Study on Plasma Metabolomics Analysis of Yanghe-patch in the treatment of impaired glucose tolerance with Yang-deficiency constitution

Corresponding author: Weng Siying, alicewsy@163.com

DOI: 10.12201/bmr.202409.00020

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  Abstract: Objective To investigate the impact of Yanghe-patch acupoint application on individuals with impaired glucose tolerance (IGT) and its influence on serum metabolites. Methods From Oct.2022 to Jan.2024, a total of 63 patients diagnosed with IGT were enrolled for comprehensive medical care at Ningbo Hospital of TCM affiliated with Zhejiang Chinese Medicine University. The treatment groups consisted of the Yanghe-patch acupoint application therapy combined with lifestyle intervention group (31 cases) and the simple lifestyle intervention group (32 cases).The study compared the changes in blood glucose, blood lipid levels, tumor necrosis factor α(TNF-α), Yang deficiency body scores, and infrared thermal imaging temperature before and after treatment between the two groups. Furthermore, 29 healthy individuals were selected as controls, and their serum metabolites were analyzed using liquid chromatography-mass spectrometry (LC-MS). Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were employed to identify characteristic differential metabolites. Additionally, key metabolic pathways were screened through network analysis using MetaboAnalyst software. Results The treatment group exhibited a significant decrease in fasting blood glucose and glycosylated hemoglobin levels following Yanghe-patch intervention (P<0.05). Furthermore, compared to pre-intervention levels, the treatment group demonstrated reduced triglyceride and low-density lipoprotein levels (P<0.05), which were also lower than those observed in the control group (P<0.05). However, there were no notable changes in total cholesterol levels between the two groups (P>0.05). Additionally, TNF-α levels were significantly lower in the treatment group compared to the control group (P<0.05). In terms of traditional Chinese medicine evaluation parameters, individuals with Yang deficiency physique experienced a decrease at their conversion point after intervention (P<0.05), while Ren pulse and Du pulse temperatures showed a significant increase (P<0.05). Furthermore, Upper-Jiao temperature decreased significantly while Middle-Jiao and Lower-Jiao temperatures increased notably following intervention within the treatment group (P<0.05); there was no significant difference before and after treatment within the control group. Metabolomics analysis revealed that differentially expressed metabolites found in IGT patients with Yang deficiency mainly included 4-acetylaminobutyric acid, 3-dehydrocholic acid, citric acid, cystine; additionally, fourteen metabolites showed differential expression when comparing the treatment group with controls including diaminoheptadecic acid , acetyl-l-carnitine ,and betaine . MetaboAnalyst analysis demonstrated that diabetic yang-deficiency constitution formation correlated with tricarboxylic acid cycle metabolism,glycine-serine-threonine metabolic axis(Gly-Ser-Thr), aminoacyl tRNA bioanabolic pathway; whereas Gly-Ser-Thr metabolic axis,sphingolipid metabolism related to Yang Hetians therapeutic effects. Conclusion The application of Yanghe-patch acupoint has been found to alleviate serum chronic inflammation and improve symptoms of yang-deficiency in IGT patients with a constitution characterized by yang-deficiency. Metabolomics analysis has identified various metabolites associated with their mechanism of action, among which the Gly-Ser-Thr metabolic axis-related pathway is considered as the pivotal pathway for regulating the yang-deficiency constitution in IGT individuals.

  Key words: impaired glucose tolerance；TCM Constitution；Acupoint application；Metabolomics

  Submit time: 12 September 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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