Comparing acupoint catgut embedding and acupuncture therapies for simple obesity: A protocol for systematic review and meta-analysis

BACKGROUND

This systematic review aimed to assess the effectiveness and safety of acupoint catgut embedding (ACE), which is widely used in simple obese patients.

METHODS

Nine electronic databases and 2 trial registries were searched from inception to September 2021 without language limitations. All randomized controlled trials involving ACE therapies for simple obesity were included. Assessment of Cochrane's risk of bias and meta-analysis, as well as GRADE evaluation, were also performed.

RESULTS

A total of 73 randomized clinical trials involving 5872 participants were included. The overall risk of bias was high or unclear. ACE showed higher efficacy in total effective rate, body mass index, and body weight than manual acupuncture. In addition, ACE is more beneficial in total effective rate than electroacupuncture (EA). Moreover, combination therapy of ACE with EA is more effective in total body mass index and body weight than EA alone.

CONCLUSIONS

Despite some potential improvement, the evidence regarding the effectiveness and efficacy of ACE for simple obesity is inconclusive due to the poor quality of evidence. Further well-designed randomized controlled trials are needed to confirm the effectiveness of ACE for simple obesity.

Efficacy of acupuncture and moxibustion therapy for simple obesity in adults: A meta-analysis of randomized controlled trials

BACKGROUND

To evaluate the clinical efficacy of acupuncture and moxibustion therapy compared to non-acupuncture therapy in the treatment of simple obesity in adult.

METHODS

Randomized clinical trials concerning acupuncture and moxibustion therapy as a treatment of simple adult obesity were searched in the following Chinese and English databases: Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang Database, Chinese Biomedical Literature Database, PubMed, Web of Science, Embase, Medline and Cochrane Library. Two researchers independently screened suitable literature according to inclusion and exclusion criteria, extracted data, and evaluated the quality of included studies using the Jadad score scale. After that, data analysis was performed using RevMan 5.4.1 software, Stata 17.0 software and SPSS 25.0 software.

RESULTS

A total of 14 studies involving 1116 adults with simple obesity were included in the meta-analysis. Results revealed that BMI, body weight, waist circumference, total effective rate, triglyceride in the acupuncture group were superior to those in the non-acupuncture group, while there was no statistical difference in improving low density lipoprotein, high density lipoprotein and total cholesterol. As to the selection of acupoints, the acupoints of the stomach meridian of Foot Yangming have the highest frequency of use, with a frequency of 30 times, accounting for 35%. The acupoints can be divided into three clusters: the first category: RN9-SP9-SP6-RN4; the second category: ST40-RN6-SP15-ST36; the third category: ST25-RN12.

CONCLUSION

Acupuncture and moxibustion is effective in treating adult simple obesity; however, due to the low score of the included studies, we still expect the results of higher-quality literature to provide a higher-level evidence-based basis for clinical decision-making. Furthermore, for the treatment of adult simple obesity, acupoints analysis revealed that Tianshu (ST25), Zhongwan (RN12), Zusanli (ST36), Fenglong (ST40) and Qihai (RN6) can form the basis for the treatment of simple obesity in adult.

Comparative Effectiveness of East Asian Traditional Medicine for Childhood Simple Obesity: A Systematic Review and Network Meta-Analysis

Childhood obesity leads to various comorbidities and usually persists into adulthood, increasing socioeconomic burden. In the absence of a clearly effective treatment, East Asian traditional medicine (EATM) therapies have been widely used. We aimed to analyze the comparative effectiveness and safety of EATM techniques for children with simple obesity through network meta-analysis (NMA). Twelve databases were searched for randomized controlled trials (RCTs) evaluating the effect of EATMs on childhood simple obesity. Individual EATMs were ranked based on the surface under the cumulative ranking curve. The risk of bias in the individual studies and publication bias in the NMA were evaluated. Thirty-three RCTs were included. Acupuncture, chuna, chuna plus acupressure, cupping plus acupressure, herbal medicine (HM), and HM plus acupuncture significantly reduced BMI compared with lifestyle management. Based on the treatment ranking, cupping plus acupressure was optimal for BMI reduction compared with a non-medical management, followed by chuna and HM. The quality of evidence for individual findings was usually moderate to low, and no serious adverse events of EATM were reported. Cupping plus acupressure might have a large beneficial effect, and chuna or HM probably have a moderate beneficial effect on reducing BMI in children with simple obesity.

