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Bahari F, Yavari M. Hot and Cold Theory: Evidence in Systems Biology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1343:135-160. [DOI: 10.1007/978-3-030-80983-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Mobeen F, Sharma V, Prakash T. Comparative gut microbiome analysis of the Prakriti and Sasang systems reveals functional level similarities in constitutionally similar classes. 3 Biotech 2020; 10:379. [PMID: 32802721 PMCID: PMC7413973 DOI: 10.1007/s13205-020-02376-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022] Open
Abstract
The traditional medicinal systems (TMS) of India (Prakriti) and Korea (Sasang) classify human individuals based on their constitution determined by the physiological and psychological traits of individuals. Similarities in the constitutions are already found between the classes of Prakriti (Vata, Pitta, and Kapha) and Sasang (TE: Taeeumin, SE: Soeumin, and SY: Soyangin) systems. Gut health is an important aspect of this constitution based classification in TMS. To determine the role of gut microbes in such classifications, we have analyzed the gut microbiome (taxa and imputed functions) in the constitutionally similar Prakriti and Sasang classes. An enrichment of Bacteroides and Prevotella enterotypes is observed in the Sasang and Prakriti samples, respectively. The impact of the constitution is found to be more prominent with respect to the taxa and predicted-functions within the Prakriti classes. Gut microbiome functional-level similarities are found to correlate well with the host phenotypes of the constitutionally similar Prakriti and Sasang classes. An enrichment of carbohydrate and amino-acid metabolism is observed in the Vata and SE classes which may be responsible for meeting with their high energy demands and lean phenotype. The Pitta and SY classes exhibit the high capacity to metabolize toxins. An enrichment of functions responsible for predisposition to obesity and high drug metabolism is observed in the Kapha and TE classes. The contribution of gut adaptive functions is found to correlate with the constitution-based classification in both Prakriti and Sasang systems. The TE class harboured the highest number of biofilm-forming and stress-tolerant microbes thus exhibiting the maximum tolerance of environmental stress. Similarities in the gut microbiota and the resulting disease predisposition patterns are found to exist between the constitutionally matching Prakriti and Sasang classes.
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Affiliation(s)
- Fauzul Mobeen
- School of Basic Sciences, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh 175005 India
| | - Vikas Sharma
- School of Basic Sciences, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh 175005 India
| | - Tulika Prakash
- School of Basic Sciences, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh 175005 India
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Baek Y, Seo BN, Jeong K, Yoo H, Lee S. Lifestyle, genomic types and non-communicable diseases in Korea: a protocol for the Korean Medicine Daejeon Citizen Cohort study (KDCC). BMJ Open 2020; 10:e034499. [PMID: 32276954 PMCID: PMC7170630 DOI: 10.1136/bmjopen-2019-034499] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) are the leading cause of death worldwide, including in Korea; thus, customised techniques for chronic disease management for the prevention, early diagnosis and treatment of NCDs are crucial. The Korean Medicine Daejeon Citizen Cohort (KDCC) study has been tasked with developing precise health promotion model for preventing and managing chronic diseases that considers individual traits, lifestyle factors and clinical data based on traditional Korean medicine. METHODS AND ANALYSIS The KDCC study is a prospective cohort study of the community-based population in Korea. This study will sample 2000 adults aged 30-55 years in Daejeon area using stratified cluster sampling. The baseline survey began in 2017 and was completed in 2019, and follow-up surveys will be conducted three times every 2 years until 2025. In follow-ups, factors related to cardiovascular disease, metabolic syndrome and relevant diseases, as well as respondents' health status information, will be examined via questionnaire surveys and health examinations. DISCUSSION The KDCC study will investigate the effects of an interaction of Korean medicine type with genome based, lifestyle and various clinical information on chronic diseases and individuals' health status using longitudinal epidemiological data. These findings are expected to inform the development of tailored health promotion programmes based on precision Korean medicine. TRIAL REGISTRATION NUMBER KCT0004297.
