title: The association between arterial stiffness and tongue manifestations of blood stasis in patients with type 2 diabetes.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a hypercoagulable state and is associated with highly increased risk of vascular complications. In the theory of traditional Chinese medicine (TCM), these vascular complications are classified as blood stasis. Diagnosis of the tongue plays an important role in TCM; a bluish tongue, petechiae, and engorged sublingual collateral vessels are manifestations of blood stasis. This study aimed to characterize the tongue manifestations of blood stasis and derive a relationship between blood stasis and vascular disorders in patients with type 2 DM.
  
  
  METHODS
  We conducted a cross-sectional study of 140 patients with type 2 DM, and compared demography, laboratory, physical examination, ankle brachial index(ABI), brachial-ankle pulse wave velocity (ba-PWV), and tongue manifestation datas. An automatic tongue diagnosis system was used to capture tongue images and characterize clinical tongue manifestations.
  
  
  RESULTS
  A bluish or petechiae tongue was assoicated with a significant decrease in high-density lipoprotein level, and bluish tongue was associated with significant increase in blood triglyceride in patients with type 2 DM. On assessing arterial stiffness, patients with a petechiae tongue had a higher ba-PWV for both sides (L:1938.41 ± 469.54 cm/sec v.s.1723.99 ± 302.16, p = 0.02; R:1937.28 ± 405.55 v.s.1741.99 ± 325.82, p = 0.03).
  
  
  CONCLUSIONS
  Blood stasis, particularly a tongue with petechiae, may be associated with arterial stiffness in patients with type 2 DM. Furthermore, tongue diagnosis could detect blood stasis relevant to DM and could serve as a feasible predictor for DM.
authors: Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.|Department of Chinese Medicine, Changhua Christian Hospital, No.135 Nanxiao St., Changhua, Taiwan.
authors: Po-Chi
authors: PC
authors: Hsu
authors: School of Chinese Medicine, China Medical University, No. 91, Hsueh-Shih Rd., Taichung, Taiwan. yuchuen@mail.cmu.edu.tw.|Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. yuchuen@mail.cmu.edu.tw.
authors: Yu-Chuen
authors: YC
authors: Huang
authors: Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan.|Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: John Y
authors: JY
authors: Chiang
authors: School of Chinese Medicine, China Medical University, No. 91, Hsueh-Shih Rd., Taichung, Taiwan.|Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan.
authors: Hen-Hong
authors: HH
authors: Chang
authors: Department of Endocrinology, Changhua Christian Hospital, No.135 Nanxiao St., Changhua, Taiwan. 48795@cch.org.tw.
authors: Pei-Yung
authors: PY
authors: Liao
authors: Department of Chinese Medicine, Changhua Christian Hospital, No.135 Nanxiao St., Changhua, Taiwan. 126478@cch.org.tw.|Graduate Institute of Statistical and informational Science, National Changhua University of Education, Changhua, Taiwan. 126478@cch.org.tw.
authors: Lun-Chien
authors: LC
authors: Lo
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D063177:Pulse Wave Analysis; D014059:Tongue / Q000473:pathology*; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Arterial stiffness,and brachial-ankle pulse wave velocity (ba-PWV); Blood stasis; Diabetes mellitus (DM); Tongue diagnosis; Traditional Chinese medicine (TCM)