Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland.
Department of Physiotherapy, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland.
Int J Mol Sci. 2023 Jun 19;24(12):10338. doi: 10.3390/ijms241210338.
The aim of the study was to assess the impact of manual lymphatic drainage (MLD) on the parameters of carbohydrate metabolism, lipid metabolism and the level of selected adipokines and cytokines in people with abnormal body mass index (BMI). In addition, an attempt was made to assess the optimal cut-off values of serum concentrations of the biochemical parameters studied in identifying the risk of obesity and insulin resistance (IR). The study included 60 subjects who underwent 10 and 30 min long MLD sessions three times a week. The study group included 15 patients with a normal body mass index (group I; = 15), overweight patients (group II; = 15) and obese patients (group III; = 10). The control group was IV; = 20 subjects not undergoing MLD. Biochemical tests were carried out on all subjects at stage 0' (before MLD therapy) and at stage 1' (one month after MLD therapy). In the control group, the time between the sample collection at stage 0' and stage 1' was the same as in the study group. Our results showed that 10 MLD sessions may have a positive effect on the selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR values in normal weight and overweight patients. In addition, in the study group, the highest AUC values in identifying the risk of obesity were found for leptin (AUC = 82.79%; cut-off = 17.7 ng/mL; = 0.00004), insulin (AUC = 81.51%; cut-off = 9.5 µIU/mL; = 0.00009) and C-peptide (AUC = 80.68%; cut-off = 2.3 ng/mL; = 0.0001) concentrations as well as for HOMA-IR values (AUC = 79.97%; cut-off = 1.8; = 0.0002). When considering the risk of IR, we observed the highest diagnostic value for insulin (AUC = 93.05%; cut-off = 1.8 ng/mL; = 0.053), which was followed by C-peptide (AUC = 89.35%; cut-off = 17.7 ng/mL; = 0.000001), leptin (AUC = 79.76%; cut-off = 17.6 ng/mL; = 0.0002) and total cholesterol (AUC = 77.31%; cut-off = 198 mg/dL; = 0.0008). Our results indicate that MLD may have a positive effect on selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR, in normal weight and overweight patients. In addition, we successfully established optimal cut-off values for leptin in the assessment of obesity and insulin in the assessment of insulin resistance in patients with abnormal body mass index. Based on our findings, we hypothesize that MLD, when combined with caloric restriction and physical activity, may serve as an effective preventive intervention against the development of obesity and insulin resistance.
本研究旨在评估手动淋巴引流（MLD）对糖代谢、脂代谢参数以及异常体重指数（BMI）人群中选定的脂肪因子和细胞因子水平的影响。此外，还试图确定血清生化参数浓度的最佳截断值，以识别肥胖和胰岛素抵抗（IR）的风险。
研究纳入了 60 名接受 10 分钟和 30 分钟长的 MLD 治疗，每周 3 次的患者。研究组包括 15 名体重正常的患者（I 组，n = 15）、超重患者（II 组，n = 15）和肥胖患者（III 组，n = 10）。对照组为 IV 组，n = 20 名未接受 MLD 的患者。所有患者在 0'阶段（MLD 治疗前）和 1'阶段（MLD 治疗后 1 个月）进行生化测试。在对照组中，样本采集在 0'阶段和 1'阶段之间的时间与研究组相同。
我们的结果表明，10 次 MLD 治疗可能对所选生化参数产生积极影响，包括体重正常和超重患者的胰岛素、2h-PG、瘦素和 HOMA-IR 值。此外，在研究组中，发现瘦素（AUC = 82.79%；截断值 = 17.7 ng/mL；p = 0.00004）、胰岛素（AUC = 81.51%；截断值 = 9.5 µIU/mL；p = 0.00009）和 C 肽（AUC = 80.68%；截断值 = 2.3 ng/mL；p = 0.0001）浓度以及 HOMA-IR 值（AUC = 79.97%；截断值 = 1.8；p = 0.0002）对肥胖风险的 AUC 值最高。在考虑 IR 风险时，我们观察到胰岛素（AUC = 93.05%；截断值 = 1.8 ng/mL；p = 0.053）的诊断价值最高，其次是 C 肽（AUC = 89.35%；截断值 = 17.7 ng/mL；p = 0.000001）、瘦素（AUC = 79.76%；截断值 = 17.6 ng/mL；p = 0.0002）和总胆固醇（AUC = 77.31%；截断值 = 198 mg/dL；p = 0.0008）。
我们的研究结果表明，MLD 可能对体重正常和超重患者的胰岛素、2h-PG、瘦素和 HOMA-IR 等选定生化参数产生积极影响。此外，我们成功确定了瘦素在评估肥胖和胰岛素在评估异常体重指数患者胰岛素抵抗方面的最佳截断值。基于我们的发现，我们假设 MLD 与热量限制和体力活动相结合，可能作为预防肥胖和胰岛素抵抗发展的有效干预措施。