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Affiliation(s)
- Younghwa Baek
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
| | - Bok-Nam Seo
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
| | - Kyoungsik Jeong
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
| | - Horyong Yoo
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea (the Republic of)
| | - Siwoo Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
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Effect of Lifestyle Factors on Hypertension by Constitution Type: A Large Community-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019. [DOI: 10.1155/2019/3231628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background. The risk of hypertension differs according to lifestyle factors and individual constitution types. The aim of this study was to investigate the effect of lifestyle factors on hypertension and to assess whether those effects differ according to the constitution types. Methods. A total of 5,793 men and women were recruited between 2012 and 2014. Odds ratios for hypertension associated with constitution types and lifestyle factors were estimated. Lifestyle factors included smoking status, body mass index, alcohol consumption, physical activity, and sleep quality. Constitution types were estimated based on the Sasang constitutional medicine as the TE type, SE type, and SY type. Results. The risk of hypertension was significantly higher for SY (odds ratio 1.25 (95% confidence interval 1.03 to 1.52) and TE types (1.38 (1.10 to 1.74)) than the SE type even with adjustment of health behaviors. Compared with individuals who had an unhealthy lifestyle, those with healthy lifestyle scores showed significantly lower risk of hypertension in only SY (odds ratio 0.62 (95% confidence interval 0.48 to 0.81)) and TE types (0.69 (0.58 to 0.81)). The difference in risk for hypertension among constitution types was decreased with a healthy lifestyle (1.34 in SY and 2.35 in TE types, as compared with the SE type) versus an unhealthy lifestyle (2.21 in SY and 3.64 in TE types, as compared with the SE type). Conclusion. The risk of hypertension was different by Sasang constitution types. The impact of lifestyle factors differed according to Sasang constitution types, and the difference in risk of hypertension among constitution types was decreased with a healthy lifestyle.
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Traditional Knowledge-based Medicine: A Review of History, Principles, and Relevance in the Present Context of P4 Systems Medicine. PROGRESS IN PREVENTIVE MEDICINE 2017. [DOI: 10.1097/pp9.0000000000000011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kim HK, Lee H, So JH, Jeong SH, Seo DY, Kim JY, Kim S, Han J. Energy metabolism and whole-exome sequencing-based analysis of Sasang constitution: a pilot study. Integr Med Res 2017; 6:165-178. [PMID: 28664140 PMCID: PMC5478259 DOI: 10.1016/j.imr.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/02/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Traditional Korean Sasang constitutional (SC) medicine categorizes individuals into four constitutional types [Tae-eum (TE), So-eum (SE), Tae-yang (TY), or So-yang (SY)] based on biological and physiological characteristics. As these characteristics are closely related to the bioenergetics of the human body, we assessed the correlation between SC type and energy metabolism features. METHODS Forty healthy, young (22.3 ± 1.4 years) males volunteered to participate in this study. Participants answered an SC questionnaire, and their face shape, voice tone, and body shape were assessed using an SC analysis tool. Thirty-one participants (10 TE, 10 SE, 3 TY, and 8 SY) were selected for further analysis. Collected blood samples were subjected to blood composition analysis, mitochondrial function analysis, and whole-exome sequencing. RESULTS The SY type showed significantly lower total cholesterol and high-density lipoprotein cholesterol levels than the SE type. Cellular and mitochondrial Adenosine triphosphate (ATP) levels were similar across types. All types showed similar basal mitochondrial oxygen consumption rates, whereas the TE type showed a significantly lower ATP-linked oxygen consumption rate than the other types. Whole-exome sequencing identified several genes variants that were exclusively detected in particular SC types, including 19 for SE, seven for SY, 11 for TE, and six for TY. CONCLUSION SC type-specific differences in mitochondrial function and gene mutations were detected in a small group of healthy, young Korean males. These results are expected to greatly improve the accurate screening and utilization of SC medicine.
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Affiliation(s)
- Hyoung Kyu Kim
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK21 plus Project Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Republic of Korea
| | - Heetak Lee
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Korea
| | - Ji Ho So
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Seung Hun Jeong
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK21 plus Project Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Republic of Korea.,Department of Oral Biochemistry, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Dae Yun Seo
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK21 plus Project Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Republic of Korea
| | - Jong-Yeol Kim
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Sanguk Kim
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Korea
| | - Jin Han
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK21 plus Project Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan, Republic of Korea
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Lee HY, Lee WJ, Kim HW, Jang ES, Ahn YC, Ku BC, Kang W, Lee SW, Son CG. A Systematic Review on Sasang Constitutional Type-Associated Susceptibility to Disorders in Korea. J Altern Complement Med 2016; 22:950-956. [PMID: 27754711 DOI: 10.1089/acm.2016.0177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND/OBJECTIVE Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders. METHODS A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex. RESULTS From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants. CONCLUSIONS This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.
