TCM Constitution and the Risk of Hyperglycemia in Young and Middle-Aged Adults: A Retrospective Cohort Study

It is worth investigating whether the cluster of physical symptoms, body signs, and subjective feelings can be used to predict the risk of hyperglycemia, especially among the general young- and middle-aged adults who irregularly receive lab tests.

A retrospective cohort was established based on anonymous health check data from 2018 to 2023 in a single center. Hyperglycemia was identified if fasting blood glucose was ≥ 5.6 mmol/L and/or HbA1c ≥ 5.7%. Traditional Chinese medicine (TCM) body constitution was identified using China's national standard questionnaire, which is a scheme of preventive medicine derived from traditional medicine, including nine types of constitution. Participants may have a single or mixed type of TCM constitution. Cox proportional hazards models were used to assess the association between TCM constitution and the risk of new-onset hyperglycemia. Stratified analyses were performed by age, sex, and low-density lipoprotein cholesterol levels.

Of the 8462 participants (37.46 ± 9.42 years) included, 2376 (28.08%) individuals developed hyperglycemia during the median follow-up of 27.93 months. Blood stasis constitution (sublingual vein distension, pigmentation; HR = 2.30, 95% CI 1.38-3.82) and those mixed with others (HR = 1.72, 95% CI 1.18-2.52), qi stagnation constitution (sentimental, depressed; HR = 1.91, 95% CI 1.13-3.24) and those mixed with others (HR = 1.87, 95% CI 1.24-2.83), phlegm-dampness constitution (soft/fat belly, loose and sticky stool; HR = 1.65, 95% CI 1.09-2.49), yang-deficient constitution (cold-sensitive; HR = 2.27, 95% CI 1.13-4.57), and damp-heat constitution (halitosis, prone to acne; HR = 1.48, 95% CI 1.03-3.14) showed significant association with the increased risk of hyperglycemia in the general population. With the exception of yang-deficient constitution (insufficient sample size), all other TCM constitutions showed significantly higher association with hyperglycemia in adults aged 18-44 years, but not in those aged ≥ 45 years.

Assessment based on a TCM constitutional questionnaire can serve as a risk indicator of the risk of hyperglycemia in the general population, particularly among young adults.