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-Acupuncture | Sham Acupuncture | |||
|---|---|---|---|---|
| Before treatment | After treatment | Before treatment | After treatment | |
| Weight (kg) | 59.8 | 58.2 | 54.6 | 54.1 |
| BMI (kg/m2) | 22.8 | 22.2 | 21.4 | 21.2 |
| Waistline (cm) | 78.3 | 76.4 | 73.9 | 73.8 |
| Hipline (cm) | 95.0 | 94.8 | 91.1 | 91.4 |
| WHR | 0.82 | 0.81 | 0.81 | 0.81 |
| Fasting glucose (mmol/L) | 5.1 | 4.8 | 5.1 | 4.9 |
| Fasting insulin (mmol/L) | 10.3 | 9.8 | 10.1 | 9.0 |
| HOMA-IR | 2.4 | 2.1 | 2.4 | 2.0 |
| AUC (180 min) | 126 | 99 | 102 | 88 |
| HOMA-IS | 369 | 276 | 347 | 271 |
| Visfatin (ng/mL) | 30.9 | 27.6 | 31.0 | 28.6 |
| Leptin (mmol/L) | 112.9 | 209.6 | 212.5 | 162.0 |
| Resistin (pg/mL) | 101.2 | 155.4 | 100.1 | 109.3 |
| Adiponectin (ng/Ml) | 8.4 | 7.6 | 8.7 | 7.8 |
| IL-6 (pg/ML) | 3.69 | 9.39 | 6.02 | 5.68 |
| HDL-C (mmol/L) | 1.92 | 1.49 | 1.72 | 1.67 |
| LDL-C (mmol/L) | 5.89 | 5.67 | 3.58 | 4.80 |
| TG (mmol/L) | 1.62 | 1.35 | 1.24 | 1.07 |
| TC (mmol/L) | 8.16 | 7.58 | 6.41 | 8.47 |
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
- 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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