So-Yang Type Research Articles

한국인 중년성인에서 사상체질과 폐기능장애, 대사증후군의 연관성 연구

Objectives Impaired lung function(ILF) and sasang constitution(SC) is associated with metabolic syndrome(MS). However, the relationship between ILF and SC is unclear. So, we assessed the relationship between ILF and MS according to SC, and examined whether SC is an independent risk factor for ILF. Methods This study included 1,148 subjects 40years and older who were performed the health examination at Kyung Hee University Hospital in Korea between December 2011 and February 2013. We defined ILF if FVC or <TEX>$FEV_1$</TEX> value were less than lower limit of normal(LLN), and classified ventilatory patterns as obstructive pattern and restrictive pattern. MS was assessed according to AHA/NHLBI criteria. We used multivariate logistic regression to analyze the association of ILF with MS respective to SC types, and to identify the risk of SC types for ILF. Odds ratio(OR) was calculated by adjusting for age, sex, smoking status, drinking, physical activity, and BMI. Results In whole subjects, ILF was associated with MS [OR (95% CI), 1.69 (1.24-2.31) for FVC, 1.67 (1.20-2.33) for <TEX>$FEV_1$</TEX>]. And in Taeeum type(TE type) and Soeum type(SE type), ILF was associated with MS [1.63 (1.10-2.42) for FVC, 1.48 (1.01-2.24) for <TEX>$FEV_1$</TEX> in TE type; 6.93 (1.14-42.00) for FVC in SE type], while in Soyang type(SY type), it wasn't. The restrictive pattern was associated with MS in TE type and SE type, while in SY type, it wasn't. Furthermore, TE type and SY type had more risk for ILF than SE type [1.71 (1.12-2.59) for SY type, 1.95 (1.23-3.08) for TE type in FVC; 2.06 (1.26-3.36) for TE type in <TEX>$FEV_1$</TEX>; 1.85 (1.21-2.85) for SY type, 2.17 (1.35-3.49) for TE type in Restrictive pattern]. Conclusions These results show that SC is an independent risk factor for ILF, especially TE type and SY type than SE type, and the prevalence of MS is an independent risk factor for ILF in TE type.

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

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 methodsFrom 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. ResultsOf 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). ConclusionsThe 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.

CBCL을 통해 살펴본 아동 사상체질별 문제행동의 차이 분석

Objectives The goal of the present study was to elucidate the characteristics of behavior problems in Sasang typology with child patients. Methods Subjects consisted of 176 (95 boys, 81 girls) children from 36 months to 83 months were diagnosed by two clinical experts in pediatrics and Sasang medicine. There were 22 So-Yang types, 141 Tae-Eum types, and 13 So-Eum types. The behavior problems were measured with Child Behavior Checklist (CBCL) and ANOVA (analysis of variance) was used for the analysis. Results There were no significant differences between Sasang types among subject's age (F(2, 173)=.190, p=.827) and sex (<TEX>${\chi}^2$</TEX>(2, N=176)=1.639, p=.441) as well as their mother's age (F(2, 169)=.060, p=.942) and education level (<TEX>${\chi}^2$</TEX>(4, N=172)=.394, p=.983) and their father's age (F(2, 168)=1.184, p=.309) and education level (<TEX>${\chi}^2$</TEX>(4, N=172)=5.664, p=.226). So-Yang types (<TEX>$50.14{\pm}22.35$</TEX>; <TEX>$17.27{\pm}8.60$</TEX>) had higher scores than Tae-Eum types (<TEX>$38.74{\pm}21.32$</TEX>; <TEX>$12.62{\pm}7.98$</TEX>) in total problems and internalizing problems score of the CBCL, respectively. More specifically, So-Yang types (<TEX>$5.90{\pm}2.81$</TEX>; <TEX>$3.77{\pm}1.90$</TEX>) had significantly higher depression/anxiety and somatization subscale score than Tae-Eum types (<TEX>$4.04{\pm}2.73$</TEX>; <TEX>$2.30{\pm}2.12$</TEX>). Scores of So-Yang types were significantly higher than those of CBCL clinical group in depression/anxiety and somatization subscales. Conclusions There were significant differences between child outpatients with different Sasang types, which would be taken into consideration concerning development of Sasang type diagnosis in addition to parenting, treatment, and prevention for children.