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Affiliation(s)
- Hyun-Yong Lee
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Woo-Jin Lee
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Hae-Won Kim
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Eun-Su Jang
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- 2 Department of Health Service Management, Daejeon University , Daejeon, Republic of Korea
| | - Bon-Cho Ku
- 3 KM Fundamental Research Division, Korea Institute of Oriental Medicine , Daejeon, Republic of Korea
| | - Weechang Kang
- 4 Department of Statistics, Daejeon University, Daejeon, Republic of Korea
| | - Si-Woo Lee
- 5 Mibyeong Research Center, Korea Institute of Oriental Medicine , Daejeon, Republic of Korea
| | - Chang-Gue Son
- 1 College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
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Kim Y, Park K, Yoo J, Jang E. Sasang Constitution May Play a Key Role in Increasing the Number of Sub-Elements of Metabolic Syndrome. J Altern Complement Med 2016; 22:204-11. [PMID: 26914220 DOI: 10.1089/acm.2015.0209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS), a representative cluster of chronic diseases, is defined by the presence of three or more of the following five elements: high blood glucose, high blood pressure, low high-density lipoprotein (HDL)cholesterol, high serum triglyceride levels, and abdominal obesity. Recently, innate factors have been continuously demonstrated as important risk factors for increasing the number of MS sub-elements. Sasang constitutional medicine (SCM) is a traditional Korean medicine in which each Sasang constitution (SC) type has a different susceptibility to pathology and diseases. The aim of this study is to determine whether the SC could be an independent risk factor for single and multiple MS sub-elements. METHODS Twenty-four Korean medical clinics joined the study, and 3334 participants aged 20-80 years were recruited. Clinical data related to MS and general characteristics were obtained. The chi-square test and a one-way analysis of variance were conducted, and the odds ratios (ORs) with 95% confidence intervals (CIs) were generated through multinomial logistic regression according to the SC. RESULTS The prevalence of single and multiple MS sub-elements was significantly different according to SC. The ORs of the Tae-Eumin (TE) type were significantly high for abdominal obesity, diabetes mellitus, hypertriglyceridemia, low HDL cholesterol, and hypertension. The ORs for the So-Yangin type were also high in hypertriglyceridemia and low HDL cholesterol compared with the So-Eumin type, even after being adjusted for sex, age, body mass index, and eating habits. As the numbers of MS sub-elements increased, the ORs of the TE type also increased. CONCLUSIONS This study showed that the SC types may be risk factors for not only single MS sub-elements but also multiple MS sub-elements and that the TE type's risk degree is associated with an increase in the number of MS sub-elements.
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Affiliation(s)
- Yunyoung Kim
- 1 Department of Nursing, Sangmyung University , Chungcheongnam-do, South Korea
| | - Kihyun Park
- 2 Mibyeong Research Center, Korea Institute of Oriental Medicine , Daejeon, South Korea
| | - Jonghyang Yoo
- 2 Mibyeong Research Center, Korea Institute of Oriental Medicine , Daejeon, South Korea
| | - Eunsu Jang
- 2 Mibyeong Research Center, Korea Institute of Oriental Medicine , Daejeon, South Korea .,3 Department of Diagnosis College of Korean Medicine, Daejeon University , Daejeon, South Korea
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Pham DD, Leem CH. Body temperature regulation: Sasang typology-based perspective. Integr Med Res 2015; 4:189-194. [PMID: 28664126 PMCID: PMC5481800 DOI: 10.1016/j.imr.2015.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 07/24/2015] [Accepted: 08/01/2015] [Indexed: 11/30/2022] Open
Abstract
Global warming induces a dramatic elevation of heat-related morbidity and mortality worldwide. Individual variation of heat stress vulnerability depends on various factors such as age, gender, living area and conditions, health status, and individual innate characteristics. Sasang typology is a unique form of Korean traditional medicine, which is based on the hypothesis that constitution-specific traits of an individual determine the particular distinctive tendency in various aspects, including responses to the external environment. Recent scientific evidence shows that Sasang types differ in body composition, metabolic profile, susceptibility to certain disease patterns, and perspiration. This review aims to interpret these findings under the context of heat balance consisting of heat production (Hprod), heat loss (Hloss), and heat load (Hload). Based on the published data, at a given body mass, the TaeEum type tended to have a lower Hprod at rest and at the exhaustion state, which may indicate the lower metabolic efficiency of this type. Meanwhile, the surface-to-mass ratio and heat capacity of the TaeEum type appear to be lower, implying a lower heat dissipation capacity and heat storage tolerance. Thus, because of these characteristics, the TaeEum type seems to be more vulnerable to heat stress than the other constitutions. Differences in temperature regulation across constitutional types should be taken into account in daily physical activity, health management, and medical research.
