients with depression.Sex,duration of symptoms,balanced,Qi-deficiency,phlegm-dampness,Qi-stagnation,and inherited-special constitutions were related with anxiety;Sex,income,duration of symptoms,balanced,Qi-deficiency,Yang-deficiency,phlegm-dampness,Qi-stagnation,and inherited-special constitutions were related with depression.CONCLUSIONS:According to our study,the commonly constitution types of AR were Yang-deficiency and inherited-special.We found that the prevalence value of anxiety and depression were high.People with Qi-deficiency,phlegm-dampness,Qi-stagnation,and inherited-special constitutions were more likely to have mental problems than the others.Controlling these influential factors might be beneficial for clinical health management of AR patients,and the government should apply appropriate mental health treatment services to offer psychiatric support.

Translation, Adaptation and Validation of a Chinese Medicine Questionnaire to Brazilian Portuguese

The Constitution in Chinese Medicine Questionnaire [CCMQ] organizes 9 body constitutions according to Traditional Chinese Medicine [TCM]. The translation was realized by a Medical Doctor [MD] specialized in TCM and the back translation by an english-speaking MD. Comprehensibility assessment was performed (N = 40, main scores ranged from 4.20 to 4.95). On the test-retest reliability Cronbach’s alpha was 0.920 in the first application and 0.943 in the second, the intraclass correlation scores ranged between good and excellent (0.6 - >0.80). The results show that the adaptation of the CCMQ is valid and ready to be used.

Clinical research linking Traditional Chinese Medicine constitution types with diseases:a literature review of 1639 observational studies

OBJECTIVE:To analyze clinical studies on correlations between Traditional Chinese Medicine(TCM)body constitution types and diseases published in the past 10 years,and to provide an evidence base to support the use of such correlations for health maintenance and disease prevention.METHODS:We searched five databases for the period April 2009 to December 2019:China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed and Embase.Three types of observational studies on correlation between constitution types and diseases were included:cross-sectional,case-control and cohort studies.Descriptive statistical methods were employed for data analysis.RESULTS:A total of 1639 clinical studies were identified:1452(88.59%)cross-sectional studies,115(7.02%)case-control studies and 72(4.39%)cohort studies covering 30 regions of China and five other countries(Malaysia,South Korea,Singapore,Thailand and France).The collection of studies comprised 19 disease categories and 333 different diseases.The 10 most commonly studied diseases were hypertension,diabetes,stroke,coronary atherosclerotic heart disease(CAHD),sleep disorders,neoplasm of the breast,dysmenorrhea,fatty liver disease,chronic viral hepatitis B and dyslipidemia.We found high distributions for each biased constitution type in different patient populations as follows:Qi-deficiency constitution in stroke,diabetes,chronic obstructive pulmonary disease,acquired immunodeficiency syndrome and hypertension;Yang-deficiency constitution in female infertility,osteoporosis,irritable bowel syndrome,gonarthrosis and dysmenorrhea;Yin-deficiency constitution in hypertension,diabetes,constipation,female climacteric states and osteoporosis;phlegm-dampness constitution in hypertension,stroke,fatty liver disease,diabetes and metabolic syndrome;damp-heat constitution in acne,chronic gastritis,chronic viral hepatitis B,human papillomavirus infection and hyperuricemia;blood-stasis constitution in CAHD,endometriosis and stroke;Qi-stagnation constitution in hyperplasia and neoplasms of the breast,insomnia,depression and thyroid nodules;and inherited-special constitution in asthma and allergic rhinitis.CONCLUSION:Eight biased TCM constitutions were closely related to specific diseases,and could be used to guide individualized prevention and treatment.More rigorously designed studies are recommended to further verify the constitution-disease relationship.

The Investigation of the Correlation between Metabolic Syndrome and Chinese Medicine Constitution Types in Senior Retired Military Personnel of the People's Liberation Army

Objective： To investigate the incidence of metabolic syndrome （MS） and the distribution of constitutional pattern in elderly retired personnel of the People＇s Liberation Army. Methods： Adopting the method of cross-sectional field investigation, from June to December in 2008, the investigation questionnaires were completed by the aged over 60 and collected from 69 military retired residences in the 4 cities of Shanghai, Nanjing, Hangzhou and Qingdao. Other data, including demographic characteristics, physiological characteristics, life style and former medical history, were collected and analyzed. The statistical analysis for the database was drawn up by the software Epidata 3.0. Results： A total of 4,502 people were included in this study, and 35.3% of them were diagnosed with MS. There was no obvious difference in mobility among ages （60 to 69, 70 to 79 and over 80, P〉0.05）. Referring to the MS patients in the 70s age group, both the phlegm- dampness and dampness-heat constitutional types were evidently higher than those in the 60s age group （P=0.019, P=O.O08）; while MS patients in 80s and older showed a significantly lower incidence of dampness- heat constitution than those in the 60s （P=O.O0）; and qi-deficiency constitution was obviously higher in the 80s age group than those in the other two groups （P=O.O0）. The top 3 constitutions in MS people were, respectively, phlegm-dampness, dampness-heat and qi-deficiency constitution; while in non-MS people, the top 3 constitutions were gentleness, qi-deficiency and phlegm-dampness. When the patient＇s body mass index （BMI） was more than 25 kg/m2, the rate of phlegm-dampness and dampness-heat constitution significantly increased, while the rate of qi-deficiency constitution declined; the discrepancy was significant （P=O.O0）. Conclusions： The prevalence rate of MS in military senior people was 35.3%, which did not vary among the three age groups. Phlegm-dampness, dampness-heat and qi-deficiency constitution were the three dominant constitutional types seen in the MS patients. The distribution of constitution formation was different in MS people and non-MS people. For different dimensions of BMI, the proportion of each kind of constitutions was varied.