OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding at fat layer for abdominal obesity and its effects on glucose and lipid metabolism. METHODS: Ninety-six patients with abdominal obesity were randomly divided into an acupoint embedding group (48 cases, 3 cases dropped out) and a sham embedding group (48 cases, 3 cases dropped out). Both groups received lifestyle interventions as basic treatment. The acupoint embedding group underwent thread-embedding at Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), and bilateral Liangmen (ST 21), Fenglong (ST 40), and Pishu (BL 20), with the thread implanted in the fat layer. The sham embedding group followed the same acupoint selection and procedure but without catgut implantation. Both groups were treated once every two weeks for 12 weeks, for a total of six treatments. Waist circumference, body weight, body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were measured, and appetite was assessed using the visual analogue scale (VAS) before and after treatment and at 12 weeks after treatment completion (follow-up) in the two groups. Visceral fat area (VFA) and subcutaneous fat area (SFA) at abdomen were measured, and blood glucose and lipid metabolism markers, including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR) index, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), leptin, tumor necrosis factor-α(TNF-α), and interleukin-6 (IL-6), were also tested before and after treatment in the two groups. Clinical efficacy was evaluated two weeks after treatment completion. RESULTS: After treatment and at follow-up, the waist circumference, body weight, BMI, WHR, WHtR, and appetite VAS scores in the acupoint embedding group were decreased compared to those before treatment (P<0.01). In the sham embedding group, waist circumference, body weight, BMI, WHtR, and appetite VAS score were also reduced after treatment compared to those before treatment (P<0.01). Except for body weight after treatment, the acupoint embedding group showed lower waist circumference, body weight, BMI, WHR, and WHtR values after treatment and at follow-up compared to the sham embedding group (P<0.01, P<0.05). Additionally, the appetite VAS score in the acupoint embedding group was lower than that in the sham embedding group after treatment (P<0.01). Both groups showed a reduction in abdominal VFA and SFA after treatment compared to those before treatment (P<0.01, P<0.05). In the acupoint embedding group, serum FBG, FINS, HOMA-IR index, TC, TG, LDL-C, leptin, TNF-α, and IL-6 levels were decreased compared to those before treatment (P<0.01), while HDL-C level was increased (P<0.01). In the sham embedding group, serum FBG and HOMA-IR index were decreased compared to those before treatment (P<0.01, P<0.05). After treatment, the abdominal SFA in the acupoint embedding group was lower than that in the sham embedding group (P<0.01). Additionally, the acupoint embedding group had lower levels of serum FINS, HOMA-IR index, TC, LDL-C, leptin, TNF-α, and IL-6 compared to the sham embedding group (P<0.05, P<0.01). The total effective rate in the acupoint embedding group was 82.2% (37/45), which was significantly higher than 15.6% (7/45) in the sham embedding group (P<0.01). CONCLUSION The acupoint catgut embedding at fat layer could effectively reduce the obesity severity in patients with abdominal obesity, decrease abdominal fat accumulation, suppress appetite, improve glucose and lipid metabolism, reduce inflammatory responses, and has a sustained effect.
Humans ; Obesity, Abdominal/physiopathology* ; Male ; Female ; Acupuncture Points ; Middle Aged ; Adult ; Acupuncture Therapy ; Leptin/blood* ; Young Adult ; Body Mass Index ; Aged

