| Background:Coronary heart disease (CHD), one of the most common diseases, caused by atherosclerosis and seriously damaging human being's health. The prevention of CHD is one of the hot spot in the medical research for its high incidence, high death rate and high morbidity. Western medicine has made great progress in the study of CHD, while still not stop the progress. Traditional Chinese medicine (TCM) has unique theory and method, and plays an important role in prevention of CHD for its effective and minimal side-effect. Syndrome differentiation is essence of TCM, the syndrome of CHD is not yet unity. The rise of metabonomics provides a new method for the studardization of TCM syndrome. The paper detected the metabolities in patients with CHD group, control group and CHD patients with different syndromes by using 1H-NMR, found the characterics of different syndromes, and then provide the basis for the diagnosis of CHD syndrome.Objective:To study the differential metabolities in CHD patients with different syndromes, find the unique metabolic patterns and provide objective basis for CHD syndromes.Methods:CHD patients with angiography were differentiated by two associate chief physicians. The patients were divided into 12 cases of heart blood stasis,20 cases of stagnation of phlegm in the vessles,17cases of mutual resistance of phlegm and blood stasis,19 cases of phlegm-heat syndrome,18 cases of qi and yin deficinency and 20 cases of health people. All serum smples were detected by 1H-NMR and research the differences of metabolities in among CHD patients, health prople and CHD with different sundromes by Principal components analysis (PCA) and Partial least squares discriminate analysis (PLS-DA).Results:1. The metabolities in CHD patients and health people can obviously diatinguish. The content of lactate(Lac), alanine(Ala), Glutamine(Glc), Glucose(GLC),lipids, very low/low density lipoprotein(VLDL/LDL-C),high density lipoprotein (HDL) in CHD patients are higher than health people, while the content of Betaine, phosphocholine (Pcho),Taurine, Glycerophosphorylcholine(GPC) are lower.2. The metabolities in CHD patients with qi and yin deficinency syndrome and stagnation of phlegm in the vessles syndrome can obviously diatinguish. The content of Lac, O-acetyl glycoprotein(O-Ac), valine (Val), VLDL/LDL-C, lipids and unsaturated fatty acid in CHD patients witj stagnation of phlegm in the vessles syndrome is higher than CHD patients with qi and yin deficinency syndrome; while Pcho, GLC,trimethylamine oxide(TMAO), Lac, Ala,Glc, Betaine, Taurine,β-Glc, HDL and lipids are lower.3. The metabolities in CHD patients with qi and yin deficinency syndrome and mutual resistance of phlegm and blood stasis syndrome can obviously diatinguish. the content of Glc, O-Ac, TAMO,GPC, Betaine,GLC,Val,HDL in CHD patients with mutual resistance of phlegm and blood stasis syndrome are higher than qi and yin deficinency syndrome; while the content of Lac, Ala,β-Glc, unsaturated fatty acid, VLDL/LDL-C and lipids are lower.4. The metabolities in CHD patients with qi and yin deficinency syndrome and heart blood stasis syndrome can obviously diatinguish. the content of Val, Taurine, TAMO, Glc, GLC,β-GLC, VLDL/LDL-C in CHD paients with heart blood stasis syndrome are higher than qi and yin deficinency syndrome; while the content of Lac, Ala,β-Glc, Pcho,3-hydroxybutyric acid(3-HB), HDL and lipids are lower.5. The metabolities in CHD patients with phlegm-heat syndrome and stagnation of phlegm in the vessles syndrome can obviously diatinguish.the content of Taurine, Glu,β-Glc, Glc, HDL and lipids in CHD patients with phlegm-heat syndrome are higher than CHD patients with phlegm in the vessles