Browse > Article
http://dx.doi.org/10.15188/kjopp.2022.06.36.3.94

Prediction of Deficiency Pattern in Diabetic Patients Using Multi-frequency Bioimpedance Resistance  

Kim, Kahye (Digital Health Research Division Korea Institute of Oriental Medicine)
Kim, Seul Gee (Digital Health Research Division Korea Institute of Oriental Medicine)
Cha, Jiyun (Digital Health Research Division Korea Institute of Oriental Medicine)
Yoo, Ho-Ryong (Internal Medicine of Cardiovascular, Daejeon University)
Kim, Jaeuk U. (Digital Health Research Division Korea Institute of Oriental Medicine)
Publication Information
Journal of Physiology & Pathology in Korean Medicine / v.36, no.3, 2022 , pp. 94-99 More about this Journal
Abstract
The discovery of biomarkers related to pattern identification (PI), the core diagnostic theory of Korean medicine (KM), is one of the methods that can provide objective and reliable evidence by applying PI to clinical practice. In this study, 40 diabetic patients and 41 healthy control subjects recruited from the Korean medicine clinic were examined to determine the human electrical response related to the deficiency pattern, a representative pattern of diabetes. Qi-Blood-Yin-Yang deficiency pattern scores, which are representative deficiency patterns for diabetes mellitus, were obtained through a questionnaire with verified reliability and validity, and the human electrical response was measured non-invasively using a bioimpedance meter. In ANCOVA analysis using gender as a covariate, the 5 kHz frequency resistance and 5-250 kHz frequency reactance were significantly lower in the diabetic group than in non-diabetic control group. In addition, the multiple regression analysis showed a positive correlation (R2=0.11~0.19) between the Yang deficiency pattern score and resistance value for the diabetic group; the correlation was higher at higher frequencies of 50kHz (R2=0.18) and 250kHz (R2=0.19) compared to 5kHz(R2=0.11). In contrast, there was no such significant association in the control group. It implies that bioimpedance resistance measured at finite frequencies may be useful in predicting Yang deficiency, which is closely related to diabetic complications by reflecting the decrease in body water content and metabolism. In the future, large-scale planned clinical studies will be needed to identify biomarkers associated with different types of PI in diabetes.
Keywords
Diabetes; Multi-frequency Bioimpedance; Pattern Identification; Qi-Blood-Yin-Yang Pattern; Resistance;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Woo H-j, Kim S-h, Lee S-b, Choi M-y, Kim Y-c, Lee J-h. Development of Questionnaires for Differentiation of qi-xu, xue-xu, yang-xu, yin-xu analysis. The Journal of Internal Korean Medicine. 2008;29(4):856-70.
2 Jun M-H, Kim S, Ku B, Cho J, Kim K, Yoo H-R, et al. Glucose-independent segmental phase angles from multi-frequency bioimpedance analysis to discriminate diabetes mellitus. Scientific Reports. 2018;8(1):648.   DOI
3 Zhang GG, Lee WL, Lao L, Bausell B, Berman B, Handwerger B. The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients. Altern Ther Health Med. 2004;10(1):58-63.
4 Yuan P, Jiang T, Hirasaka K, Wang Y, Matsuo K, Miyazaki R, et al. Application of Bio-Impedance Analysis to Estimate the Condition of Yellowtail (Seriola quinqueradiata) Muscle at Different Storage Temperatures. Bioelectromagnetics. 2019;40(7):488-97.   DOI
5 L. Jodal, Electrical Theory behind The Measurement of Body Fluids with Bioimpedance Spectroscopy (BIS) [Internet], Dept. of Nuclear Medicine, Aalborg University Hospital, Denmark, 2010. http://pure.au.dk/portal/files/20320521/Lecture_notes_on_BIS.pdf.