[Effect of electroacupuncture combined with intradermal needling on simple obesity and serum intestinal lymphatic function-related factors]

OBJECTIVE

To assess the efficacy of the combined treatment with electroacupuncture (EA) and intradermal needling on simple obesity and explore its underlying effect mechanism.

METHODS

A total number of 116 patients with simple obesity were randomized into an observation group (58 cases, 3 cases dropped off and 2 cases removed) and a control group (58 cases, 4 cases dropped off and 1 cases removed). Patients in the control group received EA at Zhongwan (CV 12), Quchi (LI 11), Zusanli (ST 36), Pishu (BL 20), Weishu (BL 21), etc., for 30 min each time. On the base of the intervention as the control group, the patients in the observation group received the intradermal needling at Tianshu (ST 25), Daheng (SP 15), Zusanli (ST 36), Shangjuxu (ST 37), Quchi (LI 11), Pishu (BL 20) and Weishu (BL 21). In each group, the intervention was given once every two days, 3 times a week, consecutively for 3 months. Before and after treatment, the obesity indexes (body mass [BW], body mass index [BMI], body fat percentage [F%], adiposity [A] and waist circumference [WC]), the serum intestinal lymphatic function-related factors (vascular endothelial growth factor C [VEGF-C], delta-like ligand 4 [DLL4], adrenomedullin [ADM]), blood lipid (total cholesterol [TC], triglyceride [TG] and low density lipoprotein-cholesterol [LDL-C]), and fasting plasma glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) were observed in the patients of both groups; and the efficacy was assessed.

RESULTS

The effective rate was 88.7% (47/53) in the observation group, higher than 71.7% (38/53) in the control group (P<0.05). After treatment, except FPG in the control group, BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, as well as TC, TG, LDL-C, FBG, FINS and HOMA-IR were all reduced compared with those before treatment in both groups (P<0.05). The reduction ranges of BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, and TC, LDL-C, FINS and HOMA-IR in the observation group were all larger than those in the control group (P<0.05).

CONCLUSION

Electroacupuncture combined with intradermal needling can reduce body weight and lipid, and improve insulin resistance in treatment of simple obesity, which is achieved probably through inhibiting lymphangiogenesis and promoting lymphatic endothelial permeability.

[Simple obesity of stomach heat and damp obstruction treated with acupoint thread embedding therapy: a randomized controlled trial]

OBJECTIVE

To explore the therapeutic effect and safety of acupoint thread embedding therapy in treatment of simple obesity of stomach heat and damp obstruction.

METHODS

A total of 144 patients with simple obesity of stomach heat and damp obstruction were randomized into an acupoint thread embedding group (72 cases, 3 cases dropped off and 1 case removed) and a sham-embedding group (72 cases, 6 cases dropped off and 3 cases removed). On the base of the lifestyle adjustment, the acupoint thread embedding therapy with PGLA thread was applied to Tianshu (ST 25), Zhongwan (CV 12), Ganshu (BL 18), Shuidao (ST 28), etc. in the acupoint thread embedding group, while in the sham-embedding group, the acupoint selection and operation were all same as the acupoint thread embedding group, but without PGLA thread embedded. In either group, the treatment was given once every 2 weeks, consecutively for 12 weeks and the follow-up was conducted for 3 months after treatment. Separately, before and after treatment as well as in follow-up, the obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and fat percentage [F%]) were observed in the two groups. Before and after treatment, the indices of blood glucose and insulin (fasting blood glucose [FBG], fasting insulin [FINS] and insulin resistance index [HOMA-IR]), adipocyte factor indices (adiponectin, leptin [LP] and serine protease inhibitor [Vaspin]) and inflammatory factor indices (tumor nercosis factor [TNF-α], interleukin-1β [IL-1β] and interleukin-6 [IL-6]) were observed separately in the two groups. The therapeutic effect and safety were compared between the two groups.

