The relationship of metabolic syndrome and constitutional medicine for the prediction of cardiovascular disease.

Abstract

The concept of Sasang Constitutional Medicine (SCM) has been in existence in Traditional Korean Medicine for more than 100 years. SCM consists of 4 different types; So-Eum (SE), So-Yang (SY), Tae-Eum (TE), and Tae-Yang (TY). In Western medicine, it is more like stratifying individuals according to phenotypic expression. It is of great importance that the Sasang constitution type be evaluated accurately and recognized by the medical communities for prevention, early diagnosis and treatment of cardiovascular diseases (CVD).

SUBJECTS AND METHODS: From the Ansung-Ansan prospective cohort study, 10,038 participants were recruited from years 2001-2002. Of 10,038 original participants, 3022 subjects underwent Sasang Constitutional Type (SCT) evaluation. The Cox proportional hazard model was used to predict CVD during the ten year follow-up period.

RESULTS: Of 3022 participants, SCT classified into 364 (12%) SE, 1053 (34.8%) SY, 1605 (53.1%) TE, and no TY. Three hundred seventy nine (16%) newly developed CVD during the following period, yielding 10-year cumulative incidence of 160/1000 person. The frequency of CVD within three SCT without metabolic syndrome (MetS) shows 13.4% in SE, 13.6% in SY, and 14.3% in TE, respectively (p=NS). The CVD events were significantly different among the types when MetS was present. The demographic and clinical characteristics revealed the TE group was significantly older, more obese, higher blood pressure, glucose values, and lipid profiles levels. The frequency of MetS and type 2 diabetes mellitus (T2DM) was also higher in TE type than either SE and SY types (all p<0.001). The Cox proportional hazard analysis revealed age, female gender, rural residence, higher ALT level, and lower beta-cell function remain as an independent risk factor, as well as SY with MetS (RR=1.838 (95% CI 1.23-2.74), p=0.003). Furthermore, 10 year CVD survival rate was 86.4% in no MetS group, 83.4% in TE, 79.6% in SE, and 76.4% in SY all with MetS (p<0.001).

CONCLUSIONS: The findings from this study suggest MetS increases risk for CVD in certain physical conditions like SY type. Therefore, we would like to suggest that SCT is a strong indicator for CVD.