Skip to main content

ORIGINAL RESEARCH article

Front. Big Data
Sec. Medicine and Public Health
Volume 7 - 2024 | doi: 10.3389/fdata.2024.1443646
This article is part of the Research Topic Soft Computing and Machine Learning Applications for Healthcare Systems View all 11 articles

Exploring the pivotal variables of tongue diagnosis between patients with chronic kidney disease and health participants

Provisionally accepted
Po-Chi Hsu Po-Chi Hsu 1Jia-Ming Chen Jia-Ming Chen 2Chia-Chu Chang Chia-Chu Chang 3Yu-Jun Chang Yu-Jun Chang 2Ping-Fang Chiu Ping-Fang Chiu 2John Y. Chiang John Y. Chiang 4Lun-Chien Lo Lun-Chien Lo 1*
  • 1 China Medical University (Taiwan), Taichung, Taiwan
  • 2 Changhua Christian Hospital, Changhua, Taiwan
  • 3 Kuang Tien General Hospital, Taichung, Taiwan
  • 4 National Sun Yat-sen University, Kaohsiung, Kaohsiung County, Taiwan

The final, formatted version of the article will be published soon.

    Introduction: Chronic kidney disease (CKD) is a significant global health problem associated with high morbidity and mortality rates. Traditional Chinese Medicine (TCM) utilizes tongue diagnosis to differentiate symptoms and predict prognosis. This study examines the relationship between tongue characteristics and CKD severity using an automatic tongue diagnosis system (ATDS), which captures tongue images non-invasively to provide objective diagnostic information. Methods: This cross-sectional, case-control study was conducted from July 1, 2019, to December 31, 2021. Participants were divided into three groups based on estimated glomerular filtration rate (eGFR): control (eGFR > 60 ml/min/1.732), CKD stage 3 (30 ≤ eGFR < 60 ml/min/1.732), and CKD stage 4-5 (eGFR < 30 ml/min/1.732). Tongue images were analyzed using ATDS to extract nine primary features: tongue shape, color, fur, saliva, fissures, ecchymosis, tooth marks, and red dots. Statistical analyses included nonparametric methods and ordinal logistic regression. Results: This study revealed that significant differences in the fur thickness, tongue color, amount of ecchymosis, and saliva among three groups. Ordinal logistic regression indicated that pale tongue color (OR: 2.107, P < 0.001), bluish tongue color (OR: 2.743, P = 0.001), yellow fur (OR: 3.195, P < 0.001), wet saliva (OR: 2.536, P < 0.001), and ecchymoses (OR: 1.031, P = 0.012) were significantly associated with increased CKD severity. Additionally, each red dot and tooth mark decreased the odds of severe CKD. Conclusion: Tongue features such as paleness, wet saliva, yellow fur, and ecchymosis are prevalent in CKD patients and can serve as early clinical indicators of the disease. This study demonstrates that TCM tongue diagnosis, facilitated by ATDS, is a valuable, non-invasive method for identifying CKD and distinguishing its stages.

    Keywords: Traditional Chinese medicine (TCM), Tongue diagnosis, Automatic tongue diagnosis system (ATDS), Chronic kidney disease (CKD), Renal function

    Received: 04 Jun 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Hsu, Chen, Chang, Chang, Chiu, Chiang and Lo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lun-Chien Lo, China Medical University (Taiwan), Taichung, Taiwan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.