RESULTS

After treatment and in follow-up, except WC and WHR in the sham-embedding group, BMI, WC, WHR and F% were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and the values in the acupoint thread embedding group were lower than the sham-embedding group (P<0.01). After treatment, except FBG, LP and Vaspin in the sham-embedding group, FBG, FINS, HOMA-IR, LP and Vaspin were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and adiponectin was increased as compared with that before treatment (P<0.01, P<0.05); the improvements in the acupoint thread embedding group were more significant than the sham-embedding group (P<0.01). After treatment, the levels of serum TNF-α, IL-1β and IL-6 in the acupoint thread embedding group were reduced as compared with the values before treatment and those in the sham-embedding group separately (P<0.01). The total effective rate was 89.7% (61/68) in the acupoint thread embedding group, higher than 19.0% (12/63) in the sham-embedding group (P<0.01). There was no severe adverse reaction reported in the two groups.

CONCLUSION

Acupoint thread embedding therapy with PGLA thread can alleviate obesity, regulate glucose metabolism and adipocyte factors activity, improve insulin resistance and inhibit the expression of pro-inflammatory factors in the patients with simple obesity with stomach heat and damp obstruction, and this therapy presents a satisfactory safety in treatment.

Tuina combined with diet and exercise for simple obesity: A protocol for systematic review

BACKGROUND

The incidence of simple obesity is increasing annually, with the number of obese people in all age groups increasing significantly. Obesity has become an important public health concern. Simple obesity affects not only appearance but also health. Obesity has an increasing impact on individuals, families, and society. Therefore, the treatment of obesity is becoming increasingly important. Prior studies have shown that Tuina combined with diet and exercise is capable of producing improvements in body weight and fasted health markers. In recent years, there are many clinical studies on the intervention of simple obesity by Tuina combined with diet and exercise, however, no study systematically evaluated the clinical efficacy. The purpose of this study is to evaluate its effects of Tuina combined with diet and exercise on people with simple obesity.

METHODS

We will search the following electronic databases: PubMed, EMBASE, MEDLINE, Web of science, Cochrane Library, WanFang Data, CBM, CNKI, and VIP from the inception of the coverage of these databases to December 2021. Randomized controlled clinical trials related to Tuina combined with diet and exercise intervention on simple obesity will be included. Cochrane's collaboration tool will be used to assess the quality of the studies. RevMan 5.3 software will be used for the data analysis.

RESULTS

This study will provide a standardized evaluation for the efficacy of Tuina combined with diet and exercise for simple obesity.

CONCLUSION

The conclusion of this study will provide evidence for the safety and effectiveness of Tuina combined with diet and exercise on weight loss.

ETHICS AND DISSEMINATION

Ethical approval is not required for systematic review and meta- analysis. The results of this review will be disseminated in a peer-review journal.

PROSPERO REGISTRATION NUMBER

INPLASY202210079.

Comparison of Frequency and Severity of Sleep-Related Breathing Disorders in Children with Simple Obesity and Paediatric Patients with Prader-Willi Syndrome

Sleep-related breathing disorders (SRBDs) can be present in children with simple obesity and with Prader–Willi syndrome (PWS) and influence an individual diagnostic and treatment approach. We compared frequency and severity of SRBDs in children with simple obesity and with PWS, both without and on recombinant human growth hormone (rhGH) treatment, and correlation of SRBDs with insulin resistance tests. A screening polysomnography-polygraphy (PSG), the oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were analysed in three groups of patients—with simple obesity (group 1, n = 30, mean age 14.2 years), patients with PWS without the rhGH therapy (group 2, n = 8, mean age 13.0 years) and during the rhGH treatment (group 3, n = 17, mean age 8.9 years). The oxygen desaturation index (ODI) was significantly higher in groups 2 and 3, compared to group 1 (p = 0.00), and hypopnea index (HI) was higher in group 1 (p = 0.03). Apnea–hypopnea index (AHI) and apnea index (AI) results positively correlated with the insulin resistance parameters in groups 1 and 3. The PSG values worsened along with the increasing insulin resistance in children with simple obesity and patients with PWS treated with rhGH that may lead to a change in the patients’ care.