6 Karpova LV, Bulygina ER, Boldyrev AA. Different neuronal Na+/K+-ATPase isoforms are involved in diverse signaling pathways. Cell Biochemistry and Function. 2010;28(2):135-41   DOI
7 Harris MI, Eastman RC. Early detection of undiagnosed diabetes mellitus: a US perspective. Diabetes Metab Res Rev. 2000;16(4):230-6.   DOI
8 Lu X, Xiong Z, Li J, Zheng S, Huo T, Li F. Metabonomic study on 'Kidney-Yang Deficiency syndrome' and intervention effects of Rhizoma Drynariae extracts in rats using ultra performance liquid chromatography coupled with mass spectrometry. Talanta. 2011;83(3):700-8.   DOI
9 Chang S-A, Weng Y-X, Cheng S-C, Chang Y-J, Lee T-H, Chang C-H, et al. Application of Meridian Electrical Conductance in the Setting of Acute Ischemic Stroke: A Cross-Sectional Study. Evidence-Based Complementary and Alternative Medicine. 2019;2019.
10 Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81.   DOI
11 Wang J, Ma Q, Li Y, Li P, Wang M, Wang T, et al. Research progress on Traditional Chinese Medicine syndromes of diabetes mellitus. Biomedicine & Pharmacotherapy. 2020;121:109565.   DOI
12 Wei J, Wu R, Zhao D. Analysis of TCM syndrome elements and relevant factors for senile diabetes. Journal of Traditional Chinese Medicine. 2013;33(4):473-8.   DOI
13 Zhao T, Yang X, Wan R, Yan L, Yang R, Guan Y, et al. Study of TCM Syndrome Identification Modes for Patients with Type 2 Diabetes Mellitus Based on Data Mining. Evid Based Complement Alternat Med. 2021;2021:5528550.
14 Kim JH, Ku BC, Kim JE, Kim YS, Kim KH. Study on Reliability and Validity of the'Qi Blood Yin Yang Deficiency Questionnaire'. Journal of Physiology & Pathology in Korean Medicine. 2014;28(3):346-54.
15 Sun G, French CR, Martin GR, Younghusband B, Green RC, Xie Y-g, et al. Comparison of multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for assessment of percentage body fat in a large, healthy population. The American Journal of Clinical Nutrition. 2005;81(1):74-8.   DOI
16 Mun S, Kim S, Bae KH, Lee S. Cold and Spleen-Qi Deficiency Patterns in Korean Medicine Are Associated with Low Resting Metabolic Rate. Evid Based Complement Alternat Med. 2017;2017:9532073.
17 Yu H-M, Chang H-H, Liou S-Y, Li S-F, Hou M-M, Chen M-F. The correlation between skin electrical conductance and the score of qi vacuity. The American journal of Chinese medicine. 1998;26(03n04):283-90.   DOI
18 Caravaca F, Martinez del Viejo C, Villa J, Martinez Gallardo R, Ferreira F. Hydration status assessment by multi-frequency bioimpedance in patients with advanced chronic kidney disease. Nefrologia. 2011;31(5):537-44.
19 Tattersall J. Bioimpedance analysis in dialysis: state of the art and what we can expect. Blood Purif. 2009;27(1):70-4.   DOI
20 Buchholz AC, Bartok C, Schoeller DA. The validity of bioelectrical impedance models in clinical populations. Nutr Clin Pract. 2004;19(5):433-46.   DOI
21 Silva-Tinoco R, Castillo-Martinez L, Cuatecontzi-Xochitiotzi T, Torre-Saldana V, Rosales-Rosas D, Gonzalez A, et al. Bioimpedance phase angle and body composition parameters associated with number of diabetes-related complications. Revista Mexicana de Endocrinologia, Metabolismo y Nutricion. 2021;8.
22 Tong XL, Dong L, Chen L, Zhen Z. Treatment of diabetes using traditional Chinese medicine: past, present and future. Am J Chin Med. 2012;40(5):877-86.   DOI
23 Mei Lan C, Hyun Soo A, Jong Yeon K, Dong Shik L, Hong Jin K, Sung Su Y. Impaired Cation Transport May Lead to Bioelectrical Impedance Changes during Hepatic Ischemia. Annals of Surgical Treatment and Research. 2010;78(6):390-7.
