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JKM > Volume 37(3); 2016 > Article
Kim, Ko, and Park: Skin Color Measurement of LU10; Comparison between Functional Dyspepsia Patients and Healthy Controls

Abstract

Objectives

According to Korean Medicine theory, the skin color of LU10 serves as a diagnostic clue to dyspeptic symptoms. The aims of this study were (1) to find the difference of skin color in LU10 region between functional dyspepsia (FD) and healthy control (HC) and (2) to examine the relationship between LU10 skin color parameters and dyspeptic symptoms.

Methods

39 participants (29 FD and 10 HC) have participated in this study. They were asked to complete gastrointestinal scale (GIS), gastrointestinal symptom rating scale (GSRS), Nepean dyspepsia index (NDI), functional dyspepsia-related quality of life (FD-QoL), visual analogue scale (VAS) for dyspeptic symptoms, food retention questionnaire (FRQ) and cold heat questionnaire (CHQ). L* (luminance), a* (red-green balance) and b* (yellow-blue balance) values of LU10 region were calculated through digital images of the participant’s hand. Then we evaluated test-retest reliability of L*, a* and b* values of LU10 region. Additionally, we compared L*, a* and b* values of LU10 between FD and HC, and examined the relationship between LU10 color parameters and seven questionnaires scores.

Results

Only L* values in LU10 region were significantly higher in FD compared with HC. GIS scores and the subset scores of NDI had a positive correlation with L* values significantly. Correlation coefficients of test-retest reliability of skin color measurement of LU10 ranged from 0.871 to 0.936 representing very strongly statistically significant (P<0.001).

Conclusions

We confirmed the difference of skin color in LU10 region between FD and HC, and relationship between LU10 skin color parameters and dyspeptic symptoms.

Fig. 1
Settings for photographing participant’s hand. A digital camera with tripod, LED lights and photobox.
jkm-37-3-27f1.gif
Fig. 2
Two regions of interest (ROIs) in this trial. The ROIs were cropped using Picture Color Analyzer software. A: LU10 region at the midpoint of the palmar border of the 1st metacarpal bone, B: Reference region, proximal to the heads of 2nd and 3rd metacarpal bone (no correlation with LU10).
jkm-37-3-27f2.gif
Table 1
Baseline Characteristics of Participants
Total (n=39) Mean±SD Range
 Age (yrs) 38.36±5.92 30.0–49.0
BMI (kg/m2) 22.47±3.27 17.4–31.0
SBP (mmHg) 121.54±14.41 95.0–167.0
DBP (mmHg) 76.79±9.77 61.0–106.0
Pulse (bpm) 76.15±9.73 59.0–96.0
BT(°C) 36.23±0.33 35.2–36.8
Baseline Characteristics of Each Group
FD (n=29) HC(n=10) P-value
Age (yrs)* 40.34±5.18 32.60±3.86 <0.001a
BMI (kg/m2) 22.57±3.27 22.18±3.42 0.752a
SBP (mmHg) 121.24±14.62 122.40±14.47 0.830a
DBP (mmHg) 76.86±9.67 76.60±10.58 0.943a
Pulse (bpm) 77.31±10.31 72.80±7.24 0.211a
BT(°C)* 36.15±0.34 36.44±0.22 0.005a
Sex (M, %) 41.4 60.0 0.465b
P/H (%) 20.7 20.0 1.000b
Surgery (%) 13.8 20.0 0.636b
PD (%) 0 0 -
NPD (%)* 0 40.0 0.003b
Drinking (%) 75.9 90.0 0.653b
Smoking (%) 20.7 0 0.308b
Coffee (%) 93.1 70.0 0.096b

Data shown are mean ± standard deviation unless otherwise indicated.

FD: Functional Dyspepsia, HC: Healthy Control, SD: Standard Deviation, BMI: Body Mass Index, SBP: Systolic Blood Pressure, DBP: Diastolic Blood Pressure, BT: Body Temperature, P/H: Physical History, PD: Prescription Drug, NPD: Non-Prescription Drug,

* P < 0.05 vs. Healthy Control.

a Two Sample t-Test,

b Fisher’s Exact Test.

Table 2
Descriptive Characteristics of the Color Parameters of Regions of Interest (ROIs) and Questionnaire Scores.
Total (n=39) Mean±SD Range
Color Parameter Region L* 62.59±4.95 51–74
LU10 a* 14.69±3.06 8–22
b* 12.85±2.94 6–22
Reference Rregion L* 53.15±6.65 40–69
a* 17.69±2.99 12–24
b* 16.49±3.33 10–28
GIS 13.51±8.28 0–30
NDI-K 59.28±33.65 0–118
FD-QoL 24.00±15.56 1–54
GSRS 9.33±6.89 0–27
Cold Pattern 4.82±2.70 0–10
Heat Pattern 3.49±2.43 0–9
FRQ 65.21±19.21 20–98
VAS 45.03±18.08 2–70

Data shown are mean ± standard deviation.

L*: Luminance, a*: Red(+)/Green(-) Balance, b*: Yellow(+)/Blue(−) Balance.

GIS: Gastrointestinal Symptom Scale, NDI-K: Nepean Dyspepsia Index-Korean Version, FD-QoL: Functional Dyspepsia-related Quality of Life, GSRS: Gastrointestinal Symptom Rating Scale, Cold Pattern: Cold Subscale of the Cold-Heat Questionnaire, Heat Pattern: Heat Subscale of the Cold-Heat Questionnaire, FRQ: Food Retention Questionnaire, VAS: Visual Analogue Scale for Dyspeptic Symptoms.