Massage for simple obesity: A protocol for systematic review

BACKGROUND

Obesity has become the most serious public health problem in developed and developing countries, and simple obesity accounts for approximately 95% of the total cases. This study aims to assess the effects and safety of massage therapy for the treatment of simple obesity.

METHODS

We will search foreign and Chinese databases, including PubMed, EMBASE, MEDLINE, CENTRAL, CNKI, WanFang Data, CBM, and VIP from the inception of the coverage of these databases to July 2020. Cochrane's collaboration tool will be used to assess the quality of the studies. RevMan 5.3 software will be used for the data analysis.

RESULTS

This study will evaluate whether massage therapy is an effective intervention for simple obesity.

CONCLUSION

This study will provide evidence regarding whether massage therapy is beneficial for treating simple obesity in humans.

PROSPERO REGISTRATION NUMBER

NO.CRD42020197635.

Comparative effectiveness of herb-partitioned moxibustion plus lifestyle modification treatment for patients with simple obesity: A study protocol for a randomized controlled trial

INTRODUCTION

Obesity is a global public health issue, which results in many health complications. Moxibustion may serve as an alternative management for simple obesity, where pharmacological therapy is always difficult to be accepted by the majority of obese patients based on its safety. However, the effects of herb-partitioned moxibustion as obesity intervention have not been confirmed. This study is designed as a single-blinded, 3-dummy randomized controlled trial to evaluate the efficacy and safety of herb-partitioned moxibustion plus lifestyle modification treatment in patients with simple obesity.

METHODS AND ANALYSIS

This study will be a randomized, controlled trial conducted from April, 2019 to April, 2021 that includes 108 participants who have simple obesity and meet the eligibility criteria. The participants will be randomly divided into 3 treatment groups: heat application group, medicated plaster group, or herb-partitioned moxibustion group. Each treatment will last 4 weeks. The primary outcomes will be the clinical effectiveness. The secondary outcome measures include participants' obesity-related indicators, the IWQOL-Lite scale, and the syndrome score of Traditional Chinese Medicine. Adverse events will be recorded during the intervention period.

ETHICS AND DISSEMINATION

Ethical approval of this study was granted by the Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine on 15 November 2018 (Ethics Reference No: HBZY2018-C24-01). Written informed consents will be provided by all participants before they were enrolled in this study.

TRIAL REGISTRATION NUMBER

NCT04606680.

A prioritization regimen of the acupuncture treatment for simple obesity: Protocol for systematic review and network meta-analysis

BACKGROUND

Patients with simple obesity suffer from poor quality of life, as well as high risk of hypertension, diabetes, cardiovascular, and cerebrovascular accidents. Lots of Clinical trials suggested that acupuncture is beneficial for simple obesity, and it aims to gather solid evidence in order to provide reliable reference in establishing guidelines for acupuncture treatment of simple obesity in this study.

METHODS

Relevant databases including Cochrane Library, PubMed, Cochrane Central Register of Controlled Trials, Medline University Resource Center, Chinese Biomedical Literature Service System, and China National Knowledge Infrastructure will be retrieved from January 1950 to November 2018. Two authors will screen studies independently according to the inclusion and exclusion criteria and extract the data in a form of sheet. Quality evaluations and bias risk assessments will be performed for the methodology of included studies. Dichotomous data will be analyzed using odds ratio (OR), and continuous data using mean differences. Network meta-analysis will be conducted by using Stata 14.0. The Development and Evaluation approach will be used to rate the certainty of the evidence of estimates derived from meta-analysis. The primary outcome is body mass index (BMI), and the secondary outcomes are triglycerides, total cholesterol, low-density lipoprotein-cholesterol, effective rate, adverse effects, and recurrence rate. Trial registration number is CRD42019117387.