Tae-Eum Type as an Independent Risk Factor for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is prevalent and associated with several kinds of chronic diseases. There has been evidence that a specific type of Sasang constitution is a risk factor for metabolic and cardiovascular diseases that can be found in patients with OSA, but there are no studies that address the association between the Sasang constitution type (SCT) and OSA. The purpose of this study was to investigate the association between the SCT and OSA. A total of 652 participants were included. All participants were examined for demographic information, medical history, and completed an interviewer-administered questionnaire on life style and sleep-related variables. Biochemical analyses were performed to determine the glucose and lipid profiles. An objective recording of OSA was done with an unattended home PSG using an Embla portable device. The apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were significantly higher in the Tae-eum (TE) type as compared to the So-eum (SE) and the So-yang (SY) types. Even after adjusting for confounding variables, the TE type still had a 2.34-fold (95% CI, 1.11–4.94; P = 0.0262) increased risk for OSA. This population-based cohort study found that the TE constitutional type is an independent risk factor for the development of OSA.

Sasang types may differ in eating rate, meal size, and regular appetite: a systematic literature review.

Eating behaviours may be implicated in the increasing prevalence of obesity and metabolic disorders. The Sasang typology, a unique form of traditional Korean medicine, classifies individuals into four constitutional types that differ in a distinctive complex of external manifestations and innate natures, including eating behaviours. Our aim is to portray a picture of the distinguishing characteristics of eating behaviours across Sasang types and to provide suggestions for future studies. Six Korean and one English database were searched to acquire relevant articles. Ten peer-reviewed relevant research articles were found. The extracted data were categorised into the domains of i) food preferences; ii) eating rate; iii) eating initiation and termination; iv) meal size; v) regularity of eating; vi) regular appetite; vii) eating disorders; and viii) psychological factors. Eating rate and meal size were the issues of most concern that more frequently were different among Sasang types. The TaeEum type seemed to have obesity-linked eating behaviours, including a rapid eating rate, large meal sizes, and a strong appetite, whereas those attitudes seemed to be in contrast with those of the SoEum type. The SoYang type shared similarities with both the TaeEum and SoEum types. Future studies should be conducted with more reliable, objective, and quantitative assessment tools such as the Three Eating Factor Questionnaire or the Dutch Eating Behaviour Questionnaire.

Relation between body mass index and resting metabolic rate, cardiorespiratory fitness and insulin sensitivity in Sasang typology for young male persons: An observational study

IntroductionMetabolic efficiency and low physical fitness may be determined by inherited genetic factors and implicated in the increasing prevalence of obesity and metabolic disorders. Aim of the studyThis study examines the distinctive characteristic in energy expenditure (EE) profile, physical fitness, and obesity-linked biomarkers across Sasang types. MethodologyEE at fasting and postprandial states, physical fitness including maximal oxygen consumption (VO2max) and time to exhaustion (Te) were measured by an indirect calorimeter in 51 young male participants. Plasma insulin concentration and HOMA-IR indices before and after eating were analyzed. ResultsNo difference was found in resting metabolic rate (RMR), thermic effect of food (TEF), VO2max, Te, and in plasma insulin and glucose concentration, and HOMA-IR indices before and after eating. Body mass index (BMI) contributed to the increase of RMR in the SoYang (SY) type (n=17), but not in the TaeEum (TE) (n=17) and SoEum (SE) (n=17) types, whereas BMI was inversely associated with the physical fitness in the TE and SE types, but not in SY type, and BMI was positively related to the plasma insulin concentration and insulin sensitivity in the TE type before and after eating, but not in the SE and SY types. ConclusionTogether, it can be assumed that high BMI is related to health risk in the TE and SE types, especially in the TE type, but not in the SY type.

Development and validation of a personality assessment instrument for traditional korean medicine: sasang personality questionnaire.

Objective. Sasang typology is a traditional Korean medicine based on the biopsychosocial perspectives of Neo-Confucianism and utilizes medical herbs and acupuncture for type-specific treatment. This study was designed to develop and validate the Sasang Personality Questionnaire (SPQ) for future use in the assessment of personality based on Sasang typology. Design and Methods. We selected questionnaire items using internal consistency analysis and examined construct validity with explorative factor analysis using 245 healthy participants. Test-retest reliability as well as convergent validity were examined. Results. The 14-item SPQ showed acceptable internal consistency (Cronbach's alpha = .817) and test-retest reliability (r = .837). Three extracted subscales, SPQ-behavior, SPQ-emotionality, and SPQ-cognition, were found, explaining 55.77% of the total variance. The SPQ significantly correlated with Temperament and Character Inventory novelty seeking (r = .462), harm avoidance (r = −.390), and NEO Personality Inventory extraversion (r = .629). The SPQ score of the So-Eum (24.43 ± 4.93), Tae-Eum (27.33 ± 5.88), and So-Yang (30.90 ± 5.23) types were significantly different from each other (P < .01). Conclusion. Current results demonstrated the reliability and validity of the SPQ and its subscales that can be utilized as an objective instrument for conducting personalized medicine research incorporating the biopsychosocial perspective.