Table 3
Comparison of Questionnaire Scores between 2 Groups.
FD (n=29) HC (n=10) P-value
GIS* 17.24±5.87 2.70±2.79 <0.001a
NDI-K* 73.90±25.12 16.90±11.52 <0.001a
FD-QoL* 28.66±14.71 10.50±8.73 <0.001b
GSRS* 11.97±5.86 1.70±2.58 <0.001b
Cold Pattern* 5.93±1.98 1.60±1.78 <0.001b
Heat Pattern* 4.14±2.23 1.60±2.01 0.005b
FRQ* 72.45±13.85 44.20±17.36 <0.001a
VAS* 53.10±9.86 21.60±16.08 <0.001b

Data shown are mean ± standard deviation.

GIS: Gastrointestinal Symptom Scale, NDI-K: Nepean Dyspepsia Index-Korean Version, FD-QoL: Functional Dyspepsia-related Quality of Life, GSRS: Gastrointestinal Symptom Rating Scale, Cold Pattern: Cold Subscale of the Cold-Heat Questionnaire, Heat Pattern: Heat Subscale of the Cold-Heat Questionnaire, FRQ: Food Retention Questionnaire, VAS: Visual Analogue Scale for Dyspeptic Symptoms,

* P < 0.05 vs. Healthy Control.

a Two Sample t-Test,

b Mann-Whitney U Test.

Table 4
Comparison of L*, a* and b* Values between 2 Groups.
Color parameter FD (n=29) HC (n=10) P-value
Region LU 10 L* 63.41±5.10 60.20±3.73 0.037a
a* 14.79±3.19 14.40±2.80 0.731b
b* 13.03±3.26 12.30±1.77 0.672a
Reference Point L* 54.00±6.94 50.70±5.29 0.179b
a* 17.69±3.13 17.70±2.71 0.993b
b* 16.55±3.63 16.30±2.41 0.922a

Data shown are mean ± standard deviation.

FD: Functional Dyspepsia, HC: Healthy Control, L*: Luminance, a*: Red(+)/Green(−) Balance, b*: Yellow(+)/Blue(−) Balance.

a Mann-Whitney U Test,

b Two Sample t-Test

Bold values indicate significant P-values.

Table 5
Comparison of L*, a* and b* Values in Each Group.
Group Color Parameter LU10 Reference Point P-value
FD (n=29) L* 63.41±5.10 54.00±6.94 <0.001a
a* 14.79±3.19 17.69±3.13 0.001b
b* 13.03±3.26 16.55±3.63 <0.001a
HC (n=10) L* 60.20±3.73 50.70±5.29 0.018a
a* 14.40±2.80 17.70±2.71 0.297a
b* 12.30±1.77 16.30±2.41 0.389a

Data shown are mean ± standard deviation.

FD: Functional Dyspepsia, HC: Healthy Control, L*: Luminance, a*: Red(+)/Green(−) Balance, b*: Yellow(+)/Blue(−) Balance.

a Two Sample t-Test,

b Mann-Whitney U Test.

Bold values indicate significant P-values.

Table 6
Pearson’s Correlations between Color Parameters of LU10 and Questionnaire Scores
Questionnaire Pearson’s Correlation(r) Region
L* a* b*
GIS r 0.351 0.067 0.246
P-value 0.028 0.687 0.131
NDI-K
Total Score
r 0.235 −0.021 0.029
P-value 0.149 0.899 0.859
Frequency r 0.020 0.154 0.061
P-value 0.902 0.349 0.713
Intensity r 0.277 −0.081 0.064
P-value 0.088 0.625 0.699
Bothersomeness r 0.365 −0.123 0.074
P-value 0.022 0.454 0.653
FD-QoL r 0.225 0.006 0.151
P-value 0.168 0.973 0.358
GSRS r 0.207 −0.025 −0.036
P-value 0.206 0.880 0.826
Cold Pattern r 0.266 0.063 0.208
P-value 0.102 0.703 0.204
Heat Pattern r 0.175 0.010 0.062
P-value 0.287 0.951 0.706
FRQ r 0.182 −0.012 0.101
P-value 0.267 0.941 0.540
VAS r 0.274 0.122 0.157
P-value 0.091 0.460 0.339

L*: Luminance, a*: Red(+)/Green(−) Balance, b*: Yellow(+)/Blue(−) Balance, GIS: Gastrointestinal Symptom Scale, NDI-K: Nepean Dyspepsia Index-Korean Version, FD-QoL: Functional Dyspepsia-related Quality of Life, GSRS: Gastrointestinal Symptom Rating Scale, Cold Pattern: Cold Subscale of the Cold-Heat Questionnaire, Heat Pattern: Heat Subscale of the Cold-Heat Questionnaire, FRQ: Food Retention Questionnaire, VAS: Visual Analogue Scale for Dyspeptic Symptoms.

Bold values indicate significant P-values and Pearson’s correlations at the significant P-values.

Table 7
Test-retest Reliability of L*, a* and b* Values on LU10
Color Parameter Coefficient of Correlation P-value
L* 0.871 <0.001
a* 0.945 <0.001
b* 0.936 <0.001

L*: Luminance, a*: Red(+)/Green(−) Balance, b*: Yellow(+)/Blue(−) Balance

Analyzed by Pearson’s r.

P-value<0.05 is considered as statistically significance.

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