RESULTS

Based on current evidence, this review will rank the efficacy and safety of the various acupuncture regimen in decreasing BMI, triglycerides, total cholesterol of patients with simple obesity, and to summarize a prioritization regimen.

CONCLUSION

This evidence may be useful for clinicians, patients, and guideline-makers to select the optimum proposal of acupuncture for the simple obesity treatment.

The Characteristics Of Abdominal Fat Distribution In Japanese Adolescents With Type 2 Diabetes Mellitus

PURPOSE

The aim was to investigate the characteristics of abdominal fat distribution in Japanese adolescents with type 2 diabetes mellitus.

PATIENTS AND METHODS

Eighty-six Japanese adolescents with simple obesity or type 2 diabetes mellitus treated between 2002 and 2018 were included. The subjects were classified into the simple obesity group (SO group, n=38) and type 2 diabetes mellitus group (DM group, n=23) by matching average age and gender ratio. The metabolic parameters VFA, SFA, and V/S ratio were compared between the 2 groups. Multivariate logistic regression analysis was performed to identify clinical factors associated with type 2 diabetes mellitus. Linear regression analysis was performed between hemoglobin A1c (HbA1c) and visceral fat area (VFA), subcutaneous fat area (SFA), or VFA-to-SFA ratio (V/S ratio) among all enrolled subjects. Finally, correlation analyses were performed to determine the relationships between VFA, SFA, and V/S ratio and metabolic parameters of the DM group. For the metabolic parameters, serum lipids, alanine aminotransferase (ALT), and HbA1c were measured without fasting. The VFA and SFA at umbilical level were investigated using computed tomography.

RESULTS

VFA and V/S ratio in DM group were higher than those in SO group (p=0.04 and p<0.01, respectively). SFA in DM group was lower than that in SO group (p<0.01). VFA and SFA, and non-high density lipoprotein (HDL) cholesterol were identified as being independently associated with type 2 diabetes mellitus (odds ratio, 1.05, 0.98, and 1.04, respectively, p<0.05). HbA1c was correlated with VFA and V/S ratio (p<0.01). In DM group, VFA and SFA were positively correlated with systolic blood pressure (p<0.01), ALT (p<0.05), total cholesterol (p<0.05), and non-HDL cholesterol (p<0.01); however, V/S ratio was not correlated.

CONCLUSION

Abdominal fat distribution in Japanese adolescents with type 2 diabetes mellitus was different from those with simple obesity and might associate with glucose and lipid metabolism.

[Prevalence of simple obesity and its high-risk factors in preschool children in Fuzhou, China]

OBJECTIVE

To investigate the prevalence of simple obesity and its risk factors in preschool children in Fuzhou, China.

METHODS

The physical examination data of 14 kindergartens in Fuzhou, China were collected by stratified cluster random sampling. The detection rate of simple obesity was calculated. The children with normal body weight were selected as the control group by 1:1 case-control method. The risk factors for childhood simple obesity were investigated by self-made questionnaire and multivariate logistic regression analysis.

RESULTS

A total of 5 767 children aged 3-6 years were enrolled in this study. A total of 289 (5.01%) children with simple obesity were screened out, including 153 with mild obesity and 136 with moderate to severe obesity. The prevalence rate of simple obesity gradually increased with the age of children. The multivariate logistic regression analysis showed that the following factors were independent risk factors for simple obesity: preference for fried food (OR=4.789, P<0.05), caregivers' over-concern about diet (OR=4.620, P<0.05), eating before sleep (OR=4.006, P<0.05), eating fast (OR=3.221, P<0.05), preference for sweets (OR=2.282, P<0.05), high birth weight (OR=2.202, P<0.05), overweight or obesity in father (OR=2.074, P<0.05), overweight or obesity in mother (OR=2.047, P<0.05), more than 1.2 times the food intake at the same age (OR=2.013, P<0.05), watching TV (OR=1.665, P<0.05), and lack of exercise (OR=1.463, P<0.05).

