School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Pudong, Shanghai, China.
School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Pudong, Shanghai, China.
Sci Rep. 2023 Aug 22;13(1):13640. doi: 10.1038/s41598-023-39934-5.
Subhealth is a transitional state between health and disease, and it can be detected through routine physical check-ups. However, the complexity and diversity of physical examination items and the difficulty of quantifying subhealth manifestations are the main problems that hinder its treatment. The aim of this study was to systematically investigate the physical examination performance of the subhealthy population and further explore the deeper relationships between indicators. Indicators were obtained for 878 subjects, including basic information, Western medicine indicators, inquiries of traditional Chinese medicine and sublingual vein (SV) characteristics. Statistical differences were analysed using R software. To explore the distribution of symptoms and symptom clusters in subhealth, partial least squares-structural equation modelling (PLS-SEM) was applied to the subhealth physical examination index, and a structural model was developed to verify whether the relationship chain between the latent variables was reasonable. Finally, the reliability and validity of the PLS-SE model were assessed. The most common subclinical clinical symptoms were limb soreness (37.6%), fatigue (31.6%), shoulder and neck pain (30.5%) and dry eyes (29.2%). The redness of the SV in the subhealthy group was paler than that in the healthy group (p < 0.001). This study validates the establishment of the directed acyclic relationship chain in the subhealthy group: the path from routine blood tests to lipid metabolism (t = 7.878, p < 0.001), the path from lipid metabolism to obesity (t = 8.410, p < 0.001), the path from obesity to SV characteristics (t = 2.237, p = 0.025), and the path from liver function to SV characteristics (t = 2.215, p = 0.027). The innovative application of PLS-SEM to the study of subhealth has revealed the existence of a chain of relationships between physical examination indicators, which will provide a basis for further exploration of subhealth mechanisms and causal inference. This study has identified the typical symptoms of subhealth, and their early management will help to advance the treatment of diseases.
亚健康是介于健康和疾病之间的过渡状态，可以通过常规体检来发现。然而，体检项目的复杂性和多样性以及亚健康表现的量化难度是阻碍其治疗的主要问题。本研究旨在系统地研究亚健康人群的体检表现，并进一步探讨指标之间更深层次的关系。为 878 名受试者获得了基本信息、西药指标、中医查询和舌下静脉（SV）特征的指标。使用 R 软件分析统计差异。为了探索亚健康中症状和症状群的分布，应用偏最小二乘结构方程模型（PLS-SEM）对亚健康体检指标进行分析，并建立结构模型，以验证潜在变量之间的关系链是否合理。最后，评估了 PLS-SEM 模型的可靠性和有效性。最常见的亚临床临床症状是四肢酸痛（37.6%）、疲劳（31.6%）、肩颈痛（30.5%）和干眼症（29.2%）。亚健康组 SV 的红色比健康组更苍白（p<0.001）。本研究验证了亚健康组定向无环关系链的建立：常规血液检查到脂质代谢的路径（t=7.878，p<0.001），脂质代谢到肥胖的路径（t=8.410，p<0.001），肥胖到 SV 特征的路径（t=2.237，p=0.025），以及肝功能到 SV 特征的路径（t=2.215，p=0.027）。PLS-SEM 在亚健康研究中的创新应用揭示了体检指标之间存在关系链，这将为进一步探索亚健康机制和因果推理提供依据。本研究确定了亚健康的典型症状，早期管理将有助于推进疾病的治疗。
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