OBJECTIVE: To investigate the effect of Zuogui Jiangtang Jieyu Decoction (ZJJ) on Shh signaling and self-renewal of neural stem cells in the hippocampal dentate gyrus of diabetic rats with depression. METHODS: Diabetic rat models with depression were randomly divided into model group, positive drug (metformin + fluoxetine) group, and low-, medium-, and high-dose ZJJ groups (n=16), with normal SD rats as the control group. The positive drugs and ZJJ were administered by gavage, and the rats in the control and model groups were given distilled water. After the treatment, blood glucose level was detected using test strips, and behavioral changes of the rats were assessed by forced swimming test and water maze test. ELISA was used to examine the serum level of leptin; The expressions of nestin and Brdu proteins in the dentate gyrus of the rats were detected using immunofluorescence assay, and the expressions of self-renewal marker proteins and Shh signaling proteins were detected using Western blotting. RESULTS: The diabetic rats with depression showed significantly increased levels of blood glucose and leptin (P < 0.01) and prolonged immobility time in forced swimming test (P < 0.01) and increased stage climbing time with reduced stage seeking time and stage crossings in water maze test (P < 0.01). The expressions of nestin and Brdu in the dentate gyrus, the expressions of cyclin D1, SOX2, Shh, Ptch1, Smo in the hippocampus and the nuclear expression of Gli-1 were decreased (P < 0.01) while hippocampal Gli-3 expression was increased significantly (P < 0.01) in the rat models. Treatment of rat models with high-dose ZJJ significantly reduced the blood glucose (P < 0.01) and leptin level (P < 0.05) and improved their performance in behavioral tests (P < 0.01). The treatment also obviously increased the expressions of nestin, Brdu, cyclin D1, SOX2, Shh, Ptch1, and Smo and the nuclear expression of Gli-1 in the dentate gyrus (P < 0.01) and reduced hippocampal expression of Gli-3 (P < 0.05) in the rat models. CONCLUSION ZJJ can significantly improve the self-renewal ability of neural stem cells and activate Shh signaling in dentate gyrus of diabetic rats with depression.
Animals ; Rats ; Blood Glucose ; Bromodeoxyuridine ; Cell Self Renewal ; Cyclin D1 ; Dentate Gyrus ; Depression ; Diabetes Mellitus, Experimental ; Hippocampus ; Leptin ; Nestin ; Rats, Sprague-Dawley

PURPOSE: The purpose of this study was to investigate the effects of 12 weeks of combined exercise on vascular function-related inflammation, carotid intima-media thickness and fitness factors in obese middle-aged women with metabolic syndrome.METHODS: The subjects of this study were 40 middle-aged women in their 40s with metabolic syndrome but no specific disease. The exercise group performed aerobic exercise and resistance exercise five times a week for 12 weeks, and then measured body composition, blood pressure, vascular function-related inflammation factors, metabolic syndrome factors, carotid intima-media thickness, and physical factors.RESULTS: The exercise group showed a significant (p<0.05) reduction after exercise in all items related to body composition, systolic and diastolic blood pressure, and intima-media thickness of the right carotid and left carotid arteries. Exercise group showed a significant decrease (p<0.05) after exercise in interleukin-6, tumor necrosis factor-α, leptin, and all items of glucose metabolism-related variables. The exercise group showed a significant (p<0.05) increase after exercise physical efficiency index, grip strength, sit-ups, and sit & reach. After 12 weeks of exercise training, the reduction of intima-media thickness of the carotid artery was significantly (p<0.05) correlated with the improvement of body weight, systolic and diastolic blood pressure, grip and sit & reach, blood HbA1c, and triglyceride concentration.CONCLUSION: In conclusion, metabolic syndrome improved the body composition, blood glucose metabolism and lipid variables after 12 weeks of combined exercise program for obese middle-aged women. Significant improvement in blood pressure and carotid endometrial thickness, which is a function-related indicator, was confirmed.
Blood Glucose ; Blood Pressure ; Body Composition ; Body Weight ; Carotid Arteries ; Carotid Intima-Media Thickness ; Exercise ; Female ; Glucose ; Hand Strength ; Humans ; Inflammation ; Interleukin-6 ; Leptin ; Metabolism ; Necrosis ; Physical Fitness ; Triglycerides