CONCLUSIONS

The prevalence rate of simple obesity is 5.01% in preschool children in Fuzhou, China. The development of simple obesity is multifactorial. It is suggested that doctors, parents, and teachers should strengthen health education for preschool children, help them develop good living and eating habits, and encourage them to take more exercise, in order to reduce the development of simple obesity.

[Prevalence of simple obesity and its high-risk factors in preschool children in Fuzhou, China]

OBJECTIVE

To investigate the prevalence of simple obesity and its risk factors in preschool children in Fuzhou, China.

METHODS

The physical examination data of 14 kindergartens in Fuzhou, China were collected by stratified cluster random sampling. The detection rate of simple obesity was calculated. The children with normal body weight were selected as the control group by 1:1 case-control method. The risk factors for childhood simple obesity were investigated by self-made questionnaire and multivariate logistic regression analysis.

RESULTS

A total of 5 767 children aged 3-6 years were enrolled in this study. A total of 289 (5.01%) children with simple obesity were screened out, including 153 with mild obesity and 136 with moderate to severe obesity. The prevalence rate of simple obesity gradually increased with the age of children. The multivariate logistic regression analysis showed that the following factors were independent risk factors for simple obesity: preference for fried food (OR=4.789, P<0.05), caregivers' over-concern about diet (OR=4.620, P<0.05), eating before sleep (OR=4.006, P<0.05), eating fast (OR=3.221, P<0.05), preference for sweets (OR=2.282, P<0.05), high birth weight (OR=2.202, P<0.05), overweight or obesity in father (OR=2.074, P<0.05), overweight or obesity in mother (OR=2.047, P<0.05), more than 1.2 times the food intake at the same age (OR=2.013, P<0.05), watching TV (OR=1.665, P<0.05), and lack of exercise (OR=1.463, P<0.05).

CONCLUSIONS

The prevalence rate of simple obesity is 5.01% in preschool children in Fuzhou, China. The development of simple obesity is multifactorial. It is suggested that doctors, parents, and teachers should strengthen health education for preschool children, help them develop good living and eating habits, and encourage them to take more exercise, in order to reduce the development of simple obesity.

[Analysing the defect of control design of acupuncture: taking RCTs of treating simple obesity with acupuncture for example]

OBJECTIVE

By analysing the defect of control design in randomized controlled trials (RCTs) of simple obesity treated with acupuncture and using acupuncture as the contrast, presenting the essential factors which should be taken into account as designing the control of clinical trial to further improve the clinical research.

METHODS

Setting RCTs of acupuncture treating simple obesity as a example, we searched RCTs of acupuncture treating simple obesity with acupuncture control. According to the characteristics of acupuncture therapy, this research sorted and analysed the control approach of intervention from aspects of acupoint selection, the penetration of needle, the depth of insertion, etc, then calculated the amount of difference factor between the two groups and analyzed the rationality.

RESULTS

In 15 RCTs meeting the inclusion criterias, 7 published in English, 8 in Chinese, the amount of difference factors between two groups greater than 1 was 6 (40%), 4 published in English abroad, 2 in Chinese, while only 1 was 9 (60%), 3 published in English, 6 in Chinese.

CONCLUSION

Control design of acupuncture in some clinical RCTs is unreasonable for not considering the amount of difference factors between the two groups.

[Prescription analysis of electroacupuncture for simple obesity based on complex network technique]

OBJECTIVE

To analyze the core acupoints and compatibility of electroacupuncture (EA) for simple obesity based on complex network technique, and to explore the usage of EA waveform.

METHODS

The clinical research literature regarding EA for simple obesity published from January of 1980 to June of 2016 were searched in PubMed, CNKI, WanFang, VIP, CBM and TCM online database to establish a prescription database of EA for simple obesity. The Matlab2014a software was used to perform the center analysis and cluster analysis, and the analysis of core points and compatibility were conducted. Gephi 9.1 software was used to demonstrate the complex network diagram to further analyze the usage of EA waveform.

