Study on plasma metabolomics analysis of Yanghe-patch in the treatment of impaired glucose tolerance with Yang-deficiency constitution
Objective To investigate the impact of Yanghe-patch acupoint in the treatment of impaired glucose tolerance(IGT)with Yang-deficiency constitution and its influence on serum metabolites.Methods The study enrolled a total of 63 patients with IGT were randomly selected and stratified into two groups:The control group(32 cases)and the treatment group(31 cases)at Ningbo Municipal Hospital of TCM Affliated to Zhejiang Chinese Medical University from October 2022 to January 2024,blood glucose,blood lipids,tumor necrosis factor-α(TNF-α),Yang-deficiency body mass score,and infrared thermal imaging temperature before and after treatment were compared between two groups.Furthermore,29 healthy individuals were selected as healthy negative controls,and their serum metabolites were analyzed by using liquid chromatograph-mass spectrometer(LC-MS)among three groups.Principal component analysis and orthogonal projections to latent structures-discriminate analysis were employed to identify characteristic differential metabolites.Additionally,key metabolic pathways were screened through network analysis by using MetaboAnalyst software.Results The treatment group after Yanghe-patch showed significant reductions in fasting blood glucose,glycosylated hemoglobin,triglycerides,low-density lipopro-tein and TNF-α levels(P＜0.05).Additionally,Yang-deficiency constitution conversion points significantly decreased within the treatment group(P＜0.05),while there were significant increases in the temperatures of Ren channel,Du channel,middle-Jiao and lower-Jiao(P＜0.05).However,there was a notable decrease in upper-Jiao temperature(P＜0.05).Metabolomics analysis identified varying levels of serum metabolites in IGT patients with Yang-deficiency constitution,such as 4-acetylaminobutyric acid,3-dehydrocholic acid,citric acid,and cystine etc.16 metabolites.Treatment group exhibited distinct expression patterns for 16 metabolites(including diaminoheptadecic acid,acetyl-L-carnitine and monobutyl phthalate etc.).The analysis by MetaboAnalyst shows that Yang-deficiency constitution with IGT was linked to dysregulation in the tricarboxylic acid cycle,aminoacyl bioanabolic pathway,and Gly-Ser-Thr metabolic axis.Additionally,Yanghe-patch intervention affects the glycine,serine and threonine(Gly-Ser-Thr)metabolic axis and sphingolipid metabolism.Conclusion The application of Yanghe-patch on acupoints shows potential in alleviating chronic systemic inflammation and improving symptoms associated with Yang-deficiency constitution in individuals with IGT.Metabolomics analysis has revealed a range of metabolites involved in their mechanism,among which the Gly-Ser-Thr metabolic pathway is considered crucial for regulating the constitution of Yang-deficiency constitution in individuals with IGT.
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