Xie Xin-Cai, Cao Yan-Qiang, Gao Qian, Wang Chen, Li Man, Wei Shou-Gang
Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
Chin Med J (Engl). 2017 Mar 5;130(5):508-515. doi: 10.4103/0366-6999.200549.
Obesity 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).
Sixty 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.
After 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.
Acupuncture-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.
肥胖对铁状态有不利影响。肝脏铁调素介导的十二指肠铁吸收抑制是一种潜在机制。缺铁的肥胖患者对口服铁剂治疗的反应减弱。本研究旨在评估针刺是否能提高口服铁剂补充治疗肥胖相关缺铁（ID）的疗效。
在北京中医医院筛选了60例肥胖的ID或缺铁性贫血（IDA）患者，并将其随机分为接受口服铁剂联合针刺减肥治疗组（针刺组，n = 30）或口服铁剂联合假针刺治疗组（对照组，n = 30）。测量治疗前后的人体测量参数并检测血样。比较两组ID/IDA治疗结果的差异。
针刺治疗8周后，针刺组患者的体重、体重指数、腰围和腰臀比显著降低，而对照组未观察到显著变化。口服铁剂补充使针刺组的铁状态指标有更明显改善，包括血清铁绝对增加（11.08±2.19μmol/L对4.43±0.47μmol/L）、转铁蛋白饱和度（11.26±1.65%对1.01±0.23%）和血红蛋白（31.47±1.19g/L对21.00±2.69g/L），均优于对照组（均P<0.05）。同时，针刺组血清瘦素（2.26±0.45ng/ml对8.13±0.55ng/ml，P<0.05）和铁调素（3.52±1.23ng/ml对6.77±0.84ng/ml，P<0.05）浓度较对照组显著下降。
基于针刺的减肥可通过改善肠道铁吸收来增强铁剂替代疗法对肥胖相关ID/IDA的治疗效果，可能是通过下调全身瘦素-铁调素水平实现的。
