Study On The Correlation Between Salt Intake,salt Sensitive Genes And Traditional Chinese Medicine Syndromes In Patients With Hypertension

Objective:To analyze and compare the difference of salt intake in patients with different Traditional Chinese Medicine syndromes of hypertension;To explore the correlation between salt sensitivity related genes and Traditional Chinese Medicine syndromes of hypertension.Methods:82 patients with hypertension who were hospitalized in the cardiovascular department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from February to October 2020 were selected.The informed consent was signed.The syndrome differentiation of Traditional Chinese Medicine was divided into four types: hyperactivity of liver,phlegm turbid internal obstruction,yin deficiency and yang hyperactivity,kidney deficiency and blood stasis.24 h ambulatory blood pressure monitoring was performed in all patients;The 24-hour urine was collected and the daily salt intake was estimated by measuring the 24-hour urine sodium excretion;The samples of oral mucosa epithelium were scraped with tianamp swab DNA kit oral swab brush and sent to the detection center to extract relevant DNA for salt sensitivity related gene detection.SPSS 21.0 statistical software was used to analyze and compare the differences in salt intake among patients with different syndrom types of hypertension by Kruskal-Wallis H rank sum test.Chi square test and Logistic regression analysis were used to explore the correlation between salt sensitivity related genes and TCM syndromes of hypertension.Results:(1)Comparison of salt intake in patients with different syndrome types of hypertension:Yin deficiency and yang hyperactivity syndrome < kidney deficiency and blood stasis syndrome < liver fire hyperactivity syndrome < phlegm turbidity syndrome(P < 0.05).(2)Genetic detection included 45 salt-sensitive loci and 32 related genes.1)At AGT rs5051 locus,the distribution of TCM Syndrome Types in different genotypes is statistically significant.At this site,the distribution of syndrome types of TT type patients is:kidney deficiency and blood stasis syndrome > phlegm turbid internal obstruction syndrome =Yin deficiency yang hyperactivity syndrome > liver fire hyperactivity syndrome;CT type patients’ syndrome distribution is: kidney deficiency blood stasis syndrome > phlegm turbid internal obstruction syndrome > Yin deficiency yang hyperactivity syndrome > liver fire hyperactivity syndrome;The distribution of syndrome types of CC type patients is:hyperactivity of liver fire > hyperactivity of yin deficiency and Yang > phlegm turbid internal obstruction = kidney deficiency and blood stasis.2)At STK39 rs3754777 locus,different genotypes of patients with TCM syndrome type distribution difference was statistically significant,CC type of patients with syndrome type distribution: kidney deficiency and blood stasis syndrome > phlegm turbidity syndrome = Yin deficiency and yang hyperactivity syndrome > liver fire hyperactivity syndrome;CT type of patients with syndrome type distribution: kidney deficiency and blood stasis syndrome >phlegm turbidity syndrome > Yin deficiency and yang hyperactivity syndrome > liver fire hyperactivity syndrome;TT type of patients with syndrome type distribution: liver fire hyperactivity syndrome > phlegm fire hyperactivity syndrome Turbid internal obstruction syndrome > Yin deficiency and yang hyperactivity syndrome = kidney deficiency and blood stasis syndrome.3)There was no significant difference in the distribution of TCM syndrome types among the other 43 salt sensitive gene loci.(3)The results of logistic regression analysis showed that CC type was the influencing factor of hyperactivity of liver fire(95% CI: 2.380-12.164,P = 0.012)at rs5051 locus of AGT gene;At rs3754777 of STK39 gene,TT type was the influencing factor of hyperactivity of liver fire(95% CI: 1.066-61.536,P = 0.043).Conclusions:(1)The salt intake of hypertension patients with phlegm turbid internal obstruction was the highest,while that of yin deficiency and yang hyperactivity was the lowest.(2)Traditional Chinese Medicine syndrome types of hypertension may be associated with AGT gene polymorphism.At AGT rs5051 locus,kidney deficiency and blood stasis are the main syndrome types of TT type and CT type,while hyperactivity of liver fire is the main syndrome type of CC type,and CC type is the influencing factor of hyperactivity of liver fire.(3)Traditional Chinese Medicine syndrome types of hypertension may be associated with STK39 gene polymorphism.On STK39 rs3754777 locus,the syndrome types of CC and CT patients are mainly kidney deficiency and blood stasis,while the syndrome types of TT patients are mainly hyperactivity of liver fire,and TT type is the influencing factor of hyperactivity of liver fire.