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Affiliation(s)
- Duong Duc Pham
- Department of Physiology, Ulsan College of Medicine, Seoul, Korea
| | - Chae Hun Leem
- Department of Physiology, Ulsan College of Medicine, Seoul, Korea
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Cha S, Yu H, Park AY, Oh SA, Kim JY. The obesity-risk variant of FTO is inversely related with the So-Eum constitutional type: genome-wide association and replication analyses. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:120. [PMID: 25888059 PMCID: PMC4432511 DOI: 10.1186/s12906-015-0609-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 03/13/2015] [Indexed: 01/30/2023]
Abstract
Background Body constitutional types described in the traditional Korean medicine system, Sasang constitutional medicine, are heritable, as has been revealed by twin and family studies. Thus, individuals with the same constitution type usually have similar pathophysiological and psychological traits. In several recent genome-wide association (GWA) analyses performed to identify constitution-associated variants, the association signals were not replicated due to small sample size and dissimilar, non-objective methods for classification of the constitutional types. Methods We conducted GWA analysis and followed replication analysis in two large populations (5,490 subjects: 3,810 subjects at discovery stage and 1,680 subjects at replication stage) to identify the replicable constitution-associated variants, wherein subjects with the highest tertile of constitution probability values versus the reference with the lowest tertile of the values obtained from a recently developed constitution analysis tool were compared. Results We found that the obesity-risk variant in intron 1 of the fat mass and obesity–associated (FTO) gene was replicably inversely associated with the So-Eum (SE) type, characterized by reduced appetite, slim body, and cautious personality (rs7193144 in combined samples: odds ratio = 0.729, p = 1.47 × 10−7), and substantial association signal remained after controlling for body mass index (BMI). In contrast, the association of the variant with the Tae-Eum type, characterized by high body mass, disappeared after controlling BMI. Conclusions In summary, the obesity-risk variant in FTO intron 1 was inversely associated with the SE type, independent of BMI, which corresponded well with the characteristics of the SE type, such as the lowest body mass and lowest susceptibility to metabolic disorders among the constitutional types. Therefore, the obesity-risk variant of FTO associated with body mass increase might be involved in the determination of body constitution type. Electronic supplementary material The online version of this article (doi:10.1186/s12906-015-0609-4) contains supplementary material, which is available to authorized users.
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Jin HJ, Baek Y, Kim HS, Ryu J, Lee S. Constitutional multicenter bank linked to Sasang constitutional phenotypic data. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:46. [PMID: 25887924 PMCID: PMC4378550 DOI: 10.1186/s12906-015-0553-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/13/2015] [Indexed: 11/28/2022]
Abstract
Background Biobanks are more important in medical area because they can give researchers data for demonstrating and validating their research. In this study, we developed a biobank called the Korea Constitutional Multicenter Bank (KCMB) based on Sasang Constitutional Medicine (SCM). The aim of the KCMB was a foundation to providing the scientific basis of SCM. Methods The KCMB has been constructed since 2006 in 24 Korean medical clinics with collection of questionnaire data, physical measurements and biological information comprised the results from blood test and DNA analyses. All participants were prescribed Sasang Constitution (SC)-specific herbal remedies for the treatment, and showed improvement of original symptoms as confirmed by Korean medicine doctor. Collected data went through de-identification process using the electronic case report form system. For calculation of several SC type specific tendencies, we used the direct standardization and Chi-square tests. Results The KCMB collected clinical information from 3,711 study participants (1,353 men and 2,358 women) aged more than 10 years. The mean age (± standard deviation) was 47.1 (±16.6) and 47.7 (±15.8) years for men and women respectively. After applying the direct standardization, the estimated constitutional distributions for the SC types were as follows: 39.2% for Tae-eumin(TE), 27.1% for Soeumin(SE), 33.7% for Soyangyin(SY), and non-zero but below 0.1% for Taeyangyin(TY). The estimated distribution of TE was about 10% less, while that of SY and SE were slightly more than the distribution reported by Jema Lee established the SCM. Based on the participants’ medical history within the KCMB, each SC type had notably different frequencies for some diseases such as hypertension, diabetes, hyperlipidemia, stroke, and obesity (P < 0.001). Conclusions The KCMB may serve to verify and validate SCM theories and practices. It may also provide new insights into SCM mechanisms. The results from many studies using the KCMB data are of great importance and value for making decisions in healthcare policy and developing novel therapies.
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Kim JY, Noble D. Recent progress and prospects in Sasang constitutional medicine: a traditional type of physiome-based treatment. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2014; 116:76-80. [PMID: 25240519 DOI: 10.1016/j.pbiomolbio.2014.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/08/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
The history of the constitution perspective in medical care dates back thousands of years and extends from the East to the West. Among the various forms of constitutional medicine, Sasang constitutional medicine (SCM) is a holistic, tailored medical approach that is based on a well-structured theoretical system that includes physiopathological disciplines. Scientific evidence has demonstrated that SCM typology has a constitution-specific basis in anthropometrics, physiological characteristics, disease vulnerability, and genetic origins. Furthermore, the recent rise of systems biology, which requires whole body modeling, uses a state-of-the-art approach in interpreting the holistic spirit of Oriental medicine. This article aims to provide an overview of the recent achievements in SCM research and to discuss how the concept of balance in SCM may contribute to the development of large scale modeling in systems biology.