P02-417 - Hippocrates, eysenck and the sasang typology

IntroductionA systematic review of studies related to the psychological characteristics of Sasang typology, a traditional Korean personalized medicine utilizing acupuncture and medical herbs, was conducted with the goal of delineating generalizable psychological profiles of each types using western academic traditions.MethodsJournal articles were collected using 5 electronic database systems in the United States and Korea, and 21 peer reviewed research articles with psychometric inventories were included. Due to the heterogeneity of the studies, the present study sought to report the mutual relevance of the studies based on research results pertaining to the correlation between psychological assessment instruments.ResultsResults of the review indicate that two super-factors of Eysenck, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension compared to the So-Eum type. Current studies with Cloninger's Temperament and Character Inventory also showed that the Novelty Seeking and the Harm Avoidance can be related to the So-Yang and the So-Eum type, respectively.ConclusionsThe present systematic review indicates that Neo-Confucianism-based Sasang typology shares similarities with the western psychological tradition. There is an urgent need to study similarities and differences between both of them in multiple perspectives including mechanism of action beneath the medical intervention. The Bio-psycho-social basis of the Sasang typology can guide us to the temperament-based personalized integrative medicine covering western orthodox and traditional oriental medicine.

Impact of the Sasang Constitutional Type on the High-Sensitivity C-Reactive Protein, a Predictor of Cardiovascular Disease

Abstract Impact of the Sasang Constitutional Type on the High-Sensitivit yC-Reactive Protein, a Predictor of Cardiovascular Disease Mi-Jeong Kang * , Ji-Won Lee, Eui-Ju Lee, Byung-Hee Koh, Jun-Hee LeeDept. of Sasang Constitutional Medicine. College of Oriental Medicine, Kyung Hee University. Seoul. Korea * Kyung Hee University. Seoul. Korea 1. Objectives The purpose of this study was to investigate the high-sensitivity C-reactive protein (hsCRP) related characteristics found in each Sasang Constitutional type. 2. Methods This cross-sectional epidemiological study was conducted using data from 2,842 men and women. After typing each participant into one of the four Sasang constitutional types, they were analyzed on various cardiovascular disease-related variables. 3. Results 1) The predictors of cardiovascular disease (metabolic syndrome, high risk FRS group, high risk hsCRP group) was found to show the highest prevalence in the Taeeum type.2) In the group with metabolic syndrome, the mean hsCRP concentration in the Taeeum and Soyang types were higher than in the Soeum type. In the group without metabolic syndrome, the mean hsCRP concentration in the Taeeum type were higher than in the Soyang and Soeum types. 3) In the FRS low risk group, the mean hsCRP concentration were higher in order of Taeeum type > Soyang type > Soeum type. In the FRS high risk group, the mean hsCRP concentrations were not significantly different among the Sasang constitutional types.

A Study on the Constitution Type-Specific Presentation of Physical Symptoms

1. Objectives: This clinical study was conducted to understand the differences between Sasang constitutional types and to identify the physical symptoms presentation specific to each Sasang constitutional type. 2. Methods: In this descriptive study, 2,629 subjects (1,061 Taeeum-type, 683 Soeum-type, 885 Soyang-type) were surveyed between Nov 1, 2007 and Jul 31, 2010. The subjective symptoms experienced by the subjects were collected using a Physical Symptoms questionnaire, and the subjects were interviewed by Sasang specialists who determined the subjects' constitutional type. The data (in crude number and percentage) was analyzed on the general characteristics, Sasang constitutional type, and physical symptoms using the SPSS 17.0 software. The symptomatic presentation in men and women were analyzed on Sasang constitutional distribution using the chi-square test. 3. Results: 1) The physical symptoms specific to each Sasang constitutional type were as follows: 'frequent aphthous lesions in the oral cavity', 'lingering fatigue after sleep', 'headache', 'common cold symptoms presenting as loss of appetite or indigestion', and 'physical deterioration presenting as problems with digestion' in the Soeum type; 'physical deterioration presenting as problems in perspiration' and 'swelling and puffiness' in the Taeeum type; and 'excessive forgetfulness' in the Soyang type. 2) The physical symptoms specific to each Sasang constitutional type in men were as follows: 'Unilateral or bilateral headaches, 'frequent aphthous lesions in the oral cavity', 'common cold symptoms presenting as rhinorrhea or nasal congestion', 'common cold symptoms presenting as loss of appetite or indigestion', and 'physical deterioration presenting as problems with digestion' in the Soeum type; and 'swelling and puffiness' in the Taeeum type. 3) The physical symptoms specific to each Sasang constitutional type in women were as follows: 'common cold symptoms presenting as headaches', 'common cold symptoms presenting as loss of appetite or indigestion', 'physical deterioration presenting as problems with digestion' in the Soeum type; and 'pain in knees', 'redness of eyes', 'dryness of mouth', 'common cold symptoms presenting as coughing', 'physical deterioration presenting as problems in perspiration', 'swelling and puffiness' in the Taeeum type. 4. Conclusions: This study demonstrates that physical symptoms present in constitutional type-specific patterns. Understanding of the personal Sasang constitutional type and systematic, personalized healthcare based on constitutional typology is anticipated to contribute to improved health management strategy.

