Real vs. Sham Acupuncture PCOS Trial Results

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Real vs. Sham Acupuncture PCOS Trial Results

Impact of Low Frequency Electro-acupuncture on Glucose and Lipid Metabolism in Unmarried PCOS Women: A Randomized Controlled Trial

doi.org/10.1007/s11655-021-3482-z

Background

Polycystic ovary syndrome (PCOS) is a common gynaecological disease. These women have a higher risk of metabolic complications such as insulin resistance and dyslipidemia alongside hirsutism, irregular menstrual cycles and infertility. The latter is potentially a cause of concern among married women with PCOS, however unmarried patients are still likely to worry about the various other symptoms and long-term health issues.

Women with PCOS usually trial a variety of therapies in order to find a solution. Recently, acupuncture has gained in popularity, among the general public, as a potential treatment option for PCOS.

Although a large clinical trial in 2017 revealed that electro-acupuncture did not improve live birth rates compared to sham acupuncture in PCOS patient, secondary analysis of this trial did show that electro-acupuncture significantly improved glucose and lipid metabolism.

This finding underlined the need for more research, and a deeper analysis, on the effects of electro-acupuncture in women with PCOS.

Aim

To examine the effects of electro-acupuncture (EA) on glucose and lipid metabolism in unmarried PCOS women.

Methodology

A total of 54 eligible patients with PCOS were enrolled in this study and randomized evenly into 2 groups. One group received the EA treatment while the 2nd group received a sham acupuncture treatment. Each patient received their treatment twice a week, separated by 2-4 days. The study lasted for 16 weeks with patients receiving a total of 32 sessions each.

Each patient undertook a serum test of oral glucose tolerance test (OGTT) and insulin resistance test (IRT), at the beginning and end of the 16-week trial.

Collected blood samples was analysed primarily for fasting glucose, fasting insulin, Homeostatic model assessment of insulin resistance (HOMA-IR), area under insulin secretion curve (AUC)-180 min and Homeostatic model assessment of insulin sensitivity (HOMA-IS).

A variety of other glycolipid metabolism indicators were also analysed including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), adiponectin, leptin, vistatin and resistin.

Results

At the of the 16-week therapy, only 26 patients in the EA group and 20 patients from the sham acupuncture group completed the clinical trial.

Pre-trial data analysis revealed no statistically significant differences between the 2 groups with respect to age, past-history, BMI, waist-hip ratio (WHR) and fasting serum levels.

Similarly, post-trial data analysis found no statistically significant differences across the full range of glucose and lipid metabolic indices between the 2 groups at completion of therapy.

However, within group analysis revealed a significant decrease in weight, BMI, hipline, WHR, fasting glucose, HOMA-IS, vistatin and HDL-C, as well as a significant increase in resistin and IL-6 in the EA group.

Interestingly vistatin was also significantly reduced within the sham acupuncture group while TC was significantly increased.

Electro-AcupunctureSham Acupuncture
 Before treatmentAfter treatmentBefore treatmentAfter treatment
Weight (kg)59.858.254.654.1
BMI (kg/m2)22.822.221.421.2
Waistline (cm)78.376.473.973.8
Hipline (cm)95.094.891.191.4
WHR0.820.810.810.81
Fasting glucose (mmol/L)5.14.85.14.9
Fasting insulin (mmol/L)10.39.810.19.0
HOMA-IR2.42.12.42.0
AUC (180 min)1269910288
HOMA-IS369276347271
Visfatin (ng/mL)30.927.631.028.6
Leptin (mmol/L)112.9209.6212.5162.0
Resistin (pg/mL)101.2155.4100.1109.3
Adiponectin (ng/Ml)8.47.68.77.8
IL-6 (pg/ML)3.699.396.025.68
HDL-C (mmol/L)1.921.491.721.67
LDL-C (mmol/L)5.895.673.584.80
TG (mmol/L)1.621.351.241.07
TC (mmol/L)8.167.586.418.47
Comparison of biometric, glucose and lipid metabolic indices, before and after treatment, in the electro-acupuncture and sham acupuncture groups.

The authors noted that improved insulin sensitivity among the EA group may in fact be an indirect result of weight loss following acupuncture.

SUMMARY: DOES ACUPUNCTURE HELP PCOS

In this 16-week PCOS patient-blinded trial, real acupuncture (electro-acupuncture) failed to help PCOS related infertility, metabolic dysfunction or weight loss, compared to sham acupuncture, however sub-analysis does suggest acupuncture may help with weight loss or insulin resistance slightly.

Limitations

  1. Small study size.

Funding

No external funding was declared for this study.

Glossary

Dyslipidemia
Abnormally elevated cholesterols or fats (lipids) in the blood.

Hirsutism
Male pattern hair growth.

IL-6
Inflammatory protein Interleukin 6.

Similar studies

Wu X K, et al. (2017). Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial. https://doi.org/10.1001/jama.2017.7217

Kuang H Y, et al. (2013). Acupuncture and clomiphene citrate for live birth in polycystic ovary syndrome: study design of a randomized controlled trial. https://doi.org/10.1155/2013/527303  


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