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Affiliation(s)
- Jong Yeol Kim
- Department of Medical Research, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon 305-811, Republic of Korea
| | - Denis Noble
- Department of Physiology, Anatomy & Genetics, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
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Jang E, Baek Y, Park K, Lee S. Could the Sasang constitution itself be a risk factor of abdominal obesity? BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 13:72. [PMID: 23548105 PMCID: PMC3635926 DOI: 10.1186/1472-6882-13-72] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 02/08/2013] [Indexed: 01/21/2023]
Abstract
Background Abdominal obesity (AO) is a medical condition in which excess body fat accumulates in the abdomen. It may cause adverse effects on health and result in reduced life expectancy or increased health problems. While various genetic approaches have explained the risks of AO in Western society, the Sasang constitution (SC) has been identified as a risk factor in Korean medicine. Different SC types are associated with different fat distribution, body shapes and susceptibility to diseases. We evaluated whether the SC type could be a risk for AO in a cross-sectional study among Koreans. Methods In total, 2,528 subjects aged over 30 years were recruited from 23 medical clinics. We collected waist circumference (WC), weight, height, and some clinical information for AO from the subjects. A Chi-square test and a one-way ANOVA were performed according to SC type (p < .05), while multiple logistic regression was used to produce odds ratios (ORs). Results The rates of AO in Tae-eumin (TE), Soeumin (SE), and Soyangin (SY) types were 63.7%, 14.7%, and 32.8% in males and 84.8%, 41.7%, and 52.8% in females, respectively. The TE type was associated with increased AO prevalence compared with the SE and SY types in males (OR 1.79; 95% CI 1.02–3.15, p = 0.044 and OR 1.74; 95% CI 1.18–2.58, p = 0.006, respectively) and females (OR 1.51; 95% CI 1.03–2.23, p = 0.037 and OR 1.88; 95% CI 1.32–2.68, p < 0.001, respectively) after adjusting for age, BMI, hypertension, diabetes mellitus, hypertriglyceridemia, and low HDL cholesterol. Conclusions This study suggested that SC, particularly the TE type, might be significantly and independently associated with AO and could be considered a risk factor in predicting AO.
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Pham DD, Cha S, Kim JY. Re-interpretation of traditional Asian medicine with constitutional perspective. Integr Med Res 2013; 2:1-6. [PMID: 28664047 PMCID: PMC5481680 DOI: 10.1016/j.imr.2013.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/15/2013] [Indexed: 01/17/2023] Open
Abstract
There has been a rapid increase in tailored medicine that emphasizes the complex inter-individual interactions, and this increase has paralleled recent significant achievements in genomics and Systems Biology. However, attempts to create a virtual human have been limited to low-levels of organization, such as gene-protein networks, due to the lack of systematic concepts at the higher levels of organisms (organ, individual, and environment). Constitutional perspective of various forms of traditional Asian medicine through the ancient, middle, and modern eras, particularly the holistic approach of Sasang constitutional medicine (SCM), may provide a novel framework for creating tailored medicine. This article aims to review the theoretical development of traditional Chinese medicine and the initiation of SCM in addition to summarizing current evidence on the genetic basis, bio-physiological features, and risk of disease of different SCM phenotypes. We also suggest that the patho-physiological principle and scientific evidence underlying SCM, particularly for the TaeEum type, can be effective in dealing with obesity-linked disease, which is a predominant disease in today's society.
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Affiliation(s)
- Duong Duc Pham
- Korea Institute of Oriental Medicine, Daejeon, Korea.,National Hospital of Traditional Medicine, Hanoi, Viet Nam
| | - Seongwon Cha
- Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Jong Yeol Kim
- Korea Institute of Oriental Medicine, Daejeon, Korea
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Sohn K, Jeong A, Yoon M, Lee S, Hwang S, Chae H. Genetic characteristics of Sasang typology: a systematic review. J Acupunct Meridian Stud 2012; 5:271-89. [PMID: 23265078 DOI: 10.1016/j.jams.2012.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 05/10/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022] Open
Abstract
A systematic review on studies related to the genetic characteristics of Sasang types was conducted with the goal of delineating genetic characteristics of Sasang typology. Six electronic databases of up to the March 2011 were examined with the key words of Sasang typology, constitution, and genetics in both Korean and English. Predefined review criteria were used, including demographic characteristics, type classification methods, genotyping methods, and genotypes. Fifty-nine potentially relevant studies were identified and 40 peer reviewed research articles that contained genetic data were included. Fourteen articles reported statistically significant differences among Sasang types, which are heritability, structural variation, genome-wide screening, and pathophysiological function. Although significant genotypes were reported with vWA, CSF1PO, Penta D, HLA-Cw*04, HLA-Cw*07, PPAR-γ, MDR1, IL-α, IL-β, and IL-6 receptor, results of the review indicate that there was no conclusive genotype related to the Sasang typology. Considering the features of Sasang typology, it is recommended that the macroscopic systems medical approach on genetics be employed, rather than the single genes association approach.