RESULTS

Totally 238 prescriptions were obtained. The selection of acupoints at yang-meridians were equally important with acupoints at yin-meridians. The meridians with highest core degree were stomach meridian, conception vessel and spleen meridian. The acupoints with highest core degree were Sanyinjiao (SP 6), Tianshu (ST 25) and Zusanli (ST 36). The cluster analysis indicated three acupoint clusters, including the key-acupoint cluster, syndrome-acupoint cluster, and ashi-point cluster; it was revealed Tianshu (ST 25) and Zhongwan (CV 12) had the highest intensity of compatibility. The sparse-dense wave was mostly used in EA for simple obesity, followed by continuous wave, indicating both sparse-dense wave and continuous wave had high clinical application value.

CONCLUSION

The acupoints of EA for simple obesity are mainly in stomach meridian, conception vessel and spleen meridian; sparse-dense wave is mostly used, followed by continuous wave.

[Effects of electroacupuncture for visceral fat of simple obesity with stomach and intestinal heat]

OBJECTIVE

To observe the clinical effect of electroacupuncture (EA) for visceral fat of simple obesity with stomach and intestinal heat.

METHODS

Forty patients (waistline of male ≥ 90 cm and female ≥ 80 cm) were treated with EA at Quchi (LI 11), Zusanli (ST 36), Xiajuxu (ST 39), Shangjuxu (ST 37), Neiting (ST 44), Qiangu (SI 2), Erjian (LI 2), Tianshu (ST 25) and Fenglong (ST 40) for continuous 3 courses (12 treatments as 1 course) once every other day. The observation items before and after treatment were obesity indices[body weight (W), obesity degree (A%), body mass index (BMI), body fat percentage (F%, skinfold thickness me-thod)], body circumference indices (chest measurement, waistline, hip circumference, thigh circumference, waist-to-hip ratio) and body composition indices[body fat percentage (F%), body moisture content ratio, visceral fat cross assessment index (VFA)]. Besides, 40 healthy control subjects with similar ages and gender ratio were recruited as control.

RESULTS

The total effective rate of the observation group was 97.5% (39/40), with lower W, A%, F%, BMI, chest measurement, waistline, hip circumference, thigh circumference, waist-to-hip ratio and VFA as well as higher body moisture content ratio after treatment (all P<0.01). While there was statistical significance between the two groups for all the indices after treatment (all P<0.01).

CONCLUSIONS

EA can induce body weight and visceral fat of simple obesity with stomach and intestinal heat as well as improve body composition. Besides, body moisture ratio increases.

Comparative effectiveness of electro-acupuncture plus lifestyle modification treatment for patients with simple obesity and overweight: study protocol for a randomized controlled trial

BACKGROUND

Acupuncture is considered to be an effective and safe treatment for obese and overweight patients, although high-quality evidence regarding the effects of acupuncture on obesity are not conclusive. The aim of the current study is to investigate the effectiveness of electro-acupuncture plus lifestyle modification for treating obese and overweight patients, in comparison with lifestyle modification alone in China.

METHODS/DESIGN

To compare the effectiveness of acupuncture plus lifestyle modification, a 2-armed, controlled trial with randomization using minimization will be conducted on 150 simple obesity and overweight patients, aged 18-50 years, for a 36-week study duration. All patients will be randomly assigned to one of two groups and will receive either acupuncture plus lifestyle modification or lifestyle modification alone. Outcomes will be evaluated at baseline and at 4 weeks, 8 weeks, and 12 weeks during treatment as well as at 6-week, 12-week, and 24-week follow-up. The primary endpoint is change of body mass index (BMI) during the 12th week. Secondary endpoints are body weight; waist-to-hip ratio; biochemical tests including serum cholesterol (TC), triglyceride (TG) and high-density lipoprotein (HDL) levels; and answers to the Short Form 36 (SF-36) and the Impact of Weight on Quality of Life Questionnaire-Lite Version (IWQOL-Lite). Statistical analyses will be based on the intention-to-treat (ITT) principle. The main endpoint will be analyzed by analysis of covariance (ANCOVA), and the objective outcome results will be analyzed by logistic regression analysis. To avoid potential confounding factors, additional sensitivity analyses will be conducted following these statistical analyses.

