Stener-Victorin E, Maliqueo M, Soligo M, Protto V, Manni L, Jerlhag E, Kokosar M, Sazonova A, Behre C J, Lind M, Ohlsson C, Højlund K, Benrick A
Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden.
Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden; Endocrinology and Metabolism Laboratory, West Division, School of Medicine University of Chile Santiago Chile.
Obes Sci Pract. 2016 Dec;2(4):426-435. doi: 10.1002/osp4.78. Epub 2016 Nov 9.
Insulin sensitivity is ~40% lower in women with polycystic ovary syndrome (PCOS) than in controls. We tested the hypothesis that 5 weeks of electroacupuncture treatment improves glucose regulation and androgen levels in overweight/obese women with PCOS.
Seventeen women with PCOS, aged 18 to 38 years, with a body mass index (BMI) ≥25 kg/m and diagnosed with PCOS were included in this experimental and feasibility study and subjected to five weeks of electroacupuncture treatments three times/week. The primary outcome was changes in whole-body glucose homeostasis measured by euglycemic hyperinsulinemic clamp before and after the intervention. Secondary outcome were changes in HbA, circulating catecholamines, adipocyte size and adipose tissue expression of sex steroids and nerve growth factor (NGF).
No significant change in glucose homeostasis was observed, but HbA decreased by 9.5% ( = 0.004), circulating testosterone decreased by 22% ( = 0.0007) and dihydrotestosterone decreased by 12% ( = 0.007). The two vagal activity markers of plasma serotonin levels and the dopamine metabolite homovanillic acid decreased by 21% ( = 0.027) and 20% ( = 0.011), respectively. Adipose tissue concentrations of testosterone decreased by 18% ( = 0.049), and androstenedione decreased by 13% ( = 0.035), and mature NGF/proNGF ratio, a marker of sympathetic activity, increased ( = 0.04). These changes occurred without changes in anthropometrics.
Five weeks of electroacupuncture treatment improves HbA and circulating and adipose tissue androgens in women with PCOS. This effect is mediated, at least in part, via modulation of vagal activity and adipose tissue sympathetic activity. Based on these findings, we have recently initiated a randomized controlled study (NTC02647827).
多囊卵巢综合征（PCOS）女性的胰岛素敏感性比对照组低约40%。我们检验了这样一个假设，即5周的电针治疗可改善超重/肥胖PCOS女性的血糖调节和雄激素水平。
本实验及可行性研究纳入了17名年龄在18至38岁、体重指数（BMI）≥25kg/m²且被诊断为PCOS的女性，她们接受为期5周、每周3次的电针治疗。主要结局是干预前后通过正常血糖高胰岛素钳夹术测量的全身葡萄糖稳态变化。次要结局包括糖化血红蛋白（HbA）、循环儿茶酚胺、脂肪细胞大小以及性类固醇和神经生长因子（NGF）在脂肪组织中的表达变化。
未观察到葡萄糖稳态有显著变化，但HbA降低了9.5%（P = 0.004），循环睾酮降低了22%（P = 0.0007），双氢睾酮降低了12%（P = 0.007）。血浆5-羟色胺水平和多巴胺代谢产物高香草酸这两个迷走神经活动标志物分别降低了21%（P = 0.027）和20%（P = 0.011）。脂肪组织中的睾酮浓度降低了18%（P = 0.049），雄烯二酮降低了13%（P = 0.035），而交感神经活动标志物成熟NGF/proNGF比值升高（P = 0.04）。这些变化发生时人体测量学指标未改变。
5周的电针治疗可改善PCOS女性的HbA以及循环和脂肪组织中的雄激素水平。这种效应至少部分是通过调节迷走神经活动和脂肪组织交感神经活动介导的。基于这些发现，我们最近启动了一项随机对照研究（NTC02647827）。