Temperament and Character Profiles of Sasang Typology in an Adult Clinical Sample

The purpose of this study was to examine the biopsychological personality profiles of traditional Korean Sasang typology based on the Temperament and Character Inventory (TCI) in a Korean adult clinical sample. A total of 97 adults completed the Korean version of the TCI. The participants were classified as one of three traditional Korean Sasang types (31 So-Yang, 41 Tae-Eum, 25 So-Eum) by three specialists in Sasang typology. The seven dimensions of TCI were compared between the different Sasang types using analysis of variance (ANOVA) and profile analysis. There were no significant differences in age, gender and education across the Sasang types. The TCI profile for each of the Sasang types was significantly different (profile analysis, df = 5.038, F = 3.546, P = .004). There were significant differences in the temperament dimensions of Novelty Seeking (F = 3.43, P = .036) and Harm Avoidance (F = 5.43, P = .006) among the Sasang types. The Novelty Seeking score of the So-Yang type (31.90 ± 9.87) was higher than that of the So-Eum type (25.24 ± 9.21; P = .019) while the So-Eum type (44.64 ± 8.47) scored higher on the Harm Avoidance score compared to the So-Yang type (35.16 ± 11.50; P = .003). There were no significant differences in the temperament dimension of Reward Dependence and Persistence, and the three character dimensions of Self-Directedness, Cooperativeness and Self-Transcendence. Results demonstrated distinct temperament traits associated with traditional Korean Sasang types using an objective biopsychological personality inventory. With further study, the Sasang typology may lead to enhanced clinical safety and efficacy as part of personalized medicine with traditional medicine.

Body Mass Index and Facial Cues in Sasang Typology for Young and Elderly Persons

Facial characteristics may provide reliable information giving an insight into the inner nature of an individual. This study examines the differences in widely used facial metrics, including cheek-to-jaw width ratio (CJWR), width-to-height ratio (WHR), perimeter-to-area ratio (PAR), and facial masculinity indexes across Sasang constitutional types, to investigate the association between these facial cues and body mass index (BMI) and develop a predictive model for Sasang typing. 2D images of 911 participants were analyzed. The results indicated that TaeEum (TE) type generally has a squarer face, with the male TE type having a squarer and wider face than that of both SoYang (SY) and SoEum (SE) types. Male TE type has longer eyes than that of the SE type, and the lower face of the female TE type is longer than that of the SY type. PAR, WHR, CJWR, and eye size had associations with BMI, and the magnitude of correlation of CJWR in Korean men were twofold higher than that of the Caucasian and African men. BMI and facial metrics including PAR, WHR, CJWR, and eye size were good predictors for TE type, and the most parsimonious model for TE typing included BMI and CJWR with high predictive performances.

Investigation of Genetic Evidence for Sasang Constitution Types in South Korea

In Sasang constitutional medicine, both disease susceptibility and drug response are considered to be related to the characteristics of an individual’s physiology and psychology: a theory which is central to traditional Korean medicine. Based on such observable characteristics, Sasang constitutional medicine classifies people into four constitutional types. Genetic studies of Sasang constitution would help reveal the inheritance patterns and models of the typological traits and, moreover, help with traditional medical diagnosis and treatment. To investigate the heritable aspect of Sasang constitution, we collected various pedigrees from South Korea. The study population has 101 pedigrees composed of 593 individuals. The determination of the Sasang constitution type of each individual was performed by doctors who diagnose the Sasang constitutional type of individuals as part of their professional practice. We calculated estimates of familial correlation and heritability. Parent-Offspring pairs showed the strongest familial correlation of Sasang constitutional type, with the correlation values of 0.21 and 0.28, followed by sibling pairs with the value ranging between 0.14 and 0.25. From the heritability analysis conducted with the Variance-Component method, the heritability of TE (Tae-Eum) type, SY (So-Yang) type, and SE (So-Eum) type were 55%, 41%, and 47%, respectively. This pattern of heritability was consistent with different set of analyses, which suggest the robustness of our result. Our result clearly shows that the Sasang constitution type is heritable, and further genetic analysis based on our result will shed light on the biological mechanism of Sasang constitution.

Contributions of Sasang Constitutional Medicine

Contributions of Sasang Constitutional Medicine

Psychological profile of sasang typology: a systematic review.

A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition.

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.