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Affiliation(s)
- Kyungwoo Sohn
- Division of Longevity and Biofunctional Medicine, School of Korean Medicine, Pusan National University, Pusan, Republic of Korea
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16
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Kim BY, Yu SG, Kim JY, Song KH. Pathways involved in sasang constitution from genome-wide analysis in a Korean population. J Altern Complement Med 2012; 18:1070-80. [PMID: 22889377 DOI: 10.1089/acm.2011.0434] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Sasang constitution (SC) medicine, a branch of Korean traditional medicine, classifies the individual into one of four constitutional types (Taeum, TE; Soeum, SE; Soyang, SY; and Taeyang, TY) based on physiologic characteristics. The authors of the current article recently reported individual genetic elements associated with SC types via genome-wide association (GWA) analysis. However, to understand the biologic mechanisms underlying constitution, a comprehensive approach that combines individual genetic effects was applied. DESIGN Genotypes of 1222 subjects of defined constitution types were measured for 341,998 genetic loci across the entire genome. The biologic pathways associated with SC types were identified via GWA analysis using three different algorithms--namely, the Z-static method, a restandardized gene set assay, and a gene set enrichment assay. RESULTS Distinct pathways were associated (p<0.05) with each constitution type. The TE type was significantly associated with cytoskeleton-related pathways. The SE type was significantly associated with cardio- and amino-acid metabolism-related pathways. The SY type was associated with enriched melanoma-related pathways. TY subjects were excluded because of the small size of that sample. Among these functionally related pathways, core-node genes regulating multiple pathways were identified. TJP1, PTK2, and SRC were selected as core-nodes for TE; RHOA, and MAOA/MAOB for SE; and GNAO1 for SY (p<0.05), respectively. CONCLUSIONS The current authors systematically identified the biologic pathways and core-node genes associated with SC types from the GWA study; this information should provide insights regarding the molecular mechanisms inherent in constitutional pathophysiology.
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Affiliation(s)
- Bu-Yeo Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
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Lee BJ, Ku B, Park K, Kim KH, Kim JY. A new method of diagnosing constitutional types based on vocal and facial features for personalized medicine. J Biomed Biotechnol 2012; 2012:818607. [PMID: 22899890 PMCID: PMC3415144 DOI: 10.1155/2012/818607] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 05/30/2012] [Indexed: 11/18/2022] Open
Abstract
The aim of the present study is to develop an accurate constitution diagnostic method based solely on the individual's physical characteristics, irrespective of psychologic traits, characteristics of clinical medicine, and genetic factors. In this paper, we suggest a novel method for diagnosing constitutional types using only speech and face characteristics. Based on 514 subjects, the area under the receiver operating characteristics curve (AUC) values of classification models in age and gender groups ranged from 0.64 to 0.89. We identified significant features showing statistical differences among three constitutional types by performing statistical analysis. Also, we selected a compact and discriminative feature subset for constitution diagnosis in each age and gender group. Our method may support the direction of improved diagnosis prediction and will serve to develop a personal and automatic constitution diagnosis software for improvement of the effectiveness of prescribed medications and development of personalized medicine.
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Affiliation(s)
- Bum Ju Lee
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Boncho Ku
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Kihyun Park
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Keun Ho Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Jong Yeol Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
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Kim BY, Jin HJ, Kim JY. Genome-wide association analysis of Sasang constitution in the Korean population. J Altern Complement Med 2012; 18:262-9. [PMID: 22394158 DOI: 10.1089/acm.2010.0764] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Sasang constitutional medicine is a traditional Korean medicine in which an individual is classified into one of four types of constitution: Taeum (TE), Soeum (SE) Soyang (SY), and Taeyang (TY). These constitution types are determined with biologic and physiologic characteristics, so it has been assumed that genetic factors are associated with each constitution type. Identifying the genetic elements underlying each constitution is necessary for the elucidation of the molecular mechanism of Sasang constitutional medicine. DESIGN A total of 341,998 genetic loci across the whole genome were genotyped for 1222 subjects of defined constitution type. The genetic loci associated with each constitution type were identified and the functional connectivity of genes within these loci was analyzed using statistical text mining. RESULTS From the difference in allele frequencies between constitution types, significant genetic loci associated with each type were identified. Chromosomes 3q27.3 (rs10937331, p=2.71×10(-6)), 15q22.2 (rs7180547, p=1.58×10(-6)), and 14q22.3 (rs12431592, p=1.31×10(-6)) were most significantly associated with TE, SE, and SY constitution types, respectively. From the functional relationship analysis using all loci with a p-value≤10(-4), genes associated with each constitution type were identified. Fifteen (15) genes, including GPM6A, SYT4, and GRIK1, were significantly associated with the TE constitution type (p<0.05); 12 genes, including DRGX and AKAP11, were significantly associated with the SE constitution type (p<0.05); and 17 genes, including ZFP42, CDH22, ALDH1A2, OTX2, and EN2, were significantly associated with the SY constitution type (p<0.05). CONCLUSIONS Genetic loci and genes associated with Sasang constitution types were systematically identified from a genome-wide association study using a large number of subjects.
