关键词: 肥胖表型, 代谢正常肥胖表型, 代谢异常肥胖表型, 中医体质量表, 痰湿体质

Abstract: Background　Studies have shown that there are certain similarities in the types of TCM constitutions between obese people and those with metabolic disorders，but the risk of metabolically unhealthy in different obese people is not exactly the same.However，it is still unknown whether this difference is essentially related to TCM constitution.Objective　To explore the TCM constitution features of different obesity phenotypes.Methods　During June 2012 to January 2014，from the database of 1 814 physical examinees recruited from Preventive Treatment Center，Beijing Tongren Hospital，the First Affiliated Hospital of Anhui University of Chinese Medicine，and Zhuhai Branch，Guangdong Provincial Hospital of Traditional Chinese Medicine，1 267 normal-weight and obese cases were included after excluding those who were less than 18 years old，underweight，overweight，and had missing data.According to metabolic and obese phenotypes，they were divided into four groups:metabolically healthy normal weight（MHNW），metabolically unhealthy normal weight（MUNW），metabolically healthy obesity（MHO），and metabolically unhealthy obesity（MUO）.The TCM Constitution Questionnaire was used to investigate the TCM constitution.Partial least squares regression was used to calculate the scores of 9 types of TCM constitution for different obesity phenotypes after controlling sociodemographic and behavioral factors，including constitution of gentleness，Qi-deficiency，Yang-deficiency，Yin-deficiency，phlegm-dampness，damp-heat，blood stasis，Qi depression，and allergic.Results　The number of cases in groups of MHNW，MUNW，MHO，and MUO was 584（46.1%），207（16.3%），174（13.7%），and 302（23.9%），respectively.The mean scores of constitution of gentleness，Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype（P<0.05）.To be specific，MUO group showed higher mean score of gentleness constitution，and lower mean score of Yang-deficiency constitution compared with MHNW and MUNW groups（P<0.05）.MHO and MUO groups showed higher mean score of phlegm-dampness constitution compared with other two groups（P<0.05）.Sex-based analysis showed that，the mean scores of constitution of gentleness，Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype in males（P<0.05）.Specifically，males in MUO group demonstrated higher mean score of gentleness constitution，and lower mean score of Yang-deficiency constitution compared with those in MHNW and MUNW groups（P<0.05）.Moreover，males in MHNW group demonstrated lower mean score of phlegm-dampness constitution compared with those in other three groups（P<0.05）.The mean scores of constitution of Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype in females（P<0.05）.Specifically，females in MUO group demonstrated lower mean score of Yang-deficiency constitution compared with those in MHNW group（P<0.05）.And they also showed higher mean score of phlegm-dampness constitution compared with those in MHNW and MUNW groups（P<0.05）.Conclusion　In the case of similar metabolic status，obese people have a higher tendency to develop phlegm-dampness constitution，and gentleness constitution，but the tendency of developing Yang-deficiency constitution is lower.When people's body weights are similar，metabolic status is not associated with significant differences in TCM constitution.However，conditions are different in males and females.Males who are obesity and metabolically unhealthy all showed higher tendency to have phlegm-dampness constitution，but in females，only the obese ones tend to show higher tendency of having phlegm-dampness constitution，those with unhealthy metabolism have no the tendency.

Key words: Obesity phenotype, Metabolically healthy obesity, Metabolically unhealthy obesity, Constitution in Chinese Medicine Questionnaire, Phlegm-dampness constitution