PURPOSE: Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder that is characterized by disturbances in ovarian blood flow and angiogenesis. The aim of this study was to determine the association of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) serum levels with the body mass index (BMI) in patients with PCOS compared with healthy subjects. METHODS: The study was conducted with 80 subjects in 3 PCOS groups, including normal weight, overweight, and obese PCOS groups, and a control group of healthy subjects (n=20). The participants in all groups completed a questionnaire comprising sociodemographic and obstetric questions. The PCOS diagnosis in the study subjects was confirmed based on the Rotterdam criteria, BMI was determined according to the World Health Organization guidelines, and the lipid accumulation product index was calculated for all groups. Venous blood samples were collected from all participants after fasting to measure the serum levels of fasting blood glucose (FBG), lipids, insulin, VEGF, TSP-1, and leptin. RESULTS: Our findings showed that the serum VEGF level was significantly higher in the normal BMI PCOS group than that in the control group (P=0.03), and the TSP-1 level was significantly lower in the obese PCOS group than that in the control group (P=0.04). CONCLUSIONS: Our study demonstrated that alterations in VEGF and TSP-1 concentrations are dependent on BMI. Because abnormal ovarian angiogenesis is considered to be the main feature of PCOS, the study of ovarian angiogenic imbalance is proposed as a new tool for PCOS diagnosis and management.
Blood Glucose ; Body Mass Index ; Case-Control Studies ; Diagnosis ; Fasting ; Healthy Volunteers ; Humans ; Insulin ; Leptin ; Lipid Accumulation Product ; Overweight ; Polycystic Ovary Syndrome ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A ; World Health Organization

OBJECTIVE: To investigate the effects of aerobic exercise and glutamine (Gln) on anti-oxidative stress and inflammatory factors in type 2 diabetes mellitus (T2MD) rats. METHODS: Diabetic rat model was induced by streptozotocin (STZ). Fifty 6-week old male SD rats were randomly divided into 5 groups (n=10), including quiet control group (N), diabetes control group (D), diabetic aerobic exercise group (DE), diabetic glutamine group (DG) and diabetic aerobic exercise glutamine group (DEG). After 6 weeks, the related indicators of glucose and lipid metabolism, anti-oxidative stress and inflammatory factors in diabetic rats were detected, and the possible mechanism affecting inflammatory response were explored. RESULTS: Compared with group N, the levels of serum malondialdehyde(MDA), blood glucose, total cholesterol(TC), triglyceride(TG), insulin, leptin and tumor necrosis factor-α(TNF-α) in group D were increased significantly (P＜0.01). Compared with group D, serum levels of MDA, blood glucose, TC, TG, insulin, leptin and TNF-α in three intervention groups were decreased significantly, while the levels of SOD, GSH-Px and adiponectin were increased, and the combined effect was more obvious (P＜0.01). CONCLUSION Both aerobic exercise and Gln can relieve the glucose and lipid metabolism and disturbance, oxidative stress injury and inflammation in diabetic rats.
Animals ; Blood Glucose ; analysis ; Diabetes Mellitus, Experimental ; Diabetes Mellitus, Type 2 ; therapy ; Glutamine ; pharmacology ; Leptin ; blood ; Lipid Metabolism ; Lipids ; blood ; Male ; Malondialdehyde ; blood ; Oxidative Stress ; Physical Conditioning, Animal ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the nutritional status of children on maintenance hemodialysis due to stage 5 chronic kidney disease (CKD) and the clinical significance of nutritional assessment indices.

METHODSA total of 21 children on maintenance hemodialysis due to stage 5 CKD were grouped according to body mass index. The nutritional status was assessed based on anthropometric parameters, biochemical parameters, inflammatory factors, residual renal function, indices of dialysis adequacy, and resting energy expenditure. Related indices were compared between the children with malnutrition and those with normal nutritional status.

RESULTSOf the 21 children, 10 had malnutrition and 11 had normal nutritional status. There were significant differences between the two groups in anthropometric parameters, levels of leptin, insulin-like growth factor-1, interleukin-1, interleukin-6, and tumor necrosis factor-α, and mean 24-hour residual urine volume (P<0.05), while there were no significant differences in albumin, prealbumin, CONCLUSIONS: urea clearance index (Kt/V), and measured resting energy expenditure.

CONCLUSIONSAnthropometric parameters, biochemical parameters, residual renal function, and inflammatory factors have an important value in evaluating the nutritional status of children with stage 5 CKD on maintenance hemodialysis. Further studies are needed to investigate the value of the measurement of resting energy expenditure in the evaluation and monitoring of nutritional status in children with stage 5 CKD on maintenance hemodialysis.