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Affiliation(s)
- Bu-Yeo Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Joshi K, Ghodke Y, Shintre P. Traditional medicine and genomics. J Ayurveda Integr Med 2011; 1:26-32. [PMID: 21829298 PMCID: PMC3149388 DOI: 10.4103/0975-9476.59824] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 12/11/2009] [Accepted: 12/12/2009] [Indexed: 11/19/2022] Open
Abstract
‘Omics’ developments in the form of genomics, proteomics and metabolomics have increased the impetus of traditional medicine research. Studies exploring the genomic, proteomic and metabolomic basis of human constitutional types based on Ayurveda and other systems of oriental medicine are becoming popular. Such studies remain important to developing better understanding of human variations and individual differences. Countries like India, Korea, China and Japan are investing in research on evidence-based traditional medicines and scientific validation of fundamental principles. This review provides an account of studies addressing relationships between traditional medicine and genomics.
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Affiliation(s)
- Kalpana Joshi
- Department of Biotechnology, Sinhagad College of Engineering, Pune, India
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Lee J, Lee J, Lee E, Yoo J, Kim Y, Koh B. The Sasang constitutional types can act as a risk factor for hypertension. Clin Exp Hypertens 2011; 33:525-32. [PMID: 21958429 DOI: 10.3109/10641963.2011.561901] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
It has been suggested that an approach to hypertension based on the constitutional make-up of an individual may be effective. We conducted a retrospective chart review to explore the association of Sasang constitution with hypertension. The results show that the prevalence of hypertension was highest in the Taeeum (TE) constitutional type, and that the TE constitutional type can act as an independent risk factor for hypertension (OR in TE group = 1.37 (CI 1.06-1.78) (vs. non-TE group)). This indicates that the Sasang constitutional type could explain the variability in individual susceptibilities to hypertension, suggesting a novel constitution-based approach to hypertension.
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Affiliation(s)
- Jiwon Lee
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
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21
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Song KH, Yu SG, Cha S, Kim JY. Association of the Apolipoprotein A5 Gene -1131T>C Polymorphism with Serum Lipids in Korean Subjects: Impact of Sasang Constitution. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2011; 2012:598394. [PMID: 21860654 PMCID: PMC3157201 DOI: 10.1155/2012/598394] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 04/19/2011] [Accepted: 05/17/2011] [Indexed: 11/21/2022]
Abstract
Apolipoprotein A5 (APOA5) was identified as a strong modulator of serum lipids. Moreover, an APOA5 gene -1131T>C polymorphism has been associated with serum lipids, but the results are inconsistent according to ethnic and racial groups. We have genotyped and analyzed 1,619 outpatients of Korean oriental medicine hospitals who were classified into three Sasang constitution groups (SCGs), So-Yang (SY), So-Eum (SE), and Tae-Eum (TE). There were no significant difference in the distribution of the APOA5 -1131T>C genotype among the three SCGs. Subjects with the C allele in SY and TE showed significantly lower serum high-density lipoprotein cholesterol (HDL-C) and higher triglyceride (TG) levels than noncarriers of the C allele. These results show the differences in the prevalence of decreasing serum HDL-C and elevating serum TG levels along with APOA5 -1131T>C polymorphism according to SCG and suggest that SCG may act as a significant risk factor for hypo-HDL-C-emia and hypertriglyceridemia susceptibility.
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Affiliation(s)
| | | | | | - Jong Yeol Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon 305811, Republic of Korea
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Kim BY, Cha S, Jin HJ, Jeong S. Genetic approach to elucidation of sasang constitutional medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 6 Suppl 1:51-7. [PMID: 19745011 PMCID: PMC2741631 DOI: 10.1093/ecam/nep058] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sasang Constitutional Medicine (SCM) offers a medical principle that classifies humans into four constitution groups and guides their treatment with constitution-matched medical assistance. The principle of this traditional medicine, although requires significant scientific support, appears to suggest a genetic influence on constitution type. The relative frequency of constitution types in a population, for instance, has remained relatively constant since Jema Lee first described them from his observations. In addition, the body compartment concept of SCM appears to be related to the anterio-posterior patterning of the embryonic gut and associated internal organs. This study describes the attributes of the constitution concept of SCM that can be interpreted in the language of genetics and current approaches to identity the genetic factors that make up the constitution. These efforts should make it possible to interpret the principle of this traditional medicine scientifically. Considering the recent trend in medicine that pursues individualized or tailored medical offerings, once SCM is proven to be explainable with scientific evidence, it will be able to contribute to and take a place in the rapidly evolving medicine environment.
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Affiliation(s)
- Bu-Yeo Kim
- Department of Medical Research, Korea Institute of Oriental Medicine (KIOM), 461-24 Jeonmin-dong, Yuseong-gu, Daejeon 305-811, Republic of Korea.