24 Cui ML, Ahn HS, Kim JY, Shin HJ, Lee DS, Kim HJ, et al. Bioelectrical impedance may predict cell viability during ischemia and reperfusion in rat liver. J Korean Med Sci. 2010;25(4):577-82.   DOI
25 Kuzuya T. Early diagnosis, early treatment and the new diagnostic criteria of diabetes mellitus. British Journal of Nutrition. 2000;84(S2):S177-S81.   DOI
26 Juansah J, Yulianti W. Studies on Electrical behavior of Glucose using Impedance Spectroscopy. IOP Conference Series: Earth and Environmental Science. 2016;31:012039.   DOI
27 Mun S, Bae KH, Park K, Lee S. Association between Resting Energy Expenditure and Heat Pattern in Traditional Medicine. Evid Based Complement Alternat Med. 2020;2020:4093731.
28 Khalil SF, Mohktar MS, Ibrahim F. The theory and fundamentals of bioimpedance analysis in clinical status monitoring and diagnosis of diseases. Sensors. 2014;14(6):10895-928.   DOI
29 Mudaliar S, Chang AR, Henry RR. Thiazolidinediones, peripheral edema, and type 2 diabetes: incidence, pathophysiology, and clinical implications. Endocr Pract. 2003;9(5):406-16.   DOI
30 Weyer S, Zink MD, Wartzek T, Leicht L, Mischke K, Vollmer T, et al. Bioelectrical impedance spectroscopy as a fluid management system in heart failure. Physiol Meas. 2014;35(6):917-30.   DOI
31 Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-25.   DOI
32 Codognotto M, Piazza M, Frigatti P, Piccoli A. Influence of localized edema on whole-body and segmental bioelectrical impedance. Nutrition. 2008;24(6):569-74.   DOI
33 Rask-Madsen C, King GL. Vascular complications of diabetes: mechanisms of injury and protective factors. Cell Metab. 2013;17(1):20-33.   DOI
34 Pang B, Zhou Q, Zhao T-Y, He L-S, Guo J, Chen H-D, et al. Innovative Thoughts on Treating Diabetes from the Perspective of Traditional Chinese Medicine. Evidence-Based Complementary and Alternative Medicine. 2015;2015:905432.   DOI
35 Park MS, Ki YM. Study on Clinical Diseases of Yang Deficiency Pattern. Journal of Physiology & Pathology in Korean Medicine. 2013;27(2):153-66.
36 Yin D-H, Liang X-C, Piao Y-L. Analysis of Chinese medicine syndrome pattern in patients with type 2 diabetes mellitus and its relationship with diabetic chronic complications. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi= Chinese journal of integrated traditional and Western medicine. 2009;29(6):506-10.
37 Park MS, Kim YM. Study on Clinical Diseases of Yang Deficiency Pattern. Journal of physiology & pathology in Korean Medicine. 2013;27(2):153-66.
38 Leong PK, Wong HS, Chen J, Ko KM. Yang/Qi invigoration: an herbal therapy for chronic fatigue syndrome with yang deficiency? Evidence-Based Complementary and Alternative Medicine. 2015;2015.
39 Huang X, Chen Q, Yang G, Dai W, Lang Q, Du J, et al. Metabolic profiling study of yang deficiency syndrome in hepatocellular carcinoma by h1 NMR and pattern recognition. Evid Based Complement Alternat Med. 2012;2012:843048.
40 Ko KM, Leon TY, Mak DH, Chiu PY, Du Y, Poon MK. A characteristic pharmacological action of 'Yang-invigorating' Chinese tonifying herbs: enhancement of myocardial ATP-generation capacity. Phytomedicine. 2006;13(9-10):636-42.   DOI
41 Jacobus WE. Respiratory control and the integration of heart high-energy phosphate metabolism by mitochondrial creatine kinase. Annu Rev Physiol. 1985;47:707-25.   DOI
42 Sivitz WI, Yorek MA. Mitochondrial dysfunction in diabetes: from molecular mechanisms to functional significance and therapeutic opportunities. Antioxid Redox Signal. 2010;12(4):537-77.   DOI
43 Carmeliet E. Cardiac transmembrane potentials and metabolism. Circ Res. 1978;42(5):577-87.   DOI
44 Lian F, Chen X, Zhao L, Xu L, Tong X. Essential factors of Sui Zheng Shi Liang strategy in type 2 diabetes treatment assessed by questionnaire. J Tradit Chin Med. 2013;33(1):27-33.   DOI