Adolescent ; Child ; Energy Metabolism ; Female ; Humans ; Interleukin-6 ; blood ; Leptin ; blood ; Male ; Nutritional Status ; Renal Dialysis ; Renal Insufficiency, Chronic ; blood ; therapy ; Tumor Necrosis Factor-alpha ; blood

Because of their physiological similarity to humans, pigs provide an excellent model for the study of obesity. This study evaluated diet-induced adiposity in genetically lean pigs and found that body weight and energy intake did not differ between controls and pigs fed the high-fat (HF) diet for three months. However, fat mass percentage, adipocyte size, concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), insulin, and leptin in plasma were significantly higher in HF pigs than in controls. The HF diet increased the expression in backfat tissue of genes responsible for cholesterol synthesis such as Insig-1 and Insig-2. Lipid metabolism-related genes including sterol regulatory element binding protein 1c (SREBP-1c), fatty acid synthase 1 (FASN1), diacylglycerol O-acyltransferase 2 (DGAT2), and fatty acid binding protein 4 (FABP4) were significantly up-regulated in backfat tissue, while the expression of proliferator-activated receptor-α (PPAR-α) and carnitine palmitoyl transferase 2 (CPT2), both involved in fatty acid oxidation, was reduced. In liver tissue, HF feeding significantly elevated the expression of SREBP-1c, FASN1, DGAT2, and hepatocyte nuclear factor-4α (HNF-4α) mRNAs. Microarray analysis further showed that the HF diet had a significant effect on the expression of 576 genes. Among these, 108 genes were related to 21 pathways, with 20 genes involved in adiposity deposition and 26 related to immune response. Our results suggest that an HF diet can induce genetically lean pigs into obesity with body fat mass expansion and adipose-related inflammation.
Adipocytes/cytology* ; Adipogenesis/genetics* ; Adipose Tissue/metabolism* ; Adiposity ; Animals ; Body Weight ; Cholesterol/blood* ; Cholesterol, HDL/blood* ; Cholesterol, LDL/blood* ; Diet, High-Fat ; Inflammation/genetics* ; Insulin/blood* ; Leptin/blood* ; Lipid Metabolism ; Male ; Obesity/genetics* ; Random Allocation ; Swine ; Triglycerides/blood*

BACKGROUNDObesity has an adverse effect on iron status. Hepcidin-mediated inhibition of iron absorption in the duodenum is a potential mechanism. Iron-deficient obese patients have diminished response to oral iron therapy. This study was designed to assess whether acupuncture could promote the efficacy of oral iron supplementation for the treatment of obesity-related iron deficiency (ID).

METHODSSixty ID or ID anemia (IDA) patients with obesity were screened at Beijing Hospital of Traditional Chinese Medicine and were randomly allocated to receive either oral iron replacement allied with acupuncture weight loss treatment (acupuncture group, n = 30) or oral iron combined with sham-acupuncture treatment (control group, n = 30). Anthropometric parameters were measured and blood samples were tested pre- and post-treatment. Differences in the treatment outcomes of ID/IDA were compared between the two groups.

RESULTSAfter 8 weeks of acupuncture treatment, there was a significant decrease in body weight, body mass index, waist circumference, and waist/hip circumference ratio of patients in the acupuncture group, while no significant changes were observed in the control group. Oral iron supplementation brought more obvious improvements of iron status indicators including absolute increases in serum iron (11.08 ± 2.19 μmol/L vs. 4.43 ± 0.47 μmol/L), transferrin saturation (11.26 ± 1.65% vs. 1.01 ± 0.23%), and hemoglobin (31.47 ± 1.19 g/L vs. 21.00 ± 2.69 g/L) in the acupuncture group than control group (all P < 0.05). Meanwhile, serum leptin (2.26 ± 0.45 ng/ml vs. 8.13 ± 0.55 ng/ml, P < 0.05) and hepcidin (3.52 ± 1.23 ng/ml vs. 6.77 ± 0.84 ng/ml, P < 0.05) concentrations declined significantly in the acupuncture group than those in the control group.