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Ghodke Y, Joshi K, Patwardhan B. Traditional Medicine to Modern Pharmacogenomics: Ayurveda Prakriti Type and CYP2C19 Gene Polymorphism Associated with the Metabolic Variability. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:249528. [PMID: 20015960 PMCID: PMC3135904 DOI: 10.1093/ecam/nep206] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 11/10/2009] [Indexed: 12/25/2022]
Abstract
Traditional Indian medicine—Ayurveda—classifies the human population into three major constituents or Prakriti known as Vata, Pitta and Kapha types. Earlier, we have demonstrated a proof of concept to support genetic basis for Prakriti. The descriptions in Ayurveda indicate that individuals with Pitta Prakriti are fast metabolizers while those of Kapha Prakriti are slow metabolizers. We hypothesized that different Prakriti may have different drug metabolism rates associated with drug metabolizing enzyme (DME) polymorphism. We did CYP2C19 (Phase I DME) genotyping in 132 unrelated healthy subjects of either sex by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. We observed significant association between CYP2C19 genotype and major classes of Prakriti types. The extensive metabolizer (EM) genotype (∗1/∗1, ∗1/∗2, ∗1/∗3) was found to be predominant in Pitta Prakriti (91%). Genotype (∗1/∗3) specific for EM group was present only in Pitta Prakriti. Poor metabolizer (PM) genotype (∗2/∗2, ∗2/∗3, ∗3/∗3) was highest (31%) in Kapha Prakriti when compared with Vata (12%) and Pitta Prakriti (9%). Genotype (∗2/∗3) which is typical for PM group was significant in Kapha Prakriti (odds ratio = 3.5, P = .008). We observed interesting correlations between CYP2C19 genotypes and Prakriti with fast and slow metabolism being one of the major distinguishing and differentiating characteristics. These observations are likely to have significant impact on phenotype-genotype correlation, drug discovery, pharmacogenomics and personalized medicine.
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Affiliation(s)
- Yogita Ghodke
- Bioprospecting Laboratory, Interdisciplinary School of Health Sciences, University of Pune, India
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24
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Cha S, Koo I, Park BL, Jeong S, Choi SM, Kim KS, Shin HD, Kim JY. Genetic Effects of FTO and MC4R Polymorphisms on Body Mass in Constitutional Types. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:106390. [PMID: 19822564 PMCID: PMC3094695 DOI: 10.1093/ecam/nep162] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 09/13/2009] [Indexed: 12/20/2022]
Abstract
Sasang constitutional medicine (SCM), a Korean tailored medicine, categorizes human beings into four types through states of physiological imbalances and responsiveness to herbal medicine. One SCM type susceptible to obesity seems sensitive to energy intake due to an imbalance toward preserving energy. Common variants of fat mass and obesity associated (FTO) and melanocortin 4 receptor (MC4R) genes have been associated with increased body mass index (BMI) by affecting energy intake. Here, we statistically examined the association of FTO and MC4R polymorphisms with BMI in two populations with 1370 Koreans before and after SCM typing, and with the lowering of BMI in 538 individuals who underwent a 1-month lifestyle intervention. The increased BMI replicated the association with FTO haplotypes (effect size ≃ 1.1 kg/m2) and MC4R variants (effect size ≃ 0.64 kg/m2). After the lifestyle intervention, the carriers of the haplotype represented by the minor allele of rs1075440 had a tendency to lose more waist-to-hip ratio (0.76%) than non-carriers. The constitutional discrepancy for the accumulation of body mass by the effects of FTO and/or MC4R variants seemed to reflect the physique differences shown in each group of SCM constitutional types. In conclusion, FTO and MC4R polymorphisms appear to play an important role in weight gain, while only FTO variants play a role in weight loss after lifestyle intervention. Different trends were observed among individuals of SCM types, especially for weight gain. Therefore, classification of individuals based on physiological imbalance would offer a good genetic stratification system in assessing the effects of obesity genes.
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Affiliation(s)
- Seongwon Cha
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - Imhoi Koo
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - Byung L. Park
- Department of Genetic Epidemiology, SNP Genetics Inc., Geumcheon-gu, Seoul, Republic of Korea
| | - Sangkyun Jeong
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - Sun M. Choi
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - Kil S. Kim
- Kirin Oriental Medical Hospital, Seoul, Republic of Korea
| | - Hyoung D. Shin
- Department of Genetic Epidemiology, SNP Genetics Inc., Geumcheon-gu, Seoul, Republic of Korea
- Department of Life Science, Sogang University, Mapo-gu, Seoul, Republic of Korea
| | - Jong Y. Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 483 Exporo, Yuseong-gu, Daejeon, 305-811, Republic of Korea
- *Jong Y. Kim:
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