Abstract
In Kampo medicine, blood stasis (BS) syndrome is strongly associated with microangiopathy and can lead to atherosclerosis. Vascular endothelial dysfunction (VED), evaluated through flow-mediated dilation (FMD), plays an important role in the early stages of atherosclerosis. However, the association of BS syndrome with VED, as determined using FMD, has not been reported. This study investigated the association between BS syndrome and VED using FMD. Forty-one patients with normal glucose tolerance or impaired glucose tolerance (IGT) and without macrovascular complications were evaluated using FMD from May 2017 to August 2017. Based on the BS score, the patients were divided into the non-BS (n = 19) and BS syndrome (n = 22) groups. Physical and background characteristics, physiological function test results, and laboratory data were compared. Univariate analysis revealed that FMD and a history of dyslipidemia/IGT were significantly different between the two groups (p < 0.05). Multiple logistic regression analysis showed that BS syndrome was significantly associated with FMD (odds ratio: 6.26; p=0.03) after adjusting for the history of dyslipidemia/IGT. The receiver operating characteristic curve showed that the area under the curve for BS syndrome (0.74; p < 0.001) and history of IGT (p < 0.007) provided good diagnostic accuracy for FMD. The area under the curve for “BS syndrome + IGT” showed very good accuracy (0.80; p < 0.0001) and was higher than that for BS syndrome or IGT alone. In conclusion, the results of this study suggest that the BS score in Kampo medicine could be a useful tool for detecting the early pathogenic stages of atherosclerosis.
Highlights
Various pathological conditions can cause vascular endothelial dysfunction (VED) in the first stage of atherosclerotic changes. ese pathological conditions are often related to lifestyle behaviors, such as an unbalanced diet, lack of sleep or exercise, excessive drinking, stress, and smoking
We investigated the relationship between the blood stasis (BS) syndrome of Kampo medicine and VED, as determined by flow-mediated dilation (FMD), by examining various parameters including physical and background characteristics, physiological function test results, and laboratory test results of patients who underwent screening for atherosclerosis (Tables S1—S4 in the Supplementary Material)
Baseline characteristics of the patients in the NBS and BS syndrome groups who completed all the tests are summarized in Table 2. e BS syndrome group had a significantly lower FMD (4.9 ± 1.4 vs. 3.3 ± 1.7, p < 0.01) than the NBS group; the BS syndrome group had a significantly higher prevalence of a history of DLP/impaired glucose tolerance (IGT) (p < 0.05/p < 0.01) than the NBS group
Summary
Various pathological conditions can cause vascular endothelial dysfunction (VED) in the first stage of atherosclerotic changes. ese pathological conditions are often related to lifestyle behaviors, such as an unbalanced diet, lack of sleep or exercise, excessive drinking, stress, and smoking. According to Kampo medicine theory, the human body is composed of three major elements: qi, blood, and fluid Abnormalities in these elements help define Mibyou, the socalled “disease-oriented” healthy stage [3] which can cause subjective symptoms in patients; this condition is often not detected by Western medicine due to the absence of abnormal results in routine tests such as blood tests or physiological function tests. VED, which can be evaluated using flow-mediated dilation (FMD), is an early functional change of atherosclerosis It leads to arterial stiffness, which can be assessed using CAVI, and causes arterial stenosis, which can be evaluated using the ABI. We investigated the relationship between the BS syndrome of Kampo medicine and VED, as determined by FMD, by examining various parameters including physical and background characteristics, physiological function test results, and laboratory test results of patients who underwent screening for atherosclerosis (Tables S1—S4 in the Supplementary Material)
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