[Acupoint thread-embedding at fat layer for abdominal obesity: a randomized controlled trial].

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 (<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 (<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 (<0.01, <0.05). Additionally, the appetite VAS score in the acupoint embedding group was lower than that in the sham embedding group after treatment (<0.01). Both groups showed a reduction in abdominal VFA and SFA after treatment compared to those before treatment (<0.01, <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 (<0.01), while HDL-C level was increased (<0.01). In the sham embedding group, serum FBG and HOMA-IR index were decreased compared to those before treatment (<0.01, <0.05). After treatment, the abdominal SFA in the acupoint embedding group was lower than that in the sham embedding group (<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 (<0.05, <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 (<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.