syndrome; While the content of Lac, GLC, VLDL/LDL-C and lipids are lower.6. The metabolities in CHD patients with phlegm-heat syndrome and mutual resistance of phlegm and blood stasis syndrome can obviously diatinguish. the content of Taurine,β-Glc, Glu, Pcho, Glc, Lac, Val,HDL in CHD patients with mutual resistance of phlegm and blood stasis syndrome are higher than phlegm-heat syndrome; While the content of VLDL/LDL-C, Lac,3-HB, O-Ac, Ile and lipids are lower.7. The metabolities in CHD patients with phlegm-heat syndrome and heart blood stasis syndrome can obviously diatinguish.the content of Glc, Lac, Val, Pcho, Ala, Ile, HDL, VLDL/LDL-C and lipids in CHD patients with phlegm-heat syndrome are higher than heart blood stasis syndrome; while the content of Taurine, GLC,β-Glc and HDL are lower.8. The metabolities in CHD patients with stagnation of phlegm in the vessles syndrome and mutual resistance of phlegm syndrome can obviously diatinguish.the content of Lac, Val, O-Ac, Ile, GLC, VLDL/LDL-C,lipids and unsaturated fatty acid in CHD patients with phlegm in the vessles syndrome are higher than mutual resistance of phlegm syndrome; while the content of Betaine, Pcho, TAMO, Glc, Taurine, Glu,α-Glc,β-Glc and HDL are lower.9. The metabolities in CHD patients with stagnation of phlegm in the vessles syndrome and heart blood stasis syndrome can obviously diatinguish.the content of Lac, Val, O-Ac, Ile, Val, VLDL/LDL-C, HDL and unsaturated fatty acid in CHD patients with phlegm in the vessles syndrome are higher than heart blood stasis syndrome; while the content of Glu, Betaine, TAMO, Pcho, Glc,β-Glc and HDL are lower.10. The metabolities in CHD patients with mutual resistance of phlegm syndrome and heart blood stasis syndrome can obviously diatinguish.the content of Lac, Pcho, GLC,β-Glc, Val, Ala,α-Glc, HDL and lipids in CHD patients with mutual resistance of phlegm syndrome are higher than heart blood stasis syndrome; While the content of Glu, TAMO, Taurine, Glc, VLDL/LDL-C, and unsaturated fatty acid lipids are lower.Conclusion:1. The metabolities in CHD patients and health people can obviously diatinguish. The content of lactate(Lac), alanine(Ala), Glutamine(Glc), Glucose(GLC),lipids, very low/low density lipoprotein(VLDL/LDL-C),high density lipoprotein (HDL) in CHD patients are higher than health people, while the content of Betaine, phosphocholine (Pcho),Taurine, Glycerophosphorylcholine(GPC) are lower. 2. The metabolities among different CHD patients syndrome can be obviously diatinguish and each CHD syndrome exsits its own metabolic patterns. such as①The content of Lac, lipids, GLC, Ala, Val, Ile, O-Ac, VLDL/LDL-C are higher,while the content of Glc, HDL, Pcho, Taurine,β-Glc are lower in CHD pitients with stagnation of phlegm in the vessles syndrome,;②The content of Ala, Lac, GLC,β-GLC, lipidis, unsaturated fatty acid and HDL are higher, while the content of TAMO, Val,Pcho are lower in CHD pitients with qi and yin deficiency syndrome;③The content of GLC, HDL, Glc, Val,α-GLC,β-GLC, Pcho are high, while the content of Ile, VLDL/LDL-C, lipids are lower in CHD pitients with mutual resistance of phlegm syndrome;④The content of GLC, Taurine, Lac, VLDL/LDL-C, TAMO, unsaturated fatty acid,β-GLC and lipids are higher, while the content of Val, Glc, Pcho and HDL are lower in CHD pitients with heart blood stasis syndrome;⑤The content of Lac, GLC, VLDL/LDL-C, O-Ac, Val are higher, whlie Taurine, TAMO, Ala, Pcho and Glc are lower in CHD pitients with phlegm-heat syndrome.The metabolities in those CHD patients are closely related with disorder of lipid metabolic, glycometabolism, energy metabolism and amino acid metabolism.
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