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Background: Traditional Chinese Medicine Constitution(TCMC)refers to an integrated,metastable and natural specialty of individual in morphosis,physiological functions and psychological conditions.It is formed on the basis of innate and acquired endowments in human life process and divided into normal constitution and unbalanced ones.This study aimed to survey the distribution of TCMCs of Hong Kongs adult Chinese women and investigate the association of social-demographic,lifestyle,reproductive,healthy and emotional factors with the formation of unbalanced TCMCs.Methods: General local Chinese women between 30 to 65 years old,recruited from 18 districts of Hong Kong(n=944),were assessed using the Traditional Chinese Medicine Physical Constitution Scale for their TCMC types.Social-demographic,reproductive,lifestyle,systemic health and emotional status information were collected through structured questionnaire.The associations between different independent factors and each TCMC type,as well as the complex unbalanced TCMC types were tested individually.Significant factors related to unbalanced TCMC types were identified in final model using multiple factor analysis.Results: A total of 764(80.9%)participants were diagnosed with unbalanced TCMCs,the most common TCMC type was Qideficiency constitution(53.9%),followed by Phlegm-wetness(38.9%),Yang-deficiency(38.2%),Yin-deficiency(35.5),Blood-stasis(35.4)and Qi-depressed(31%)constitution.Among them 611(64.7%)showed at least two types of combined and unbalanced constitutions.Stepwise logistic analysis indicated that poor systemic health condition(OR,1.76-2.89),negative emotions(OR=1.39),overweight(OR=1.58),high educational level(OR=1.18)and mental work(OR=1.44)were significantly positively correlated with certain unbalanced TCMCs.Meanwhile,aging(OR,0.59-0.73),exercise habit(OR,0.61-0.79)and reproductive history(OR=0.72)showed inverse associations with unbalanced constitutions.In addition,systemic health condition and emotional status,exercise habit and age were significantly associated with the combined unbalanced TCMC types.Conclusion: The majority of middle-aged Chinese women in Hong Kong are with unbalanced and complex TCMCs.Qi-deficiency,Phlegm-wetness and Yang-deficiency constitutions are the most common constitutions.Poor systemic health condition,less-than-satisfactory emotional life,overweight and mental work might be contributors for the formation of unbalanced TCMCs,while regular physical exercise is found to be a protective factor for unbalanced TCMCs.