DISCUSSION

This trial is the first to compare the effectiveness of acupuncture plus lifestyle modification for treating obesity relative to lifestyle modification treatment alone by using a pragmatic study design. We hope that the results of this study will contribute to advancing the current methodology of acupuncture trials for obesity and will facilitate the application of useful acupuncture strategies in real-world clinical settings.

TRIAL REGISTRATION

ChiCTR-TRC- 12002762 . The date of registration is 31 October 2012.

Circulating adiponectin levels, body composition and obesity-related variables in Prader-Willi syndrome: comparison with obese subjects

BACKGROUND

People with obesity and/or the metabolic syndrome have an increased risk for developing diabetes and cardiovascular disease and may have low adiponectin levels. The obesity associated with Prader-Willi syndrome (PWS) would be expected to have similar complications. However, it was recently reported that, despite their adiposity, people with PWS have reduced visceral fat and are less likely to develop diabetes mellitus or the metabolic syndrome compared with people with simple obesity.

OBJECTIVE

To determine if plasma adiponectin levels and other variables relevant to diabetes and cardiovascular risk are different in a cohort of PWS subjects with known genetic subtypes compared with age-, sex- and weight-matched control subjects.

RESULTS

Fasting plasma glucose, C-peptide, triglycerides, leptin and cholesterol levels were similar in PWS and obese subjects. Our 20 PWS subjects (mean age = 27.7 years) had higher percent body fat (54.1 vs 48.5%) determined by DEXA measurements and lower percent lean mass (45.9 vs 51.5%) compared with 14 obese controls (mean age = 26.9 year). Plasma adiponectin levels were significantly higher in PWS (15.5 +/- 8.2 microg/ml) than in obese controls (7.5 +/- 2.7 microg/ml). A significant positive correlation was found with insulin sensitivity in PWS subjects (r = 0.75, P = 0.0003) but not in obese controls (r = 0.36, P = 0.20).

DISCUSSION

Our study confirmed an earlier observation of higher adiponectin levels in PWS subjects and less insulin resistance proportionate to their obesity status than found in subjects with simple obesity. Furthermore, no differences were seen in PWS subjects with the chromosome 15 deletion or maternal disomy 15. The reported excessive visceral adiposity in subjects with simple obesity compared with PWS may be associated with decreased production and lower circulating levels of adiponectin.

Coenzyme Q10 levels in Prader-Willi syndrome: comparison with obese and non-obese subjects

Coenzyme Q10 (CoQ10) is an essential component of the mitochondrial respiratory chain and an important scavenger of reactive oxygen species. Low levels are found in individuals with reduced energy expenditure, cardiac and skeletal muscle dysfunction, and mitochondrial disorders, many of these manifestations are seen in individuals with Prader-Willi syndrome (PWS). In addition, CoQ10 supplementation frequently is given to individuals with this syndrome. To determine if CoQ10 levels are decreased in PWS, we studied plasma CoQ10 levels in 16 subjects with PWS, 13 with obesity of unknown cause, and 15 subjects without obesity but of similar age and compared with body composition. Plasma CoQ10 levels were significantly decreased (P < 0.05), using several statistical approaches in subjects with PWS (0.45 +/- 0.16 microg/ml), compared to subjects without obesity (0.93 +/- 0.56 microg/ml), but not different from subjects with obesity (0.73 +/- 0.53 microg/ml). When plasma CoQ10 was normalized relative to cholesterol, triglyceride, and creatinine levels and fat and lean mass [determined by dual energy X-ray absorptiometry (DEXA)] in the subjects with either PWS or obesity, no significant differences were observed. However, a lower muscle mass was found in the PWS subjects.