血脂异常痰浊阻遏证和脾肾阳虚证患者血清27-HC、CPT1浓度水平特点及其典型相关性分析OA

Objective To investigate the characteristics of serum 27-hydroxycholesterol(27-HC)and carnitine palmitoyltransferase 1(CPT1)levels and their canonical correlations in patients with dyslipidemia of phlegm-dampness retention syndrome and spleen-kidney yang deficiency syndrome.Methods A cross-sectional field survey epidemiological study was conducted.A total of 58 patients with dyslipidemia who visited Dongzhimen Hospital,Beijing University of Chinese Medicine from May 2021 to February 2025 were enrolled,including 29 patients with phlegm-dampness retention syndrome and 29 patients with spleen-kidney yang deficiency syndrome.Additionally,22 healthy controls(normal group)were included,totaling 80 participants.Serum levels of 27-HC and CPT1 were measured using enzyme-linked immunosorbent assay(ELISA).The severity of syndromes was assessed using TCM syndrome scores obtained from a TCM syndrome rating scale.The characteristics of serum 27-HC and CPT1 levels in patients with dyslipidemia of phlegm-dampness retention syndrome and spleen-kidney yang deficiency syndrome were analyzed,and the canonical correlations between the levels of these oxidative stress-related factors and TCM syndromes were investigated.Results(1)There were no statistically significant differences in general characteristics(age,respiratory rate,heart rate,blood pressure)and disease-related indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG)]between patients with dyslipidemia of phlegm-dampness retention syndrome and spleen-kidney yang deficiency syndrome(P＞0.05).(2)Serum 27-HC levels in the normal group were significantly lower than those in patients with dyslipidemia of phlegm-dampness retention syndrome(P＜0.05),while serum CPT1 levels were significantly higher(P＜0.05).Serum 27-HC levels in patients with phlegm-dampness retention syndrome were significantly higher than those in patients with spleen-kidney yang deficiency syndrome(P＜0.05),while serum CPT1 levels were significantly lower(P＜0.05).(3)Serum CPT1 levels were negatively correlated with TCM syndrome scores in patients with dyslipidemia of both phlegm-dampness retention syndrome and spleen-kidney yang deficiency syndrome(P＜0.05).(4)Canonical correlation analysis indicated that serum CPT1 level had the most significant impact on TCM syndrome scores,and TCM syndrome scores in patients with phlegm-dampness retention syndrome had the most significant impact on the levels of oxidative stress indicators.Conclusion Serum levels of 27-HC and CPT1 differ between patients with dyslipidemia of phlegm-dampness retention syndrome and spleen-kidney yang deficiency syndrome.Serum CPT1 levels may reflect the severity of TCM syndromes in patients with dyslipidemia to some extent.Vascular endothelial injury resulting from enhanced oxidative stress characterizes the syndrome of phlegm-dampness retention syndrome in dyslipidemia,with macrophages playing a key role.The underlying mechanism may involve vascular endothelial injury caused by enhanced oxidative stress due to metabolic elasticity dysregulation.