Key result
Yin deficiency increased the risk of new-onset albuminuria (HR 2.09) in patients with good glucose control, while phlegm stasis increased the risk (HR 2.26) in those with poor glucose control.
Why the study?
It was unknown whether traditional Chinese medicine body constitution independently predicts new-onset albuminuria in patients with type 2 diabetes mellitus to support its integration into diabetes care management.
Does traditional Chinese medicine body constitution predict new-onset albuminuria in patients with type 2 diabetes?
Cohort (n=426)
No
Does traditional Chinese medicine body constitution predict new-onset albuminuria in patients with type 2 diabetes?
Traditional Chinese medicine body constitution types, specifically Yin deficiency and phlegm stasis, may serve as independent predictors for new-onset albuminuria in patients with type 2 diabetes, with effects varying by glycemic control.
Answers are grounded in this paper and cite their sources.
BC may flag T2DM patients for albuminuria monitoring; hypothesis-generating for TCM integration into DCMP, needing RCTs before any practice shift.
This prospective cohort study explored whether body constitution (BC) independently predicts new-onset albuminuria in persons with type 2 diabetes mellitus (T2DM) enrolled in the diabetes care management program (DCMP) of a medical center, providing evidence of integrating traditional Chinese medicine into DCMP for improving care quality. Persons with T2DM (n = 426) originally without albuminuria enrolled in DCMP were recruited in 2010 and were then followed up to 2015 for detecting new-onset albuminuria. The participants received urinalysis and blood test annually. Albuminuria was determined by an elevated urinary albumin/creatinine ratio (≥ 30 µg/mg), and poor glucose control was defined as Glycosylated hemoglobin above or equal to 7%. BC type (Yin deficiency, Yang deficiency, and phlegm stasis) was assessed using a well-validated body constitution questionnaire at baseline. Risk factors for albuminuria (sociodemographic factors, diabetes history, lifestyle behaviors, lipid profile, blood pressure, and kidney function) were also recorded. Hazard ratios (HR) of albuminuria for BC were estimated using multivariate Cox proportional hazards model. During the 4-year follow-up period, albuminuria occurred in 30.5% of participants (n = 130). The HR indicated that Yin deficiency was significantly associated with an increased risk of new-onset albuminuria in persons with T2DM and good glucose control after adjustment for other risk factors (HR = 2.09; 95% confidence interval = 1.05-4.17, P = .04), but not in those with poor glucose control. In persons with T2DM and poor glucose control, phlegm stasis was also significantly associated with a higher risk of albuminuria (2.26; 1.03-4.94, P = .04) after multivariate adjustment, but not in those with good glucose control. In addition to already-known risk factors, BC is an independent and significant factor associated with new-onset albuminuria in persons with T2DM. Our results imply Yin deficiency and phlegm stasis interacting with glucose control status may affect new-onset albuminuria in persons with T2DM.
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Lee et al. (2022) conducted a cohort in Type 2 diabetes mellitus without baseline albuminuria (n=426). Traditional Chinese medicine body constitution (Yin deficiency, Yang deficiency, Phlegm stasis) vs. Absence of the specific body constitution was evaluated on New-onset albuminuria (urinary albumin/creatinine ratio ≥ 30 µg/mg) (HR 2.09, 95% CI 1.05-4.17, p=0.04). Yin deficiency increased the risk of new-onset albuminuria (HR 2.09) in patients with good glucose control, while phlegm stasis increased the risk (HR 2.26) in those with poor glucose control.
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