CONCLUSIONAcupuncture-based weight loss can enhance the therapeutic effects of iron replacement therapy for obesity-related ID/IDA through improving intestinal iron absorption, probably by downregulating the systemic leptin-hepcidin levels.

Acupuncture Therapy ; Adult ; Female ; Hepcidins ; blood ; Humans ; Intestinal Absorption ; physiology ; Iron ; deficiency ; metabolism ; Leptin ; blood ; Male ; Middle Aged ; Obesity ; blood ; metabolism ; therapy ; Young Adult

BACKGROUND: The levels of erythrocyte polyunsaturated fatty acids (FAs) may be associated with obesity, metabolic syndrome, and cancer. Thus, we investigated the association between erythrocyte n−3 and n−6 FA composition, body mass index (BMI), and biochemical profiles. METHODS: The body composition, dietary intake, and blood parameters, including serum lipid, glucose, insulin, adipokines, oxidative stress, and erythrocyte FA, were assessed in 66 overweight and obese women (average age, 43.4 years). We also classified the participants into the overweight, obese, and morbidly obese (MO) groups based on the BMI values of 23, 25, and 30 kg/m₂, respectively. Erythrocyte FA was measured via gas chromatography. RESULTS: The serum glucose, triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels of the participants in the overweight, obese, and MO groups were not significantly different. However, the serum insulin, high-density lipoprotein, cholesterol and leptin levels were significantly different. The erythrocyte n−6/n−3 ratios of the overweight, obese, and MO groups were 2.4, 2.5, and 2.8, respectively. These data were consistent with the dietary n−6/n−3 ratio findings. Moreover, the erythrocyte n−6/n−3 ratio was correlated with serum insulin levels. CONCLUSIONS: As the severity of obesity increased, the levels of insulin and leptin and the ratio of dietary n−6/n−3 increased, which was consistent with erythrocyte FA. These results indicate that erythrocyte FA may be a predictive biomarker for the increased prevalence of obesity, insulin resistance, leptin resistance, and risk of developing metabolic disorders.
Adipokines ; Blood Glucose ; Body Composition ; Cholesterol ; Chromatography, Gas ; Erythrocyte Membrane* ; Erythrocytes* ; Fatty Acids ; Fatty Acids, Unsaturated* ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Leptin ; Lipoproteins ; Obesity ; Overweight* ; Oxidative Stress ; Prevalence ; Triglycerides

OBJECTIVETo explore the effect and mechanism of electroacupuncture (EA) for Z syndrome without organic lesion (metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome).

METHODSFifty-eight patients with Z syndrome were divided into three groups according to mild,moderate and severe degree. Acupuncture and EA were used at Daimai (GB 26), Zhongwan (CV 12), Xiawan (CV 10), Zusanli ST 36), Qihai (CV 6) and Huaroumen (ST 24), etc., once a day and five times a week. The treatment of ten times was a course, and two courses were acquired continuously. Sleep respiration monitoring (PSG) was done before EA and in one week after treatment respectively. Triacylglycerol (TG) fasting blood glucose (FBG) fasting insulin (INS) and serum leptin (Lep) were tested before and after treatment in the three groups.

RESULTSAfter treatment apnea hypopnea index (AHI) and the percentage of the time of arterial oxygen saturation (SaO₂) less than 90% taken in the total sleep time (SLT 90%) were improved apparently than those before treatment in the three groups (all P < 0.05). The levels of TG, FPG, INS and Lep were decreased after treatment in all groups (all P < 0.05).

CONCLUSIONEA can improve AHI and nocturnal hypoxia of Z syndrome, and the mechanism may be related to decreasing the indices of metabolism syndrome and leptin.

Acupuncture Therapy ; Adult ; Female ; Humans ; Insulin ; blood ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; physiopathology ; therapy ; Middle Aged ; Sleep ; Sleep Apnea, Obstructive ; blood ; physiopathology ; therapy ; Treatment Outcome ; Triglycerides ; blood ; Young Adult