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      Prevalence of and associations between metabolic syndrome and the constitutions defined by Korean Eight Constitution Medicine

      research-article
      , MD (DKM), PhD a , b , , MD (DKM), PhD, MPH c , , PhD d , , MD, PhD, MPH b , e , , MS f , , MD (DKM), PhD b , g ,
      Medicine
      Wolters Kluwer Health
      constitutional medicine, Eight Constitution Medicine, Korean medicine, metabolic syndrome

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          Abstract

          Eight Constitution Medicine (ECM) is a Korean constitutional medicine system that classifies people into 8 types: Pulmotonia (PUL), Colonotonia (COL), Renotonia (REN), Vesicotonia (VES), Pancreotonia (PAN), Gastrotonia (GAS), Hepatonia (HEP), and Cholecystonia (CHO). Metabolic syndrome (MS) is a major public health problem worldwide. We assessed the prevalence of and associations between ECM and MS. Cross-sectional convenience sample of 245 adults was used at a medical check-up center in Seoul, South Korea, from 2010 to 2015. Adults were classified into 1 of 8 constitutions by an ECM specialist. MS was diagnosed on the basis of National Cholesterol Education Program Adult Treatment Panel III and Asian Pacific Criteria for abdominal obesity. We also computed the prevalence by percentage and calculated odds ratios (ORs) for MS among 6 constitutions with PUL as the reference.

          Among 245 adults, 20 (8.2%) were diagnosed with PUL, 43 (17.6%) with COL, 35(14.3%) with REN, 4 (1.6%) with VES, 71 (29.0%) with PAN, 0 (0.0%) with GAS, 54 (22.0%) with HEP, and 18 (7.3%) with CHO. The prevalence of MS in the constitutions was significantly different: CHO, 38.9%; HEP, 35.2%; PAN, 18.3%; COL, 11.6%; PUL, 5.0%; REN, 2.9% (P = .001). We observed higher ORs for HEP and CHO (OR = 13.03, 95% confidence interval [CI] = 1.61–105.70; and OR = 13.19, 95% CI = 1.39–125.46, respectively) than for the other constitutions.

          People with HEP and CHO constitutions could be at higher risk for MS. Therefore, ECM-based diagnosis may be useful for preventing and managing MS.

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          Most cited references24

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          Diagnosis and classification of diabetes mellitus.

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            An alternative way to individualized medicine: psychological and physical traits of Sasang typology.

            Disease susceptibility and drug response of individuals are presumed to be different depending on their personality traits. The Sasang typology, a traditional Korean medical typology, explains the individual differences of vulnerability to pathology and proposes guidelines for the safe and effective use of medical herbs depending on individual traits. The purpose of the present study was to evaluate psychologic and physical characteristics of Sasang types from the perspective of personality theory. After determining the Sasang type of 79 college students based on the Questionnaire for the Sasang Constitution Classification, the psychologic and physical traits of each type were analyzed by the Meyers-Briggs Type Indicator (MBTI) and Bioelectrical Impedance Analysis, respectively. Each of the Sasang types showed significantly different profiles based on the MBTI scores (generalized estimation equation, coefficient = 11.88, z = 2.13, p = 0.033) and could be distinctively classified based on their MBTI scores (discriminant analysis Wilks' lambda = 0.611, df = 8, chi(2) = 36.7, p < 0.001). Subjects with the So-Eum type (Introversion and Judging) and the So-Yang type (Extroversion and Perceiving) showed contrasting psychologic features. However, they had similar anthropometric characteristics. Subjects with Tae-Eum type had relatively higher body fat mass. Current results demonstrated distinctive personality traits associated with Sasang types using reproducible psychometric and anthropometric instruments. With further study, the Sasang typology could serve as a scientific tool for individualized and integrative medicine.
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              Genetic versus environmental aetiology of the metabolic syndrome among male and female twins.

              The aetiology of the metabolic syndrome including hyperinsulinaemia, glucose intolerance, dyslipidaemia, hypertension and obesity is not known. We studied the relative impact of genetic versus environmental factors for the development of the components in the syndrome among male and female twins. A total of 303 elderly twin pairs participated in the study. We report concordances and heritability estimates of the components by classic twin analysis to assess the proportion of variation attributed to genetic factors. All components correlated significantly. The concordance rates for glucose intolerance, overall obesity and low HDL-cholesterol were significantly higher among monozygotic than dizygotic twins indicating a genetic influence on the development of these phenotypes. The heritability estimates for glucose concentration, BMI and HDL-cholesterol among monozygotic twins confirmed these findings. The heritability estimates for waist-to-hip ratio, fasting insulin and triglycerides, however, were low, indicating a major environmental influence. We found a higher genetic influence on glucose intolerance and systolic blood pressure and a lower genetic influence on low HDL-cholesterol and diastolic blood pressure among male twins compared to female twins. Based on the correlations between the components in the syndrome, we propose a core complex including hyperinsulinaemia, obesity, hypertriglyceridaemia and low HDL-cholesterol with only weak associations to glucose concentrations and blood pressure levels. The study confirms the notion of a multifactorial aetiology of the components including genetic and non-genetic factors. The differences in aetiology between male and female twins indicate an influence of sex on several of the components in the metabolic syndrome.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                February 2020
                14 February 2020
                : 99
                : 7
                : e19074
                Affiliations
                [a ]Elim Constitution Clinic, Seoul
                [b ]School of Medicine, Cha University, Gyeonggi-do
                [c ]College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
                [d ]Mennonite College of Nursing, Illinois State University, Illinois
                [e ]Gangnam Major Clinic, Seoul, Republic of Korea
                [f ]LA Jesun Constitution Clinic, LA, California
                [g ]Chaum Life Center, Seoul, Republic of Korea.
                Author notes
                []Correspondence: Chang-Keun Kim, Chaum Life Center, CHA University School of Medicine, 442, Dosan-daero, Gangnam-gu, Seoul 06062, Republic of Korea (e-mail: ecm1967@ 123456naver.com ).
                Article
                MD-D-19-04124 19074
                10.1097/MD.0000000000019074
                7035102
                32049808
                03156db8-f265-4a77-859a-88480c2e3422
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                : 29 May 2019
                : 29 December 2019
                : 7 January 2020
                Categories
                3800
                Research Article
                Observational Study
                Custom metadata
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                constitutional medicine,eight constitution medicine,korean medicine,metabolic syndrome

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