| Objective:Quantitative analysis was conducted to explore the differences in volumetric bone mineral density(vBMD)among the nine types of traditional Chinese medicine constitutions.This was done to investigate the overall state of osteoporosis patients,and to provide clinical data reference for the clinical management and overall prevention and treatment of osteoporosis in both Chinese and Western medicine.Methods:This study is a single-center,non-interventional,cross-sectional clinical study conducted from August 2021 to March 2022 at the physical examination center of Dongfang Hospital,Beijing University of Chinese Medicine.The study collected general information,nine types of traditional Chinese medicine(TCM)constitutions(including balanced constitution,qi deficiency constitution,yin deficiency constitution,yang deficiency constitution,phlegm-dampness constitution,damp-heat constitution,blood stasis constitution,qi stagnation constitution,and special constitution),CT scan data,and laboratory indicators from the subjects.Using the original data from clinical CT scans,quantitative computed tomography(QCT)was used as the diagnostic and evaluation standard for osteoporosis based on quality control and systematic measurement methods.The vBMD values obtained from the QCT post-processing workstation were used to determine whether the subjects had normal bone mass,low bone mass,or osteoporosis.After propensity score matching the nine TCM constitutions based on age and gender,the intergroup differences in vBMD and related laboratory indicators of the nine TCM constitutions were quantitatively analyzed.The correlation between osteoporosis and TCM constitutions and their manifestation in related laboratory indicators were also explored.Results:1.A total of 170 subjects were included in this study,with an average vBMD of 128.2±41.5 mg/cm3 and an osteoporosis incidence rate of 14.1%.The proportion of women with normal bone mass was lower than that of men(53.1%vs 64.0%),while the proportions of low bone mass and osteoporosis were higher than those of men(30.9%vs 23.6%,16.0%vs 12.4%),but the differences were not statistically significant(P>0.05).OC,β-CTX,Total-P1NP,HDL,and TSH levels in women were significantly higher than those in men(P<0.05),while BMI,diastolic blood pressure,uric acid,T4,FT4,and FT3 levels were significantly lower than those in men(P<0.05).There was a statistically significant difference in bone mass distribution among different age groups(χ2=49.844,P<0.001).The proportion of subjects with normal bone mass gradually decreased in the young,middle-aged,and elderly groups(90.9%vs 68.8%vs 26.9%),while the proportions of low bone mass and osteoporosis gradually increased(9.1%vs 27.1%vs 34.6%,0.0%vs 4.2%vs 38.5%).Age was significantly negatively correlated with vBMD(r=-0.586,P<0.001),BMI,and FT4(P<0.05),and significantly positively correlated with systolic blood pressure,25-(OH)D3,glucose,HDL,and T3(P<0.05).2.After propensity score matching,there were certain differences in the distribution of bone mass and vBMD levels between the different traditional Chinese medicine constitutions groups,but none of them reached a statistically significant level(P>0.05).Among the nine constitutions,the proportion of individuals with low bone mass and osteoporosis was highest in the Yin-deficiency and Yang-deficiency constitutions,accounting for 45.8%and 42.4%,respectively.The proportion of individuals with normal bone mass in the balanced constitution group was higher than in the non-balanced constitution group(66.7%vs.45.8%),and the mean vBMD in the balanced constitution group(122.7± 40.1 mg/cm3)was higher than in the non-balanced constitution group(113.0 ± 38.0 mg/cm3).Compared with their respective control groups,individuals with dampness-heat,blood stasis,qi stagnation,and special constitutions showed varying degrees of increase in vBMD(132.8± 38.6 mg/cm3 vs.121.3 ± 34.9 mg/cm3,137.2 ± 43.4 mg/cm3 vs.117.5 ± 41.2 mg/cm3,135.9 ± 41.5 mg/cm3 vs.123.1 ± 38.1 mg/cm3,147.6 ± 41.0 mg/cm3 vs.129.9 ± 43.9 mg/cm3).3.After propensity score matching,there was a significant correlation between the traditional Chinese medicine constitution and bone mineral density,BMI,blood pressure,and related laboratory indicators(P<0.05).The proportion of non-overweight and non-obese individuals in the balanced constitution group was lower than that in the non-balanced constitution group,while the proportion of overweight individuals was higher than that in the non-balanced constitution group(χ2=12.323,P=0.001);individuals with phlegm-dampness constitution had a higher BMI than those without(t=2.104,P=0.038).The systolic blood pressure of individuals with yin-deficiency constitution was lower than that of those without(Z=1.968,P=0.049),while the systolic blood pressure of individuals with special sensitivity constitution was higher than that of those without(Z=1.990,P=0.047).The levels of OC,25-(OH)D3,β-CTX,and Total-P1NP in the balanced constitution group were significantly lower than those in the non-balanced constitution group,while the iPTH level in the yin-deficiency constitution group was significantly lower than that in the non-yin-deficiency constitution group(P<0.05).The ASO level in the yin-deficiency constitution group was significantly higher than that in the non-yin-deficiency constitution group,while the CRP level in the phlegm-dampness constitution group was significantly higher than that in the non-phlegm-dampness constitution group(P<0.05).There were differences in the distribution of blood glucose levels among individuals with yang-deficiency constitution,and the proportion of individuals with normal blood glucose levels was higher than that in the non-yang-deficiency constitution group(88.1%vs 69.5%,P=0.046);the GLU level in the balanced constitution group was significantly higher than that in the non-balanced constitution group,while the GLU level in the yang-deficiency constitution group was significantly lower than that in the non-yang-deficiency constitution group(P<0.05).The proportion of individuals with normal blood lipids in the balanced constitution group was lower than that in the non-balanced constitution group(25.0%vs 54.2%,P=0.039);the TG level in the phlegm-dampness constitution group was significantly higher than that in the non-phlegm-dampness constitution group,while the LDL level in the qi-deficiency constitution group was significantly lower than that in the non-qi-deficiency constitution group(P<0.05).There were statistical differences in thyroid function grading and indicators between the balanced constitution,yin-deficiency constitution,damp-heat constitution,qi-depression constitution,and special sensitivity constitution groups and their corresponding control groups(P<0.05).Conclusion:1.Age and gender are important factors influencing bone mass distribution and vBMD.Age and gender are related to BMI,blood pressure,and laboratory indicators of bone density.2.The TCM constitutions of Pinghe,Yin deficiency,Yang deficiency,Damp-heat,Blood stasis,Qi stagnation,and Special diathesis have certain effects on bone mass distribution and vBMD.Among them,Pinghe,Damp-heat,Blood stasis,Qi stagnation,and Special diathesis have a positive effect on vBMD,while Yin deficiency and Yang deficiency have a negative effect on bone mass distribution.3.The TCM constitutions of Pinghe,Qi deficiency,Yin deficiency,Yang deficiency,Dampness,Damp-heat,Qi stagnation,and Special diathesis are all related to indicators of bone density(including BMI,blood pressure,bone metabolism indicators,rheumatism three items,blood sugar,thyroid function,etc.).4.In the prevention,treatment,diagnosis,and evaluation of osteoporosis,it is recommended to primarily use imaging data such as vBMD and supplement it with laboratory indicators.Based on the differentiation of TCM constitutions,the overall bone status of patients should be comprehensively understood to achieve individualized prevention and treatment of osteoporosis. |
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