Etiology Exploration of Non-alcoholic Fatty Liver Disease From Traditional Chinese Medicine Constitution Perspective: A Cross-Sectional Study

Abstract

Background: From the traditional Chinese medicine (TCM) constitution theory perspective, the phlegm-dampness constitution is thought to be closely related to the occurrence of non-alcoholic fatty liver disease (NAFLD). However, this viewpoint still lacks rigorous statistical evidence. This study aimed to test the association between the phlegm-dampness constitution and NAFLD.Methods: We conducted a cross-sectional study. Participants were residents living in Chengdu, China, undergoing health checkups at the health management center of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between December 2018 and September 2020. TCM constitution type was diagnosed by DAOSH four examinations instrument, NAFLD was diagnosed according to the liver ultrasonography and medical history. Multivariate logistic regression and propensity score matching (PSM) were used to analyze a total of 1,677 qualified data.Results: 1,037 participants had biased constitution(s), 67.8% of which had mixed constitutions (with at least two constitutions). Among 1,677 participants, the phlegm-dampness constitution was associated with the yang-deficiency, yin-deficiency, dampness-heat, qi-depression, and blood-stasis constitutions. The correlation coefficients were 0.11, 0.32, 0.42, 0.20, 0.14, respectively. Between the phlegm-dampness constitution and NAFLD, the odds ratio (OR) and the 95% confidence interval (CI) was 2.05 (1.57–2.69) in the crude model. After adjusting for age, gender, Body mass index (BMI), other biased constitutions, smoking, high blood pressure, diabetes, and dyslipidemia, the OR reduced to 1.51 (1.04–2.18). The associations of seven other biased TCM constitutions and NAFLD were not statistically significant in the fully adjusted model. The PSM analysis showed consistent results with the logistic regression.Conclusions: Among eight biased TCM constitutions, the phlegm-dampness constitution is independently associated with NAFLD. We speculate the phlegm-dampness constitution is a risk factor of NAFLD. Longitudinal studies are needed to confirm this causal relationship in the future. In addition, inconsistent with some TCM practitioners' experience, we disagree that the blood-stasis constitution is associated with NAFLD.

To explore the pathogenesis and scientific connotation of non‐alcoholic fatty liver based on the theory of turbid toxin of traditional Chinese medicine

“…Most of the medical practitioners agree that the key pathological factors of NAFLD are phlegm, dampness, turbidity, stasis, and heat, and the affected organs are mainly the liver, spleen, and kidney. A study involving 1677 patients diagnosed with NAFLD using the four diagnostic instruments suggested that the disease is associated with phlegm and dampness [9]. However, this paper proposes that turbid toxin is the primary factor in the formation of NAFLD.…”

Association between the traditional Chinese medicine constitution and metabolic dysfunction-associated fatty liver disease in older people: A cross-sectional study

“…Research has shown a strong correlation between the occurrence of metabolic disorders and the TCMC [ [12] , [13] , [14] ]. In fact, studies have been conducted on the distribution of TCMC types in NAFLD [ 15 , 16 ], but relevant, rigorous, large-sample investigations on the physical characteristics are lacking. Moreover, there is a significant difference between the new nomenclature (MAFLD) and the traditional nomenclature (NAFLD) in terms of disease connotation.…”

Dietary patterns and metabolic dysfunction-associated fatty liver disease in China’s multi-ethnic regions

“…In China, the prevalence of MAFLD is reported to be 29.2% [ 3 ], mainly due to sharp changes in lifestyle and diet [ 4 ]. In western China, where the majority of ethnic minorities live, the prevalence of MAFLD ranges from 21.8 to 26.1% [ 5 , 6 ]. Of note, during the last decade, the prevalence of MAFLD in this region has doubled according to previous studies [ 6 , 7 ].…”